14 Must Know Facts about Physician Recruiters

Physicians are not well informed about job search methods and about recruiters, about how they really work and about their limitations. Residents in particular lack awareness of the disadvantages of working with recruiters. Graduating residents are just stepping out of an educational, basically helpful environment. They are naive in business matters and rarely understand the economical pressures that shape recruiter behavior.

The fact sheet below was developed after years of personal experience with physician recruiters, based on being a candidate looking for a new job as well as an employer looking to hire a new associate for my practice. I am writing specifically about contingency recruiters, and that these facts and rules do not refer to retained recruiters, in-house recruiters or locum tenens recruiters.

Recruiters will deny all of these facts or at least try to gloss them over. Many actually will claim to be proud of avoiding one of the drawbacks below, which is ...just marketing. I leave it up to you whom to believe: a physician without any financial interest that reports out of personal experience and research, or recruiters who defend the living they make based on marketing slogans.

Also consider that there are always the "exceptions that confirm the rule". There are those recruiters that market less "aggressively", that really care about you, that do visit the practices they represent, that are straightforward about what they are able to accomplish and what they cannot, but that does not change the big picture I am describing.

As much as recruiters may try, as nice or good hearted or ethical or hard working or well-meaning they might be, some facts will never change:
a. recruiters are hired and paid by the employer
b. they charge a $ 20,000 fee for their services and
c. they only get paid after closing the deal.
These facts lead to all the consequences and problems described here. I am not trying to indict recruiters, I am describing the basic framework they practice in.


1. Physician Recruiters are hired and paid by employers to fill a vacancy. They are not hired nor paid by the candidate. This is much more important than candidates think! Their loyalty therefore is to the paying party, the employer, not to the searching candidate. They do not get paid to consider the desires, careers or preferences of the candidates. The candidate is useful as far as he or she fills the job the recruiter gets paid to fill. A recruiter for example will never "negotiate a salary" for you, as some claim. You really think they will go against the employer who pays them and create higher costs for them? When it comes down to it, recruiters are not on the side of the job seekers. They are on their own side: closing the deal and getting paid.

2. Recruiters charge $ 20,000 to fill a position. This is the biggest handicap for recruiters, something that no recruiter can overcome. This creates a barrier to hire them. This places recruiters at a severe disadvantage compared to you, the physician, when you are looking for a job and applying for a position. You come without the price tag and instantly are more attractive.
Obviously you could argue about the significance of those 20K. Maybe the hiring hospital is flush in money and can afford to spend it, maybe they consider physicians valuable enough to spend that kind of money on recruitment, maybe the loss of revenue with an open position is even more expensive, but 20,000 are still 20,000. Maybe the yearly collections of the physician (neurosurgeon) dwarfs those 20K, but to me as an ObGyn it means about 8 complete "9 months of prenatal care plus delivery" and to a family physicians it means seeing a whole lot of patients!

3. 80-90 percent of private practices refuse to work with physician recruiters, since they are very expensive. The usefulness of recruiters in medicine is reduced dramatically by the fact that they cannot reach that 80-90% of the job market - which is most of the private physician job market and pretty much the whole job market in desirable areas.
Keep in mind that 50-60% of physician jobs are filled through networking, 10-30% through advertising by employers on Job Boards and 15-25% by recruiters. What kind of help can you expect from someone who can only reach 20% of possible jobs?
What do recruiters do in response to this? They tell you that those areas are "oversaturated" and try to lure you to under served areas, where recruiters do get jobs.

4. What does a day in the life of a recruiter look like? Recruiters are salespeople and spend their days on the phone. Recruiters spend part of their day cold-calling practices, groups and hospitals to see if they are interested in their services. Then they pay large fees to NTNJobs, eHealthCareers and numerous other Internet boards to post job descriptions. Then they spend a few hours each day cold calling physicians, sending fliers, postcards or e-mails to program directors, specific departments and numerous physicians fishing for applicants.
Candidates will usually respond to recruiters by e-mail, submit their CVs and recruiters then forward these CVs with names blacked out to the potential employers.

