INDUSTRY PERSPECTIVES

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INDUSTRY PERSPECTIVES 5 Reasons Clients Are Frustrated with Locums Agencies Stasi Crump, Marketing Consultant, Delta Locum Tenens WHAT MAKES ONE LOCUMS AGENCY MORE SUCCESSFUL THAN ANOTHER?

From slow credentialing to big paychecks, here are five reasons why clients grow frustrated with locum agencies.

Candidates who ghost an assignment, or leave before the work is done, force the hospital or medical facility into a tough spot.

SHORTAGE OF CANDIDATES/INACCURATE ADVERTISING A shortage of qualified candidates is an industry-wide challenge, particularly for specialties like urology, neurology, and family medicine.

It s a right place, right time business, said Don Price, physician recruiter for Fischer Titus Medical Center. You have to do the work you have to make the calls.

1 INDUSTRY PERSPECTIVES 5 Reasons Clients Are Frustrated with Locums Agencies Stasi Crump, Marketing Consultant, Delta Locum Tenens WHAT MAKES ONE LOCUMS AGENCY MORE SUCCESSFUL THAN ANOTHER? WHAT DO IN-HOUSE RECRUITERS LOOK FOR IN A STAFFING FIRM? If you want to endear your firm to clients, learning from mistakes is a great place to start. From slow credentialing to big paychecks, here are five reasons why clients grow frustrated with locum agencies. FAILURE TO COMMIT Steve Jacobs, a physician recruiter with WellSpan Health, said he s frustrated, When somebody commits and then doesn t commit or doesn t show up. Candidates who ghost an assignment, or leave before the work is done, force the hospital or medical facility into a tough spot. Since locum agencies are the thread between employer and provider, it s our job to ensure the right candidate is placed in the right job. SHORTAGE OF CANDIDATES/INACCURATE ADVERTISING A shortage of qualified candidates is an industry-wide challenge, particularly for specialties like urology, neurology, and family medicine. However, agencies should only promote candidates they truly represent and put in the hours to see results. It s a right place, right time business, said Don Price, physician recruiter for Fischer Titus Medical Center. You have to do the work you have to make the calls. DEFICIENT DOCUMENTATION Most locum providers deliver excellence in patient care. What clients say is missing is the attention to detail necessary for paperwork and documentation. Because locums providers aren t invested in the hospital, they often aren t plugged into the protocol and may lack the training to provide proper documentation. This gap can lead to paperwork mistakes that hurt the hospital s bottom line. BIG PAYCHECKS Locums providers tend to receive a higher rate of pay than permanent providers. This can rankle the staff, particularly if the locums doctor is seen as an outsider who isn t personally invested in the hospital. DELTA LOCUM TENENS IS AMONG THE 2 PERCENT OF HEALTHCARE STAFFING AGENCIES IN THE NATION TO RECEIVE BEST OF STAFFING HONORS FROM INAVERO. VISIT DELTALOCUMTENENS.COM TO LEARN MORE ABOUT HOW DLT CAN ASSIST WITH YOUR HEALTHCARE STAFFING NEEDS TODAY. the 1st Quarter 2017 April 16 - March 17 SLOW CREDENTIALING It can take months to get credentials for a locums provider, and this leaves many last-minute needs for providers unfilled. Even worse, Jacobs says, by the time the credentialing is complete, the provider has taken a job somewhere else. Clients and staffing firms have called for a national credentialing system, and time will tell if it will happen. THE PHYSICIAN RECRUITING

