How NOT to Recruit an NP

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Specializes in Psychiatric and Mental Health NP (PMHNP).

For anyone who is involved in recruiting NPs, here is what NOT to do. I am also venting here. ?

So, I am looking for a new job (why is another topic). I am interested in what is known as the "North State" - the part of California that is north of San Francisco and Sacramento, to the Oregon border on the north and the Nevada border on the east. This area has a terrible shortage of ALL providers - MDs, DOs, NPs, PAs in primary care and also in all specialties. As a result, while this is largely a very affordable area, pay is generally quite good, especially when the low cost of housing is factored in. The area has some good-sized towns and small cities, but is mostly rural. Most of this area has a high HPSA score, so it is good for Nurse Corps Scholars and NPs looking to apply for loan repayment.

1. Don't make insulting compensation offers. New grad NPs in this area w/o experience are typically getting $100K to $115K base salary for primary care, more for specialties. Most also get sign on bonuses and relo, along with performance bonuses. My first year comp was $124K.

One clinic offered me $40 per hour!!! When I pointed out this was about $80K per year, I was told that they had no trouble recruiting NPs for that amount in Redding. HAHAHAHA. I actually repeated that to an MD and a headhunter and both of them burst out laughing.

2. Don't accuse applicants of lying about what YOU posted about YOUR clinic's compensation and what other organizations are paying. This clinic advertised, on several internet job boards that they were paying $60 to $80 per hour. When I pointed this out, I was told I was lying. Same when I told them what other organizations were posting!

Within one week, I had an offer in hand for $130K compensation in a much better organization, that was thrilled to have me. I am expecting at least 2 other offers within the next 2 weeks, so I will have some negotiating power.

3. Don't act like you are doing the applicant a big favor when it is clearly not true. In addition to the insulting compensation offer, the bad-offer-CMO (who happened to be an NP) said that bringing me on board was going to be a real hardship because not only did they have this opening (someone moved away), but they also had 2 other providers who were going to be out for a few months. Somehow, as a result, me coming on board was going to cause them a lot of headaches! (Hmmm, wouldn't it be helpful to get a new NP in the nick of time?)

4. Don't discount valid experience. I have over one year experience as a primary care NP, and as it is a rural setting, I was often the ONLY provider in some of our clinics, and successfully treated patients, up to 19 or 20 per day, both primary and urgent care patients. I have excellent references, which I provided. I only received positive feedback in my previous position and was literally told that there was no negative feedback for me. The bad-offer-CMO told me I clearly needed remedial supervision and training, but how she came to this conclusion is a mystery to me.

5. Don't be incompetent in front of the applicant. I show up for the shadow day at 8 am. Bad-offer-CMO tells me she has to see 18 patients that day. OK. After 2 hours, at 10 am, she has seen 2 patients and they were both very routine - just reviewing annual labs. And she questions MY experience? I at least know how to reasonably adhere to a schedule! Many patients would just walk out if they were treated this way. We all run late sometimes, but I make an effort to be efficient and to apologize to my patients if I am running late.

In contrast, another organization that invited me to shadow, was humming. In 6 hours, I observed 2 colonoscopies, shadowed 4 different doctors for several appointments, and was also given a walking tour of their campus, with discussion time for questions. The doctors were all very nice and attentive to their patients and they were also efficient and they still had time to talk to me in between and made me feel very welcome.

6. Know your bonus plan! And bonus plans need to make sense and incentivize desired behavior. The weird CMO told me she didn't understand her own bonus plan! (I swear I am not making this up) Then she said it was tied to one's assigned group's productivity and because 2 providers were out, no one in their group would get a bonus. Huh? Wouldn't that mean the remaining group members would have to work harder and be more productive? Why would a productivity bonus plan be based on what OTHER people are doing that I have no control over?

7. Make the applicant feel wanted, ESPECIALLY if you have a hard time getting anyone to take the job! This is when the hiring organization has to go into sales mode. Needless to say, this weird clinic sure didn't do that.

Good Example #1: I shadow for 6 hours and get great vibes from clinic. As I am driving home, headhunter calls me, tells me they loved me, and I will be getting offer within 1 week.

Good Example #2: 6 hours of interviews and shadowing, along with a nice lunch. Get job offer on the spot in my hot little hands before I leave.

