Building a Market to Achieve a Vision: Part Two

Part Two: Building Productive Practices

This is the second article in a two-part series describing how Geisinger Health System links strategic planning with physician recruitment and practice development to build a sustainable legacy of community-based healthcare services. Part I focused on the strategic planning process. This article focuses on recruitment and practice development effective strategic planning requires a thorough understanding of population needs and an assessment of existing resources for meeting those needs. This analysis forms the blueprint for program growth to fill community gaps in care or to strengthen a continuum of services. For Geisinger Health System (GHS), bringing these blueprints to life requires effective deployment of human and capital resources across a largely rural, 31-county span of central and northeastern Pennsylvania.

Effective physician recruitment and practice development are core components of a successful program of growth and sustainability across GHS clinical services in the communities we serve. Poor recruitment decisions or ineffective practice development methods result in low personal and professional satisfaction and generate a sustained financial drag on the organization. In contrast, when executed effectively, recruitment and practice development build professional satisfaction and retention and minimize financial strains associated with practice growth.

GHS employs several planning and practice development tools to guide recruiting new physicians into the right situation with the right preparation to quickly build productive and satisfying practices. One set of tools—a long-range plan and recruitment review process—supports the hiring process. The other—a practice ramp-up process—enables rapid and effective growth of the new practice. These tools form the basis for the practice development cycle.

Planning and Decision Making

The first planning mechanism is a five-year provider recruitment plan. As noted in the prior article, GHS’s strategy and business development (SBD) team conducts in-depth market reviews every two years as a basis for major service line program and recruitment planning. SBD profiles outpatient and inpatient market trends, identifies opportunities to fill community care gaps and strengthen GHS’s continuum of services, and highlights near- and long-term program development opportunities. Service lines use these analytics as a core component of a five-year plan that contains specialty and program-specific provider recruitment targets for each market. Service line plans roll up to a system-wide recruitment plan as part of our five-year financial model.

The second planning mechanism focuses on the decision to recruit. Because internal and external circumstances are constantly changing, the first step in the recruitment process is for SBD and service line leadership to review the practice and the market. This review is designed to determine whether market or internal conditions are favorable for recruitment and practice development. The next step is development of a structured recruitment justification detailing the market opportunity in the physician’s intended service area, service line performance, practice appointment access, and other considerations. Service line leadership reviews the justifications with GHS’s clinical enterprise leadership team. Recruitment is contingent on successful completion of the review process.

Practice Building

The planning process supports the recruitment decision, but our focus shifts to practice development as soon as a new physician decides to join GHS. Recognizing the critical link between effective practice development and sustainable program growth, GHS clinical enterprise leadership has established a goal for new physicians to reach the McGladrey specialty-specific 60th percentile productivity within the first six months of practice. When this goal was established in 2010, it took an average of 18 months for new physicians to reach this level of productivity. It was clear that accomplishing this magnitude of improvement would require a new approach to on-boarding and practice growth. As a result, we developed a new physician ramp-up program that has become an integral element of rapid and effective practice development.

The ramp-up process is set in motion the day a recruit returns his or her signed employment offer letter. Our experience has highlighted the importance of sufficient lead time to ensure the practice and community referral network are prepared to get the physician off to a successful start. If the groundwork for referral development is not initiated until a physician arrives, too much time has been lost and the opportunity for a quick and effective start is compromised.

GHS’s Public Relations and Marketing Department originated and coordinates the program and it is executed through the collaborative efforts of Public Relations and Marketing, SBD, and the physician liaisons. The program elements reflect our assessment of the most important drivers of successful practice growth.

Gathering Background Information

The foundation of the ramp-up process is a comprehensive fact base for the new physician—where he/she will be practicing (home site and outreach), specialty and/or subspecialty focus, work history, special interests, past practice development experience, and style of communicating with referring physicians. This information is compiled through the recruitment justification process and confirmed in discussions with the physician and service line operations leaders. This information is collected as soon as possible as it forms the backbone for our market analysis as well as our marketing plans and physician liaison tactics.

Operational Planning

A dedicated staff member oversees the ramp-up process. This staff person ensures that key operational systems are activated and ready to support the new recruit. The staffer oversees creation and implementation of a clinic (office) template 30 days prior to the physician’s first day of work. This individual also educates the scheduling services team, creates web profiles, works with public relations colleagues to prepare press releases, and performs a variety of other tasks that are worked on from the time the physician is hired. Our goal in creating a centralized and templated approach to this work was to ensure that new physicians walk into an environment where they can focus on practicing medicine beginning on day one.

Marketing and Business Development Plan and Review

In parallel with getting the operational systems ready, our marketing, physician liaison, and SBD staff build a marketing and business development plan for new recruits joining key specialties and/or programs. Tese plans are based on background information gathered in the process noted above and contain several sections:

  • Referral Patterns:
    Referral patterns are analyzed based on information about where the physician will practice, the top referral pathways for the specialty, the physician’s scope of practice, and (where applicable) past GHS experience. This analysis highlights strengths and weaknesses as well as top opportunity areas.

  • Target Audiences:
    Referral analysis and supplemental information drive a list of key target audiences including specific population segments, geographic markets, and referring providers.

  • Audience-specific Messages and Objectives:
    Messages and objectives for each target audience focusing on key differentiating aspects of the physician’s practice are developed.

  • Recommendations:
    Specific recommendations for physician practice development activity as well as direct-to-consumer marketing are put into play. A key component of the recommendations is listing the top priority groups for a new physician to visit early in his or her practice.

  • Marketing Tactics:
    Specific tactics related to each audience are utilized.

  • Physician Liaison Strategy:
    The groups/physicians that the new physician will meet during his or her first months in practice, key messages for these groups, and the time line

This plan is reviewed in a meeting, or series of meetings, with the new physician and service line executive and operations leaders. The goal is to: (1) communicate our commitment to building a successful practice for the new recruit, (2) enlist the support of the new recruit and service line leadership to commit the resources and time required to implement the plan, and (3) make any adjustments needed based on new information or feedback.

Execution and Review

Upon acceptance of the plan, marketing and the physician liaison team are responsible for execution. Followup meetings provide an opportunity for the physician, service line leaders, marketing, physician liaisons, and SBD staff to chart progress and discuss adjustments based on results. The coordinator of the ramp-up program generates a monthly progress report that is shared with senior leaders in the health system.


Despite serving a stable to declining population, GHS successfully expanded its employed physician group by 17% from 2009 to 2011 (712 to 831 employed physician FTEs). During the same period, we reduced the average time to reach target productivity levels from nine to four months. The physician ramp-up program has been an important element of our ability to simultaneously grow services and reduce the length of time required for new physicians to build productive practices. We estimate return on investment associated with the ramp-up program at more than $2 million this fiscal year as a result of rapidly and effectively bringing new physicians to their targeted productivity level.


A thorough understanding of population and community health needs creates the foundation for long-term, sustainable, communityfocused program development. Effective physician recruitment, practice development, and retention are cornerstones for successfully meeting these needs. Implementing effective ways to: (1) link recruitment to community needs, (2) ensure operational systems are in place, and (3) lay the groundwork for referral relationship building from the first day of practice significantly improves the likelihood of rapidly building productive and rewarding practices. These steps combine to increase physician satisfaction and deliver value for the organization.

< Go Back