Recruiters love to give you the impression that they have resources or skills that you don't possess, yet, once you see what they actually do, you realize that you can do it perfectly well on your own. No, they don't have secret sources in high positions; they just want you to think that. Unlike what they sometimes claim, most recruiters do not visit practices and they do not get face to face with physicians. Usually they work nationally and seeing offices and physicians means travel and would be very time consuming and expensive.

5. Most recruiters subscribe to a background database, usually the NAPR "Job Bank". Paying subscribers store short profiles of jobs and candidates in these confidential, recruiter-only databases. Since thousands contribute to these databases recruitment becomes more efficient due to sharing of resources and combining efforts. "Maybe my candidate fits your job". Fees are usually split between the recruiter who has the candidate and the one who has the job. This is the same model that Realtors use. When a recruiter says "we personalize a search for you", (I love that slick line) he means that he enters your name in the recruiter background database and checks if there is a matching job for you. The only problem is: the whole database is filled with left-over and hard-to-fill jobs.

6. Occasionally recruiters market themselves as "screening candidates and practices carefully" to give themselves an air of quality. Based on my personal experience I doubt this. Screening does not fill positions and only filling vacant positions gets them paid.

7. Recruiters are first and foremost salespeople, not helpers. Given the fact that recruiters only get paid their $20,000 if they close the deal, they are highly motivated to sell.
This explains their behavior:
They contact as many physicians as possible per day, hoping to find the one that can fill the job. They try to convince you that the jobs in "Desirable city" are not so desirable and that the countryside jobs they have actually might be better for you.
Recruiters loose interest in you immediately if you insist on a job in very desirable area or if you are looking for part time jobs. Their chances of getting paid in all these scenarios are very low and therefore the interest in you vanishes.
Because of the pressure to sell and the strong competition, all too often the candidate becomes just a number, a meal ticket, a means to fill the job, to close the deal and get paid.

8. Physicians can easily find 2-5 times more jobs than the best recruiter. Doctors have been the target of marketers for a long time. They are all listed in multiple databases. List of doctor contact info can be easily bought from a large number of sources, some of them in a few minutes online. Check out InfoUSA.com! Since physicians are so easy to reach, candidates do not need any help from recruiters. Medicine actually does not appear to be an appropriate field for recruiters.
Please refer to my blog for excellent information how you personally can find more jobs than any recruiter.
Physicians applying to an employer without a recruiter do not have a 20,000 price tag attached and they immediately become a preferred candidate. Recruiters vehemently deny this in public, but admit it privately. In the end recruiters are more of a distraction and burden to a job seeker rather than a benefit.

9. Recruiters are not "free for the candidate". This is a common marketing myth. Yes, the employer formally pays the fee. This fee is "recruitment cost" and therefore part of the overhead, the expense, caused by the candidate. The employer will recover this cost from the employed candidate in one way or another. Getting a job through a recruiter usually means a lower salary or fewer benefits, at least in the frist year.
Although, the true price of working with a recruiter is less visible and much higher: you get a less desirable job!

10. Recruiters may have many jobs, but they do NOT HAVE GREAT JOBS. Here I have to declare my own bias. I consider jobs in attractive, large cities "great jobs", an opinion that not everybody shares.
No matter if we talk about city or countryside though, the recruiters tend not to get the best jobs. The most attractive jobs are never advertised and are filled by word of mouth or direct mail. The moderately attractive jobs are advertised in print and on the Internet. Only those jobs that employers just cannot fill, even though many physicians look at them and decline, are handed over to recruiters to fill.
Recruiter told me" We get jobs in areas where there are more jobs than applicants" and "The function of recruiters in medicine is to fill the less desirable jobs", and Pam Pohly, another recruiter writes "Recruiters get the hard to fill jobs". Do you really want one of those jobs?
Ask yourself before talking to any recruiter: Do I really want a less desirable job?
After all, why would any employer pay 20,000 to a recruiter if a job can be filled by word of mouth of with $400-800 of advertising in a few journals?

11. Physician recruiters advertise using their own language: "easy access to", "a short drive to" means the locations is 1 to 2 hours from an attractive city. "Easy access to city A and B" is even worse, this job is in the dead middle between 2 separate suburban areas. "A great place to raise a family" means there is absolutely nothing to do in that town. If you are single, you are dead!
Much more important is what recruiters do NOT mention, such as high turnover of associates, low salary, high-buy-in and other hidden drawbacks.
But how can a recruiter find out in a 10 minute phone conversation what goes really on in a practice or hospital? They can't and the candidate is the one who suffers the consequences.
Recruiters sometimes "forget" to mention drawbacks of jobs, since that disclosure would hurt the sale.

