Rural Healthcare: How to Recruit and Attract Clinical Talent in Rural Areas

Healthcare providers in rural areas face unique obstacles when it comes to recruiting and retaining clinical talent. The growing shortage of nurses and physicians coupled with declining rural populations makes it more challenging than ever for rural healthcare organizations to attract physicians, nurses and other specialized clinical professionals. In this post, we cover the healthcare recruitment challenges faced by rural healthcare organizations and actionable advice on how to overcome them with smart talent acquisition strategies.

Rural Healthcare Challenges

Modern Healthcare reports that 77 percent of rural counties in America are experiencing shortages of primary care physicians, and the number of surgeons practicing in rural counties has decreased by 21 percent. What’s more, the Council of State Governments reports that more than 60 percent of areas experiencing nursing shortages are located in rural regions. Recruiting and retaining clinical professionals in these underserved rural communities remains a significant challenge for states and county governments and healthcare organizations. Economic, educational, professional and cultural dynamics affect the clinical talent shortages in rural areas including the following factors:

• Many universities and institutions of higher learning are located in more urban regions, limiting rural healthcare organizations recent graduate talent pool.
• Access to professional development and education programs may be limited in rural areas which can discourage candidates looking to further their career training and education.
• Candidates with experience working in urban areas may not be prepared for or willing to adapt to the culture and lifestyle changes inherent with living in rural communities.
• Rural healthcare organizations may not have enough opportunities for career advancement within the organization.
• Rural healthcare organizations often face understaffing leading to increased workloads, extended shifts and less scheduling flexibility.
• Urban healthcare organizations may be able to offer more competitive salaries, benefits and better working conditions.
• Rural communities may offer fewer career opportunities for spouses and children of candidates.

Recruiting Strategies for Rural Healthcare Organizations

To overcome healthcare recruiting challenges, rural healthcare organizations need to employ various strategies focused on attracting and retaining clinical talent. Below, we list four approaches rural healthcare organizations can utilize to source, hire and retain clinical talent.

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Recruit Foreign-Born Talent

Rural healthcare providers should not limit their talent search locally. Federal programs like Conrad State 30 allow a state’s health department to request J-1 Visa waivers for a maximum of 30 foreign-born physicians per year. For foreign-born physicians to be accepted into the program, they must agree to work in a Health Professional Shortage Area or Medically Underserved Area. Healthcare organizations located in one of these federally designated areas can reach out to their state’s health department and request J-1 Visa recipients be sent to their facility if they display sufficient need.

Non-immigrant H-1B Visas can also be used to fill clinical employment gaps for rural healthcare organizations. H-1B Visas are employer-sponsored and are reserved for “specialty occupations,” including medical doctors, nurses and physical therapists. H-1B visas are issued for three years and can be extended to six years depending on circumstance.

While exact H-1B Visa requirements vary by state and each state is given some flexibility in determining program rules, all of the following are required by U.S. Citizenship and Immigration Services:

• The recipient must have a full-time contract for employment as a direct care healthcare worker in a region designated as a Health Professional Shortage Area, Medically Underserved Area or a Medically Underserved Population.
• A firm commitment from an international medical graduate to begin employment within 90-days of receiving a visa waiver.
• Three years of employment, specifically in H-1B temporary worker status, with the sponsoring employer.
• A no-objection letter from the visa recipient’s home country if the talent exchange was subsidized by the home government.

Offer Recent Graduates Loan-Repayment Assistance    

According to Debt.org, more than 76 percent of medical school graduates exit school with average $189,000, in student loan debt. What’s more, 47 percent of graduates owed $200,000 loans and 13 percent owed more than $300,000. Rural healthcare organizations can attract these young clinical professionals by offering loan repayment programs and incentives. If a rural healthcare organization is unable to afford its a loan repayment program, there are multiple state and federal programs designated to assist rural healthcare organizations. Below, we list three long-standing federally subsidized loan repayment incentive programs:

• Federally Qualified Health Centers is a student loan reimbursement program provided by the Bureau of Primary Health Care and the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services.
• National Health Service Corps provides scholarships and loan-repayment for allopathic and osteopathic professionals and other primary care professionals practicing in rural communities.
• State Loan Repayment Program is similar to the NHSC loan repayment program. Recipients are required to commit to work in a public or non-profit medical facility in an underserved community for a minimum of two years and each participating state is required to match the monies received from the program.

Maintain a Steady Candidate Pipeline

The healthcare talent shortage has placed a premium on clinical healthcare workers. Rural healthcare organizations have to reconcile the fact that some of their talent may be lured away by offers from competitors in more attractive locations. To stay ahead of talent attrition, rural healthcare organizations need to build and maintain a verdant candidate pipeline. Below we share strategies on how to build and cultivate relationships with potential candidates:

• Healthcare organizations should position themselves as rural training sites for medical students, primary care residents, nurses and other clinical roles looking to experience healthcare in a rural setting.
• Staff members should be encouraged to network and cultivate a rapport with potential candidates at medical conferences, professional development workshops, networking events and trade shows.
• Recruit traveling nurses, physicians and locum tenens clinical professionals who may also be on the lookout for permanent practice opportunities.
• Recruiters for rural healthcare organizations should be provided with subscriptions to candidate sourcing services and encouraged to reach out to candidates who have experience working in rural healthcare.

Sell the Community to Candidates

Many candidates may have preconceived notions regarding rural communities — and not all of them positive. To assuage a candidate’s doubts about working and living in a rural setting, it is important for healthcare organizations to highlight the strengths and positive attributes of their community. Recruiters can point to the lower cost of living in the community and how that can make the compensation packages more attractive. Elements of a community’s culture such as recreational and leisure activities, natural beauty, festivals, fairs, the arts scene, spiritual and religious institutions and a community’s character may make the position more attractive once highlighted. Additional factors such as the community being a good place to raise children, an opportunity for more professional independence and the chance to offer more personable patient care are all positives that can be presented to interested candidates.

Conclusion

For rural healthcare organizations facing recruiting and retention challenges, employing some of the approaches and strategies outlined in this blog will help attract vital clinical talent. Improved talent acquisition, in turn, will enhance the quality of care rural healthcare organizations provide to their communities.