A Waco hospital system’s plan to double its network of primary care doctors will take some moxie to pull off, industry experts said.

Primary care is the hottest area of medicine right now.

To recruit doctors, hospitals are increasing salary offers and providing incentives like signing bonuses and student loan repayment.

Providence Healthcare Network officials said they are confident they can carry out their plan of recruiting about 30 such doctors during the next three years. Many of those doctors will work out of new clinics Providence plans to build.

Some of Providence’s expansion might be accomplished by the hospital system forming new relationships with doctors already in the community.

But the health system almost certainly will have to bring in new faces.

Making the best offer

That means competing with the deluge of offers physicians like Dr. Joseph Koch are getting. He is in the final year of a family medicine training program run in conjunction with Waco’s Family Health Center.

Although Koch won’t complete the program until June, he is getting a steady stream of job offers.

Some are from East Texas, where he has made inquiries about practicing.

Others are from random institutions across the country that are trying to secure anyone they can, he said.

Some of his fellow senior residents have all but finalized their jobs, Koch said.

“It’s a good spot to be in,” Koch said. “It seems like there are unlimited opportunities to find a good job.”

Koch’s experience isn’t an anomaly. Kurt Mosley, who works for the nation’s largest health care staffing firm, said primary care doctors have been the most sought-after physicians for several years.

“Everybody is out after them,” said Mosley, who is vice president of strategic alliances for Merritt Hawkins/AMN Healthcare. “It’s crazy. As doctors, they know it’s a buyer’s market.”

Faster service

More primary care physicians coming to Waco would be a boon for patients.

For one, it should make getting in to see a doctor easier.

That’s particularly true for seniors, because Providence has said the new doctors will accept Medicare patients.

More doctors also should help shield the community from a predicted nationwide shortage of primary care doctors.

Already, too few physicians are going into areas like family care, internal medicine and pediatrics, Dr. Roland Goertz said. He heads up Family Health and is president-elect of the American Academy of Family Physicians.

Now, with national health care reform being implemented, the need for primary care is expected to increase, Goertz said. Some 32 million Americans who have been without health insurance will soon have coverage and need a doctor, he said.

Drawing doctors

So what are Providence’s chances of quickly recruiting a large number of primary care doctors?

Mosley said physicians primarily look at three things when deciding where to work — practice type, geographic location and compensation.

Providence could have an edge because doctors increasingly want to be employed by hospitals, Mosley said. They don’t want to deal with the business side of medicine and like the idea of an established system helping them build a patient base, he said.

The fact that Waco is a mid-size community will also be a plus with certain doctors, Mosley said. Small, rural areas are the most difficult areas to lure doctors.

Some physicians are only interested in big cities. Mosley said. But doctors know they might make less in a metropolitan area because of competition.

Quality-of-life factors such as a low cost of living and good schools also can be a draw for mid-size communities, he said.

As for compensation, Mosley said most primary care doctors are offered a base salary, with a potential “production bonus” for seeing a lot of patients. That’s the model used by Central Texas’ three hospital systems.

Signing bonuses have become expected and student loan repayment is another popular incentive, he said.

The standard offer is for an employer to pay off a loan in four years. But some recent offers in Texas have included a two-year pay-off, Mosley said.

Odis Nichols, Providence’s vice president of operations, said it might offer signing bonuses to get new doctors on board, as it has done in the past. Providence has never offered loan repayment, though, he said.

One advantage Providence has over many hospital systems, Nichols said, is having two family medicine programs in its backyard.

Family Health’s program graduates 12 people each year. About 25 percent of them have stayed in the community during the past decade, Goertz said.

Scott & White also has a family medicine residency program, which recently increased to eight slots. About one-third of its graduates stay in Central Texas, associate regional chief medical officer Dr. Michael Reis said.

Looking near, far

Providence is optimistic it will be able to recruit doctors from afar, Nichols said.

Physicians want the security of employment, along with the freedom to care for patients as they see fit. That’s what Providence is offering, he said.

“I think there is availability out there,” Nichols said. “It’s just a matter of offering the right opportunity to them.”

Scott & White has a similar take. The competitive recruiting environment has sometimes meant it’s harder and takes longer to find primary care physicians, Reis said. But the Temple-based health system has been able to fill spots as needed.

Scott & White only offers signing bonuses on rare occasions, Reis said. The same is true for loan repayment, he said.

Instead, Scott & White’s best recruiting tool is its culture, Reis said. Most physicians like that it’s a teaching hospital and that it employs nearly 900 physicians across a wide variety of specialties, he said.

“The collegiality and communication we have in our system is really attractive to doctors,” Reis said.

Hillcrest CEO Glenn Robinson agreed that offering doctors an environment that includes academic programs aids recruitment. Hillcrest’s affiliation with Scott & White and its involvement in Family Health’s residency program have helped attract doctors, he said.

Hillcrest sometimes offers signing bonuses, but it has not done loan repayment in recent years, he said.

cculp@wacotrib.com

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