2 PLACEMENTS & INTERVIEWS Candidate Sources PLACEMENTS & INTERVIEWS Placement Data by Specialty This data represents average statistics of placements and interviews by Delta Physician Placement over the twelve-month survey period. Since these averages only Job Boards 23% include placements and interviews, the compensation information presented indicates the rate at which candidates are choosing to interview or sign. Average days information can be used to forecast a probable timeline for a recruitment effort in a particular specialty. Average Average Days emarketing 47% Networking 19% Other 11% Data indicates sources of candidates for placements and interviews from April 2016 through March The information contained herein is of a general nature and is not intended to address the circumstances of any particular individual or entity. No one should act on such information without appropriate counseling and thorough examination of the particular situation. For more information regarding specific specialties, regions, or trends, contact Eric Sasser, Director of Advertising, The Delta Companies at (800) x4600 or esasser@thedeltacompanies.com. Subscription information and an archive of previous versions is available at The Delta Companies Placements by Population 31% 35% 34% Surgery Primary Care Sub - Specialties Hospital Based Starting Sign-on Bonus Potential From Interview to Placement Total Placement Family $233,060 $24,838 $270, Family Med.- Obstetrics $198,750 $23,333 $247, Internal $219,444 $23,571 $226, Obstetrics/Gynecology $316,875 $26,250 $351, Pediatrics $223,125 $22,000 $294, Psychiatry $240,431 $50,562 $267, Orthopedic Surgery $487,500 $25,000 $550, Surgery - General $373,000 $30,625 $408, Surgery - Vascular $350,000 - $800, Urology $512,500 $35,000 $582, Gastroenterology $567,500 $37,500 $667, Neurology $325,000 $50,000 $275, Emergency $315,600 $40,000 $418, Hospitalist $237,500 $15,000 $270, Pediatric Hospitalist $227,500 $45,000 $237, Fastest Days-to-Fill Subscribe Data indicates the percentage of placements made from April 2016 through March 2017 by the population of the search facility s metropolitan area. Data reflects averages from placements and interviews by Delta Physician Placement from April 2016 through March Potential data reflects average yearly compensation at full production excluding benefits. Average Days data does not include off-contract placements. Average Days Total Placement data is calculated from profile to placement.

3 MARKET DEMAND LOCUM TENENS Nationwide Search Distribution 3.5% Days Requested - Top Specialties 7.6% 5.7% 15.1% 6.3% Psychiatry 9.1% 9.1% 2.2% 8.8% 20% 40% Hospitalist 5.4% 5.0% 1.3% Practitioner 13% Map represents searches initiated by Delta Physician Placement on behalf of healthcare facilities from April 2016 through March % Specialty Demand Comparison 1 st Quarter st Quarter Family Family 2. Psychiatry Psychiatry 3. Obstetrics/Gynecology Family - Obstetrics 4. Hospitalist Hospitalist 5. Internal Internal 6. Emergency Orthopedic Surgery Family - Obstetrics Pediatric Critical Care Pulmonary Critical Care Pediatrics Ophthalmology Otolaryngology 10. Surgery - General Emergency 11. Urology Gastroenterology 12. Neurology Neonatal-Perinatal 13. Pediatric Hospitalist Surgery - General Search Specialty Distribution Hospital-Based 11% Surgery 14% Sub-Specialties 18% Primary Care 57% Data indicates the percentage of searches initiated by specialty grouping between April 2016 through March Candidate Placements Top 5 States Providers Have Taken New Opportunities 1. Texas 2. Iowa Data indicates the top specialties by days requested from April 2016 through March Nationwide Physician Distribution Internal 5.3% 2.0% 9.5% 5.1% 5.9% 8.4% 9.7% 5.6% 7.1% 7.4% 3.5% 4.9% 7.5% 4.8% 10.4% 14. Pediatric Pulmonology Anesthesiology 3. Ohio 15. Medical Oncology Cardiology - Invasive Data compares the top 15 most requested searches initiated by Delta Physician Placement, comparing the first quarters of 2016 and Pennsylvania 5. Colorado Compares all states for the top 5 candidate placements as initiated by Delta Physician Placement from April 2016 through March Map represents the percentage of licensed physicians by region working with Delta Locum Tenens.

INDUSTRY PERSPECTIVES No Time to Wait: 3 Reasons Why You Need to Recruit Now Mark Montague, Marketing Consultant, Delta Physician Placement MARKET DEMAND Nationwide Search Distribution Specialty

And in the healthcare sector, there is a forecasted shortage of up to 104,900 doctors by 2030. Mitigating the expected shortages in providers with a forward-looking plan.

