By CRAIG FREILICH

Hospitals and clinics in the North Country are struggling to stay fully staffed with doctors and nurses, medical technologists and nursing assistants.

“There are large supply and demand issues here,” said Ray Babowicz, Community Health Center of the North Country director of communication and marketing. “Recruiting for all positions can be a challenge,” whether for doctors, physician assistants or nurses to come to the area, he said.

“Those retiring outstrip the immediate future supply, and that’s not going to change quickly,” he said.

But some local medical institutions are taking steps to ensure a good supply in the future.

Right now, providers are using outside “head-hunting” agencies to find personnel and are offering doctors thousands of dollars in signing bonuses, reimbursement for moving expenses, and help with paying off student loans.

Signing bonuses of $1,000 or more are being offered in some cases to licensed practical nurses and registered nurses. And United Helpers offers free training classes to encourage more people to become certified nurses aides, which are frequently in short supply

Many Specialists Sought

Canton-Potsdam Hospital is currently looking for doctors in the specialties of non-invasive cardiology, dermatology, family practice, and a family practitioner of internal medicine (with a substance abuse fellowship), a general surgeon, a hospitalist/nocturnist, an internist, a neurologist, and an obstetrician/gynecologist, and also nurse practitioners or physician assistants specializing in orthopedics, pain management, rheumatology, emergency medicine, and primary care.

Claxton-Hepburn Medical Center in Ogdensburg is “suffering a little bit from a primary care shortage,” a frequent problem among rural hospitals nationwide, said Lou-Ann McNally, CHMC executive director for human resources and education. “We’re still looking for an internal medicine doctor. It’s been a little tough.”

It’s also getting harder to find medical lab technologists, such as staff who will take the blood samples taken from patients and perform analysis on them, she said.

Most new doctors seek jobs with higher pay than what many North Country providers offer. So recruiters at area hospitals take advantage of many doctors’ hopes of making and keeping people healthy in an area not as well served as other places but which provides outdoor recreation opportunities and scenic beauty.

“RNs are getting a little tougher even with a school nearby,” McNally said. SUNY Canton offers a four-year nursing program.

How far a hospital will go “depends on how much trouble we’re having recruiting at any given time,” said McNally.

“Retaining and recruiting quality staff is always a priority,” said Stephen E. Knight, United Helpers CEO. “Our staff are at the core of everything we do. They are what sets us apart.”

United Helpers says it tracks and measures retention and turnover statistics carefully and looks for any trends.

“Retaining good employees is not an accident or simply fortuitous,” said Michelle R. Matthews, HR Specialist at United Helpers. “United Helpers is committed to onboarding, leadership development, and providing opportunities for growth for all employees.”

Bonuses For Nurses, Therapists

It’s not just physicians who are getting signing bonuses and loan repayments. They are also being offered to nurse practitioners, physician assistants, and nurses, therapists and other practitioners particularly if they have earned a specialty credential.

Claxton-Hepburn is advertising for experienced emergency room, operating room and intensive care unit registered nurses. Lower-level medical staff are also being sought with incentives offered, according to local employment ads.

A $1,000 signing bonus is offered to licensed practical nurses (LPNs) at the St. Lawrence Health Alliance in Ogdensburg; United Helpers is offering free training for prospective certified nursing assistants (CNAs); the St. Regis Nursing Home in Massena is offering an “extremely competitive experience based wage benefit package” for LPNs and CNAs.

To bring new medical staff in, employers are using social media, medical school online bulletin boards, and advertising in newspapers and professional journals to reach prospects.

And they are paying recruiting agencies to find medical professionals willing to come here.

“Yes, we’re working with firms to find providers,” said St. Lawrence Health System Vice President of Physician Practice Management Carlos Alberto III.

“We use lots of different methods – the old ‘cold-call’ method, social media, job boards, chat boards, email,” he said.

In order to have a capable staff with a diversity of specialties, many rural hospitals all over the country having to compete by offering hefty financial incentives.

In addition to full employment benefits such as health insurance, payments into a retirement plan, and vacation time, hospitals in the North Country are offering all sorts of incentives.

For instance a cardiologist who would come to the North Country could be offered a salary “well above the MGMA (Medical Group Management Association) median,” plus a $35,000 signing bonus, relocation payments of $15,000, payment of student loans up to $23,000 per year, payments of professional licensing and association dues and fees up to $2,000 per year, up to five days off and $4,000 per year for continuing medical education, and other emoluments.