Good Example #3: Next week, going for all day of interviews and shadowing, also includes realtor to show me area, good places to live, etc, ending with dinner with CMO and CEO and if all goes well, an offer on the spot.

8. Treating an applicant poorly will lose you other applicants. Especially in a small area, where providers know each other, word is going to get around. I know 3 other good NPs that are looking, and of course, I told them to stay away from this clinic!

9. Have some freakin' business sense. Lacking this indicates your clinic isn't going to do well financially. In addition, it makes you look stupid. For the bad example I am riled up about, I found this opening directly. So, clinic doesn't have to pay headhunter. And they don't have to pay a boatload of cash for a locums. I am already here, so no relocation time or money! That needs to be reflected in the offer! Duh!

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There is more, but I'm tired. I don't know why, but the above experience made me very angry and left a bad taste in my mouth.

If a clinic didn't offer me a job, but it was a good interview experience, and the reason given for not hiring me was valid, I would be disappointed, sure, but I would recommend other NPs for the job who are a better fit.

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Sounds to me like the vast difference between primary care and specialties. Noting you mentioned seeing a colonoscopy. I generally like my primary care clinic and while they are expanding and getting bigger, I still don't think they have their wits about them or an understanding of what they want.

Provider meetings typically turn into *** fests and the management will bounce between numbers expectations to the fact that overall quality is in the tank. No consideration that to improve quality, you need to sacrifice numbers (note you shouldnt be treating 28 PPD if you honestly think you will have quality outcomes). They complain about 40% of providers doing the majority of visits but fail to acknowledge those providers are doing nothing beneficial for their patients short of opiate and benzo refills. This is the story of much of the primary care world and sadly a big reason I'm considering the military again or moving to a state with np autonomy.

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Specializes in Psychiatric and Mental Health NP (PMHNP).
45 minutes ago, djmatte said:

Sounds to me like the vast difference between primary care and specialties. Noting you mentioned seeing a colonoscopy.

You make interesting points. The colonoscopies were at a very large primary care practice. They offer colonoscopies and have their own lab, xray machine, DEXA, US, mammogram machine and will be getting a CT among other things. The CMO says he can offer these for cheaper, plus it is way more convenient and faster for the patients - for example, if we suspect a DVT, we can do an US right away, as opposed to sending them to an ER for a long wait and a huge bill. Right now, that is my top choice for a job. They also have a separate building with a beautiful Women's Health facility that is decorated like a luxurious day spa! Evidently their Ob/Gyn is well known and people come from other states to see him.

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Interesting and good luck FullGlass with the job search.

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Very interesting...sorry this happened to you. Do you mind me asking why you are looking for a new job after 1 yr? Just curious to see if this is the norm, I know as a nurse we sometimes do 1hr med-surg and then head for a specialty area... does this applies to primary care? I am a new graduate NP.

good luck!

Coco

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Specializes in Psychiatric and Mental Health NP (PMHNP).
On 7/20/2019 at 11:37 AM, Cococure said:

Very interesting...sorry this happened to you. Do you mind me asking why you are looking for a new job after 1 yr? Just curious to see if this is the norm, I know as a nurse we sometimes do 1hr med-surg and then head for a specialty area... does this applies to primary care? I am a new graduate NP.

good luck!

Coco

Thank you - as to why, I just posted a long explanation as to why. Again, thank you for your good wishes.

You can do primary care for your whole career, if that is what you want. Primary care can be a real drag, and often pays less, which is why a lot of NPs switch to Urgent Care or specialties.

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Sounds to me like she doesn't want to fill the position, she's just going through the motions. Either she's pushing people away and waiting for a particular person or she's pushing people away so she can see more patients herself and collect more money.

Either way, good luck on the job search.

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Specializes in Psych/Mental Health.

Is it common to be able to shadow the job for a day to check out the prospects? I've never heard of this as a RN. I always ask for a tour around the unit but that's pretty it.

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Specializes in NICU.

At least for a few hours. In the in-patient world I would attend rounds and then go to lunch for the interview part.

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Specializes in Nephrology, Cardiology, ER, ICU.

Yeah shadowing for an APRN position is common. So is having lunch/dinner and other people involved (i.e., meet with realtor to discuss housing, schools, etc)

Btw here is FullGlass's reason for leaving:

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Ha! None of this surprises me one bit!

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That is a frustrating experience. It sounds like you really dodged a bullet because if that is their best face forward, I can't imagine what they are like once you work there.

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