BATTLING AGAINST BURNOUT Fifty-one percent of physicians have reported feelings of burnout, according to Medscape s Lifestyle Report 2017, Race and Ethnicity, Bias and Burnout, which is a staggering

The five practices with the greatest percentage of burnout, according to Medscape, are emergency medicine (59%), OB/Gyn (56%), family medicine (55%), internal medicine (55%), and infectious disease

Because burnout is a serious and pervasive issue, hospitals and medical facilities must think about the future and recruit accordingly.

Approving an H-1B visa takes months, and now employers no longer have the option to pay a premium processing fee to get approval in a couple of weeks.

4 INDUSTRY PERSPECTIVES No Time to Wait: 3 Reasons Why You Need to Recruit Now Mark Montague, Marketing Consultant, Delta Physician Placement MARKET DEMAND Nationwide Search Distribution Specialty Demand Comparison EXPERTS PREDICT BETWEEN 22 PERCENT AND ABOUT 40 PERCENT OF EMPLOYEES ACROSS INDUSTRIES ARE PLANNING TO LEAVE THEIR JOBS WITHIN A YEAR. And in the healthcare sector, there is a forecasted shortage of up to 104,900 doctors by Mitigating the expected shortages in providers with a forward-looking plan. As such, here are the top three reasons why you shouldn t wait to recruit healthcare providers. BATTLING AGAINST BURNOUT Fifty-one percent of physicians have reported feelings of burnout, according to Medscape s Lifestyle Report 2017, Race and Ethnicity, Bias and Burnout, which is a staggering 25 percent increase over the last four years. Contributing to this mindset are bureaucratic tasks, a lack of work-life balance, and difficult patients. The five practices with the greatest percentage of burnout, according to Medscape, are emergency medicine (59%), OB/Gyn (56%), family medicine (55%), internal medicine (55%), and infectious disease (55%). Physicians who experience burnout are less likely to have job satisfaction, and are inclined to look for other work, adding to staffing turnover. Because burnout is a serious and pervasive issue, hospitals and medical facilities must think about the future and recruit accordingly. SLOWED H1-B VISA PROCESS The processing procedures for securing temporary visas for skilled workers, known as H-1B visas, have changed. Approving an H-1B visa takes months, and now employers no longer have the option to pay a premium processing fee to get approval in a couple of weeks. Employers who often rely on physicians who aren t American born (about 25 percent of all physicians) or American trained will have to wait much longer for staffing solutions. In addition, foreign medical students who rely on U.S. facilities to train and complete their residencies are also impacted. LARGER COMPENSATION PACKAGES The cost to hire providers increases every year, from salaries to overall compensation packages. In the past five years, there has been a 10 percent increase in signing bonuses, with non-physician providers reporting a median $5,000 signing bonus and physicians reporting a $20,000 median signing bonus. The longer employers wait to recruit, the more expensive staffing becomes. Hospitals and medical facilities are facing an uphill battle to meet the demand for providers, and Delta Physician Placement is here to assist with permanent healthcare staffing solutions. As our population ages and lives longer, and as more physicians retire and are replaced by younger providers who define job satisfaction by fewer hours and less on-the-job stress, proactive recruiting of qualified candidates will be key to success. DELTA HEALTHCARE PROVIDERS IS AMONG THE 2 PERCENT OF HEALTHCARE STAFFING AGENCIES IN THE NATION TO RECEIVE BEST OF STAFFING HONORS FROM INAVERO. VISIT DELTAHEALTHCAREPROVIDERS.COM TO LEARN MORE ABOUT HOW DHP CAN ASSIST WITH YOUR PT PLACEMENT TODAY. of physicians reported feelings of burnout in 2017 increase in signing bonuses in the past five years expected shortage of doctors in the U.S. by % 9.6% 7.4% 10.7% 9.6% 4.9% 12.1% 0.8% 4.7% 1.6% 7.1% 6.0% 0.5% Map represents searches initiated by Delta Healthcare Providers on behalf of healthcare facilities from April 2016 through March PLACEMENTS & INTERVIEWS Placements by Population 29% 32% 14% 25% 1 st Quarter st Quarter Registered Physical Therapist 2. Physical Therapist Registered 3. Practitioner 4. Dentist 5. Licensed Clinical Social Worker Data compares the top 5 most requested searches initiated by Delta Healthcare Providers in the first quarters of 2016 and Years of Experience 30% 22% 15% 33% < 2 Years 2-5 Years Occupational Therapist Practitioner Dentist 6-10 Years > 10 Years THE HEALTHCARE RECRUITING Data indicates the percentage of placements made from April 2016 through March 2017 by the population of the search facility s metropolitan area. Data indicates the average years of experience of candidates for placements and interviews from April 2016 through March 2017.

