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Focus on Rural Health

Virtual Workshop Seeks to Change the Rural Recruitment Mindset

By Stacy Kusler on

On June 9th Benjamin Anderson started his presentation with the now-familiar phrase: "Can everyone see my screen?" What was originally planned as an in-person, full-day event, the Rural Recruitment Reimagined Workshop instead took place virtually to more than 60 participants from around the state of North Dakota. Anderson, a former rural Kansas hospital CEO and current vice president for rural health and hospitals for the Colorado Hospital Association, was the main presenter for the day. He was joined by a panel of faculty members and millennial physician residents from the Via Christi Family Medicine (VCFM) Residency in Wichita, Kansas, as well as faculty members from the University of North Dakota (UND) School of Medicine & Health Sciences (SMHS). The workshop focused on recruiting and retaining the new generation of physicians to rural communities, and the importance of hospitality from the health care facility, colleagues, and most importantly, community members in keeping these younger providers.

Welcome Wagon

It sounds simple enough. Be nice to the people you hire, and they'll stick around. But it's not that easy, Anderson told the audience, especially when talking about the millennial physician generation. "Lifting two fingers off the top of your steering wheel is not hospitality," Anderson said. "In fact, to a newcomer, that can feel like the middle finger. The action communicates 'I see you, but I don't care enough to stop and get to know you better.'" His message to workshop attendees was to focus on addressing the millennial physician's primary question: Who will be my family here?

Wanting flexibility doesn't mean I don't want to work hard.

Physicians coming into the workforce now are in a tough spot professionally. Many healthcare employers are looking for new physicians to fit the old mold, which is that of a physician who works 80 hours per week, is motivated by salary, and rarely removes his or her doctor's "hat." Rather, new physicians are keenly aware of what it means to work hard versus work healthy. Instead of seeking a job that offers high pay in return for a grueling schedule, new physicians are looking for flexibility and a sense of community where they can make a difference through their job, as well as enjoy their non-work time. In fact, all four millennial physicians on the panel said they would forgo a higher salary in return for more flexibility. "Wanting flexibility doesn't mean I don't want to work hard," said Josh McCoy, a recent family medicine resident program graduate, and one of the panelists for the workshop. "Our generation is just not interested in the baggage that comes from being the doc who does nothing but work."

The Long Game

Anderson shared a lesson he learned early on in his career, which was that doctors are people too, and people inherently want to have connections and personal engagement for a fulfilling life. He took this opportunity to encourage workshop attendees to change the narrative of how to encourage new physicians to become part of the community: "Instead of saying 'go to enough ball games, and people will eventually let you into their circle,' try saying 'come to the ball game with me and I would love to introduce you to some of my friends.'" In other words, a warm and welcoming community doesn't just start on the physician's first day, and it is not the sole responsibility of the employer.

Faculty from the UND SMHS say laying the foundation for a hospitable community starts as early as medical school training opportunities. Dr. Kamille Sherman is the co-director of the Rural Opportunities in Medical Education program (ROME). This is a 24- to 28-week rural experience during the third year of medical school. Sherman says successful ROME sites have invested in teaching physicians, good relationships with hospital leadership, and perhaps most importantly, a community liaison who can help integrate the student into extra-curricular or non-work activities.

You can recruit them, but you won't retain them without community.

"The students are in these communities long enough that they could help coach a basketball or softball season," she said. "It's really important that the students have experiences that allow them to think 'I could see myself living here,'" she said. Those experiences make a lasting impression on medical students who may return to those same communities later during residency, or better yet, share their good experiences with fellow medical students who will want to come and train there, too.

Two By Two

Dr. Todd Stephens, faculty member for VCFM, said that a facility recruiting the millennial generation should remember these important points: They are used to being measured, they are focused on debt reduction, they're interested in flexibility, they are attracted to serving a need, and they are used to working and training in teams. "You can recruit them, but you won't retain them without community," he said. "And it's not just the CEO's job, it really is the entire community's job to provide a sense of family and home for newcomers."

Whether we are aware of it or not, our generation really seeks safety.

One way to create instant community for a new physician is to hire two at the same time. While this recruitment strategy may seem like a dream to most, McCoy put it another way. "Whether we are aware of it or not, our generation really seeks safety. Not personal safety or financial security, necessarily, but safety in relationships, and safety in community with people who have our back. Safety in knowing someone who has been there before, or is going there with you. I think if you can recruit in groups, that really helps," he said.

Recording Available

A recording of the full workshop is available for North Dakota healthcare employers. For more details, email

This article appeared in the Fall 2020 issue of North Dakota Medicine.

Stacy Kusler Stacy Kusler is the connection between rural healthcare facilities in North Dakota and qualified health professional job seekers. As the workforce specialist, she assists rural facilities to attract medical providers and other health professionals to their communities by sharing job opportunities. Through her position, Stacy is working to reduce the healthcare workforce shortages throughout the state.