12. Recruiters advertise insidiously by masquerading as "job search experts" and "advisers". This kind of marketing is much more dangerous, since it is often not recognized as the advertisement it is. This misleading marketing includes posing questions such as "How do you choose the recruiter that is right for you?” The implication of this question is that there is actually a recruiter that is right for you. Posing this question is similar to "Should I shoot myself in the left or right foot?" NO, you should not shoot yourself at all, and NO, you should not use a recruiter at all!
Often recruiters post tidbits of helpful info on their websites, such as links to licensing boards, short "5 points to improve your CV", but that is all marketing fluff to attract you or to make your CV more marketable. They will never give you advise how to best find a job - outside of recruitment. That would be bad for business and would threaten the basis of their existence. Therefore this info is never complete nor truly useful. In the end is only a means to get you as a client. Nothing wrong with that, you just have to be aware.
Anytime you read - anywhere - that someone recommends recruiters or even considers them a good alternative to networking, you are dealing with either a recruiter or someone who just has no clue about how the job market works.

13. Recruiters are NOT advisers, helpers, career counselors, CV writers or job market experts. They are usually neither qualified nor versed in any of these matters. They may read a lot of CVs, but that does not make them experts at writing or editing them. They will not take the time to go over your CV and advise you. They check your CV mostly for one single question: Can I sell this candidate?
They are not experts in the job market, even though they spend their time trying to fill job vacancies. Recruiters know only a small segment of the job market, the segment that is available to them. Do not trust their opinions in that matter, their opinions are shaped by the marginal 10-20% of jobs they are aware of.

14. Worst of all: recruiters do not disclose their limitations. They will not tell you that they cannot get jobs in desirable cities and locations. They will not tell you that they cannot get jobs with desirable practices. They will not tell you about alternative ways of finding jobs. This is a serious ethical issue - imagine a physician not treating a patient, just because he personally is unable to perform a certain surgical procedure! We send our patients to someone else who can help them. Recruiters never do that. Physician recruiters simply tell you that the great areas where you are looking for a job are " oversaturated". In reality this is a code for "unreachable for recruiters who charge 20K to fill a job". They will never tell you: "Just mail a letter to every doctor in Desirable City and you will get a job", because this might threaten the foundation of their existence. Imagine all physicians just mailing letters to eployers and getting jobs! Instead recruiters tell you "Call back in a few weeks, maybe I have something then". The obvious idea is to keep you as a client and maybe get that commission later, in blatant disregard of what you want and need! I consider this a lack of responsibility towards clients.

Summary: AVOID physician recruiters!

The better way to find a job is a simple and very successful method: mail a letter containing your CV with a cover letter to every physician of your specialty in the area where you want to work. You buy the list of contact info online from e.g. InfoUSA.com, then load it onto your computer and mail-merge it with your cover letter in Word. Voila - hundreds of personalized letters addressed to every single physician in your area of interest. Most successful!!
See my previous blog post for a detailed description.

How can all this come up after recruiters have been serving the physician community for 20 years?
Personal computers and then the Internet have changed our lives. Contact information for physicians, once hard to find and expensive, can now easily selected and downloaded on the web within a few minutes. A PC can easily produce hundreds of customized, personalized letters and the new Internet fax services allow us to fax a letter to thousands of doctors with a few clicks.

That, together with Internet job boards that are becoming easier to navigate and with physicians and hospitals becoming more computer savvy, leads to a future of job searching directly without middlemen. More and more candidates will contact employers directly and
viceversa.

So, what keeps recruiters in business?
It is those employers who sadly do not know how to find candidates and those employers who do not have the personnel to recruit themselves. It is those colleagues who pay recruiter fees, who allow recruiters to pay for their advertising avalanche on the web. It is all paid by us, the physicians! This can change! I have described in detail the know-how that employers need to recruit successfully. Please check past posts in my blog for this.