5 PLACEMENTS & INTERVIEWS Placement Data by Specialty This data represents average statistics of placements and interviews by Delta Healthcare Providers over the twelve-month survey period. Since these averages only include placements and interviews, the compensation information presented is an indicator of the rate at which candidates are choosing to interview or sign. Average days information can be used to forecast a probable timeline for a recruitment effort in a particular specialty. Nursing Allied/Other Extenders Rehabilitation Starting Average Sign-on Bonus Student Loan Repayment Relocation Reimbursement From Interview to Placement Average Days Total Placement Occupational Therapist $82,879 $9,658 $25,625 $4, Physical Therapist $82,651 $11,932 $18,068 $4, Speech-Language Pathologist $78,265 $6,600 $11,550 $3, Fastest Days-to-Fill Occupational Therapy Assistant $75,000 $15,000 - $5, Physical Therapy Assistant $68,481 $10,833 $25,000 $12, Practitioner $120,649 $13,447 $36,711 $10, Physician Assistant $117,000 $10,750 $35,333 $5, Dentist $160,880 $15,000 $50,000 $7, Diagnostic Medical Sonographer $66,520 $10,000 - $8, Audiologist $80, $5, Licensed Clinical Social Worker $65,000 $5,000 - $14, Director of Emergency Dept. $105,000 $3,000 - $4, CRNA $170,667 $25,000 $20,000 $9, Registered $78,789 $8,315 $25,030 $6, Candidate Sources STAFFING Facility Demographics 19% Home Health emarketing 53% The data below is comprised of travel placements made by Delta Healthcare Providers over a three-month survey period. 28% Outpatient 24% Skilled Job Boards 24% 8% Inpatient Cold Calls 7% Referrals 7% Websites 3% Other 6% Data indicates sources of Delta Healthcare Providers permanent candidates for placements and interviews from April 2016 through March % Mixed >200 26% % k 15% Candidate Placements Compares all states for the top 5 candidate placements as initiated by Delta Healthcare Providers from April 2016 through March <10k 16% 10-50k 23% <100 49% Number of Beds Top 5 States Providers Have Taken New Opportunities 1. California 4. Texas 2. Alaska 5. New Mexico 3. Oregon >100 46% Years of Experience Recent Grads < 2 Years 2-5 Years 6-10 Years > 10 Years 3% 11% 44% 14% 28% Case Manager $81,500 - $20,000 $4, Practice Settings Community Population Data is compiled from assignments placed by Delta Healthcare Providers from January 2017 through March Data reflects averages from placements and interviews by Delta Healthcare Providers from April 2016 through March Average data reflects average yearly compensation for each position listed above. Average Days data does not include off-contract placements.

INDUSTRY PERSPECTIVES. Improving Physician Leadership: An excerpt from Building the Physician Leadership Team of the Future

INDUSTRY PERSPECTIVES. Improving Physician Leadership: An excerpt from Building the Physician Leadership Team of the Future INDUSTRY PERSPECTIVES Improving Physician Leadership: An excerpt from Building the Physician Leadership Team of the Future Chloe Lewis and Team, Advisory Board Company the 1st Quarter 2015 April 14 - March