7 Tips to Recruit Effectively in Neurology

Neurologists specialize in the diagnosis, treatment, and care of patients with brain and nervous system issues, including behavioral disorders, traumatic brain injuries, strokes, sleep disorders, Parkinson’s Disease, Alzheimer’s disease, and a wide array of degenerative conditions that accompany advanced age. Although people age 65 or more comprise only 14% of the U.S. population, they account for 34% of inpatient procedures and 37.4% of neurologic diagnostic treatments and tests. In total, nearly $800 billion is spent to treat various types of neurological disease.

Studies Claim Demand for Neurologists Greatly Surpasses Supply

Neurological disorders disproportionately affect adults age 65 and over. And, with over 10,000 baby boomers turning 65 every day, the demand for neurologists will significantly increase, while the supply is not keeping pace. A 2013 study by the American Academy of Neurology (AAN) which examined the current number of neurologists (full- or part-time), retirement projections, the number of new graduates, found that demand outstripped supply by 11%, and estimated that demand would accelerate to 19% by 2025. Another  study by the Association for Advancing Physician and Provider Recruitment (AAPPR) in 2019 shows that the average time to fill Neurology positions within healthcare facilities across the U.S. was 184 days or 6 months.

Further, according to AAPPR, these figures may be understating the shortage because they don’t account for more recent factors that increase the demand for neurology care, including:

• Increase sub-specialization
• Development of inpatient/outpatient split patient care
• Increase in the value candidates place on work-life balance
• The large percentage of candidate in need of visa support

The Emergence of Sub-Specialization and Split Practice

Technological advances in recent years have resulted in a much greater number of treatment options for patients with neurological conditions. This rise has resulted in increased patient demand for specialist care which has fostered growing sub-specialization in the field. Based on the latest data from the AAN, 90% of residents plan to pursue a fellowship following residency.

Accompanying this trend towards sub-specialization, neurology departments have started to divide inpatient from outpatient responsibilities. In many facilities, on-site specialists (i.e. neurohospitalists) have assumed in-patient neurology care thus relieving the outpatient/private practice neurologist of the responsibility. Neurohospitalists traditionally work a 7-day on/7-day off schedule, primarily in 10-12-hour shifts, while neurological subspecialists prefer outpatient roles permitting them to focus on their area of expertise.

Recruiting Considerations: Adapting Strategy to Existing Trends

Due to the strong demand for neurologists, it has become a significant challenge for hospitals, health systems and private practices to recruit and retain top providers in the field.  What follows are 7 suggested recruiting strategies in light of current trends.

1. Tailor the role to the sub-speciality

As we see, sub-specialization is now the rule in this field. Many neurologists search for jobs in order to have the opportunity to utilize the sub-specialty training they received in a fellowship program. Recruiters should partner with Practice managers and facility administrators to determine which sub-specialists are appropriate for their patient population. While there is often a greater need for generalist neurologists, especially in smaller or rural areas, it’s still a good idea to advertise for the sub-specialties that your facility can support while incorporating 50% generalist work into the role. It will be important to create a job post that will be attractive to sub-specialists by emphasizing responsibilities while devoting one or two bullet points to more generalist tasks.

2. Consider scheduling options

Adapt scheduling to accommodate candidates’ interest in either inpatient or outpatient work. For example, if a candidate wishes to work inpatient full time but your facility doesn’t have the patient need or budget to accommodate this schedule, consider teaming up with a larger (or another smaller) hospital to share a full time neurohospitalist that works 7 on/7 off at each facility.

3. Ensure work-life balance

According to Merritt Hawkins’ 2017 Survey of Final-Year Medical Residents, younger physicians are seeking opportunities that offer a good balance between professional responsibility and their personal life. The survey showed that “lifestyle” was rated as the most important factor by 74% of residents when considering a job offer. The field of Neurology is attractive as it offers a high level of scheduling stability leading to a predictable personal life due to consistent patient flow. Work-life balance is a considerable value and those facilities that advertise part-time positions or flexible scheduling have a strong advantage in this candidate market.   

4. Provide visa support

Due to the healthcare shortage in the U.S., 30 to 40% of new graduates are from foreign universities so it would be to your facility’s advantage to provide an H-1B or J-1 visa waiver.

5. Offer competitive compensation 

The chart below illustrates the increase in average neurology starting salaries over the last several years as tracked in Merritt Hawkins’ Review of Physician and Advanced Practitioner Recruiting Incentives:

 

2016/17	Low $220,000	Average $305,000	High $400,000
2015/16	Low $220,000	Average $285,000	High $500,000
2014/15	Low  $180,000	Average:$277,000	High $350,000

 

Compensation for certain sub-specialties and in less popular areas may need to be significantly higher to attract talent. In addition to base salaries, neurologists are generally provided with added incentives, such as a sign-on bonus, Continuing Medical Education (CME) allowance and relocation assistance as shown in the chart below.

 

Average Signing Bonus	$29,670
Average CME	$3,560
Average Relocation Allowance	$11,070

 

Source: Merritt Hawkins’ Review of Physician and Advanced Practitioner Recruiting Incentives

6. Implement a telemedicine program

Having a telemedicine program could be an effective strategy to attract neurologists to your facility. According to the Association of Neurological Surgeons, telemedicine introduces process efficiencies into the doctor/patient relationship in that it allows neurologists the opportunity to treat additional patients and provide patients access to care in rural areas. What’s more, tele-neurology programs provide a viable option for neurologists to treat patients with mobility issues, such as those suffering from Parkinson’s disease or epilepsy.

7. Promote culture and benefits

A positive, collaborative neurology practice environment is likely to include competitive compensation, recognition and rewards programs, split model of care, along with the opportunity to specialize in one or more areas, such as epilepsy, migraines, sleep disorders, senility, neuromuscular disease or neuroimaging.  Opportunity for academic affiliation, via teaching or research is also an attractive benefit. 

Conclusion

There is a widespread agreement among both policy makers and academia that the U.S. faces a critical shortage of primary care doctors. What is not discussed as often is the  shortage within specialty practice areas as well, including neurologists. For this reason, it’s imperative to shape your recruiting strategy to accommodate the unique professional needs of practitioners in this field. Sharing the above-noted strategies with key internal stakeholders can position your facility attractively to candidates in a very competitive neurology hiring market.

 

To start hiring for your Neurology positions, contact our recruitment expert Philip Prigal today.