“In an area that is underserved for primary care, there are federal and state dollars for which providers can apply to get big student loan payoffs,” C-PH’s Alberto said.

Help Paying Off Loans

Potential providers can take advantage of the National Health Service Corps (NHSC), a federal program through which “primary care medical, dental and mental/behavioral health clinicians can get up to $50,000 to repay their health profession student loans in exchange for a two-year commitment to work at an approved NHSC site in a high-need, underserved area” such as the North Country, the NHSC web site says

For the most in-demand physicians, nurse practitioners and physician assistants, marketing campaigns include video endorsements from current employees, those financial incentives, and trips here with family members to explore the communities.

Claxton-Hepburn recently wrapped up an “immersion week” with five SUNY Upstate Medical University rural medicine students to sample North Country life, including clinical rotations in hospital departments, boat rides, and a pizza party with the fire department.

“They got out in the community, did volunteer work, had evening dinners at local physicians’ homes to hear first-hand what it’s like working and making a living in smaller communities,” said Claxton-Hepburn Executive Director of Community Relations and Planning Laura Shea.

Canton-Potsdam Hospital has a similar program of visits up here, “and we get the significant others to stay for a weekend and explore, get out into the community and ask questions,” Alberto said. He said they come back talking about the friendly and welcoming encounters they have.

Once finding a potential provider of an in-demand medical service, the process can involve “site visits, face-to-face interviews, phone interviews,” Alberto said. “It can take two or three visits to land a provider. Once they agree, we work on negotiating a contract with administrators.”

As a relatively small health care provider, Community Health Center’s Babowicz said that the money spent on recruiting “makes it all that much tougher for us,” a small non-profit dedicated to serving people from across the economic spectrum.

While they do use outside recruiting services to find doctors, “we’re not doing any incentive programs like that,” Babowicz said, referring to the elaborate and expensive efforts made by larger institutions in St. Lawrence County. “We try to use as an incentive the benefits of working at the health center,” such as vacation time, a 401K investment plan, and health care benefits.

But unlike competitors in urban settings, he said they have “a huge advantage” by “selling the area” with its landscape and outdoor recreation opportunities. “It’s nature’s playground up here.”

Clarkson Training PAs, PTs

Hospitals and clinics are taking advantage of Clarkson University’s physician assistant and physical therapy programs and Upstate Medical’s Rural Medicine Program in Syracuse and other medical educators in the region that need places for their students to engage in practical training in a full medical setting. Students are required to work on patients with doctors and other medical professionals in hospitals and clinics to experience “the real thing.”

CHMC makes itself available for clinical rotations with Clarkson’s programs, North Country Community College’s radiology technician students, and others.

“We try to make ourselves as open as we can, especially if they’re local, and we try to keep them,” Shea said.

This provides the hospitals with a chance to encourage those students to consider working here rather than running off to a high-priced premium practice in a big city.

“They come up and spend several weeks with one of our physicians here. It’s a good chance to show their potential to our doctors...or maybe not,” Alberto said. “If rural medicine is not for them it’s good to find out early.”

“The problem is getting them to stay,” Babowicz said.

But he insists local medical providers are not in competition that’s so hot they resort to stealing recruits from one another.

“We really don’t look at it as competition. We like to think we are all working together to support health care in the community we serve,” he said.

Those who are having trouble recruiting are taking steps to ensure a supply of qualified workers in the future.

“In this rural area, a lot of us depend on the Allied Health Program” offered by BOCES, McNally said.

Such programs as well as the outreach programs Ogdensburg schools and BOCES offer can pay off later, McNally said. They are designed to persuade students to explore the possibilities of a career in the medical field, and can “plant the seed to encourage kids to enter the health field.”

Shea says CHMC is taking special measures to try to insure a supply of health care workers in the future.

“We’re trying to build partnerships with Ogdensburg schools and BOCES to introduce students to careers in health care,” Shea said.

For instance, CHMC is sponsoring a Health Career Awareness Day for local students Oct. 24 at the Golden Dome in Ogdensburg.

United Helpers has added Corporate Services Liaison Nicholas Maneely to their outreach efforts. In addition to providing help for those seeking assistance with healthcare, housing and other human services, Maneely works with area high schools, universities and employment agencies to coordinate employment efforts.

“We invest a lot of time into building relationships with our area educators and health care partners,” said United Helpers’ Matthews. “We are all in this together.”