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Headhunting at hospitals: Arkansas facilities find recruiting battle for health care personnel can be cutthroat.

OFFERS OF A $5,000 signing bonus or pleas to "join our team" are not uncommon.

Although they sound like pitches for a free-agent professional sports star or a high school athlete, those are hiring promotions for hospitals recruiting nurses and medical personnel.

On any Sunday, there are three to four pages of medical and nursing help-wanted advertisements in the Arkansas Democrat-Gazette.

The ads aren't limited to Arkansas health care facilities. Hospitals and medical firms in Dallas; Atlanta; St. Louis; Shreveport, La.; and Monroe, La., are advertising in Little Rock.

East Texas Medical Center in Tyler, Texas, recently offered a bonus of $3,000-$5,000 for critical-care registered nurses. Helena Regional Medical Center offered a $2,000 sign-on bonus recently for registered nurses in several areas.

Especially for rural hospitals, the ante can be high to attract quality, experienced personnel. And sometimes even signing bonuses may not be enough to fill long-vacant positions.

Jim Maddox, chief administrative officer at North Logan Mercy Hospital in Paris (Logan County), has been unable to fill an opening for a registered nurse for six months.

"It can be very difficult to find nursing personnel," says Maddox, who adds he can't afford to offer signing bonuses. "If you are in a rural setting, you almost have to have people enrolled in school or coming out of school who are from your area. Recruiting from the outside is almost an impossible task."

Many rural hospitals rely heavily on Medicare reimbursement fees because many of their patients are elderly. Because Medicare payments often are less than what a hospital would receive from an insurance company, the rural hospital's budget is tight.

"Fighting salaries with metropolitan areas makes it hard to get good health care people," Maddox says. "It's a task."

North Logan, a 15-year-old satellite hospital of St. Edward Mercy Medical Center in Fort Smith, has 16 beds and only 35 part-time and full-time employees, from the administrative staff to the cleaning crew.

Maddox has received a good response from a recent ad seeking a radiological technologist. But even advertising in Little Rock, Fort Smith, Memphis, Tenn., and Tulsa, Okla., papers has not been enough to attract an RN to fill North Logan's opening.

Just the search is costly, says Maddox, adding that "the bigger papers charge enough to knock your socks off."

Health Careers in Demand

Mark Cartwright, communications director for the University of Arkansas for Medical Sciences in Little Rock, says virtually all health careers are in demand. Getting a degree in a health-related profession "almost guarantees employment," Cartwright says.

The larger Arkansas hospitals aren't seeing the nursing shortage they experienced three or four years ago.

Carolyn Lindsey, director of communications at St. Vincent Infirmary Medical Center, says at that time all nursing areas -- critical care, medical surgery, outpatient, emergency room -- were needed.

"The shortages of all hospitals improved by virtue of increasing numbers of graduates," Lindsey says. "There has also been a great deal of foreign nurse recruitment by hospitals other than St. Vincent."
Highest Wages
Here are the top 10 adjusted average hourly wages for Arkansas
The Bridgeway (North Little Rock) $19.85
Medical Park (Hope) $19.06
Doctors Hospital (LR) $16.81
St. Vincent Infirmary Medical Center (LR) $16.65
Jefferson Regional Medical Center (Pine Bluff) $16.21
Baptist Medical Center (LR) $16.01
Baptist Rehabilitation Institute (LR) $15.93
Baptist Memorial Medical Center (NLR) $15.72
Arkansas State/Psychology-Adolescent (Hot Springs) $15.26
Pinewood Hospital (Texarkana) $15.14
Source: Hospitals' annual Medicare cost reports.

St. Vincent recruits about 10 foreign nurses a year. The hospital also offers nursing scholarships of $1,500 a semester, which Lindsey says is more than enough for tuition and books.

Cartwright says the demand is still high for nurses.

"Nurses are really the front line of health care," Cartwright says. "They are people who usually access patients first."

"The conventional wisdom is that we'll be moving more to a health delivery system that will accentuate the primary-care givers, but also nurses. There will be nurses in the future who will have some prescriptive authority."

Gwen Wetzel, employment manager at Baptist Medical Center in Little Rock, says she routinely advertises for several positions even if there isn't a vacancy. She knows she's always likely to have an opening in those critical positions in the near-term.

One of the most critically needed medical positions nationally, Wetzel says, is a physical therapist.

"Our population is aging, and there is more of a need for physical therapists now," Wetzel says. "It is a lucrative field to go into. Physical therapists are used in the field of sports medicine, too."

Wetzel and others contacted at the large Little Rock hospitals agree they never use signing bonuses. It isn't as difficult to attract nurses and other medical personnel to a metropolitan area compared with a rural area. Smaller hospitals are the ones that must offer signing bonuses.

As part of a plan begun 20 years ago, UAMS concentrates on placing some of its graduates in rural areas in Arkansas.

A large percentage of the students who rotate through the Area Health Education Centers in Arkansas eventually set up practices near those centers. The education centers are in Texarkana, Pine Bluff, Jonesboro, Fayetteville and Fort Smith.

"The conventional wisdom is that people will practice close to where they went to school," Cartwright says. "It's uncommon, particularly in Arkansas, for someone who graduates from UAMS to go practice in Colorado."

UAMS succeeds in recruiting physicians to the hospital because of the connection with the university. In addition to practicing in their specialities, physicians are also on the faculty and have opportunities for research. That distinction has attracted some superbly qualified, high-profile physicians to UAMS.

The attraction for those doctors is "peer-oriented," Cartwright says.

Recruiting Physicians

UAMS has just added a new chairman of neurology to the faculty, Dr. Ossama Al-Mefty, who had been on staff at the University of Loyola in Chicago. He specializes in the surgery of skull-base brain tumors, Cartwright says.

"There was a list that was peer-reviewed," Cartwright says. "Then you go about getting those people interested in Arkansas and the type of work we're doing here. Many times a physician will come to UAMS because of the work of other physicians and researchers here."

One reason Al-Mefty was attracted to UAMS, Cartwright says, is Dr. Bart Barlogie, the world's foremost expert in multiple myeloma, a cancer of the bone marrow. Barlogie came to UAMS from the highly respected M.D. Anderson Hospital & Tumor Institute in Houston.

Largely because of Barlogie's arrival in Little Rock, the Arkansas Cancer Research Center at UAMS was one of the first facilities in the world to perform outpatient bone marrow transplants, Cartwright says.

"|Barlogie~ came to us, and with him a whole group of oncologists and otolaryngologists and technicians came, including a bunch of patients from around the world," Cartwright says. "It is sort of a self-fulfilling prophecy. As the reputation of our faculty is increased, it generates interest well beyond UAMS.

"That goes for biochemists, people doing spectrography, magnetic resonance imaging. They'd all like to be working for folks who are doing world-class research."
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Title Annotation:Health Care Update
Author:Smith, David (American novelist)
Publication:Arkansas Business
Date:Jul 26, 1993
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