The View from the Recruiter's Seat: Candidates are Driving the Job Market and Rejected Offers Are on the Rise

Over the past two years, recruiters in the executive and managerial space have observed significant changes in hiring practices, the most important being a shift from an employer-driven market to a candidate-driven market. Following this trend, new data indicates the talent market is now overwhelmingly driven by top performers. Recruiters who responded to the most recent MRINetwork Recruiter Sentiment Study provide cautionary advice to employers who haven't yet awakened to the new reality.

"I have been recruiting for nearly 11 years and I have never seen the market more candidate-driven than it is now. Candidates have choices and 'A' players are being heavily courted," said a recruiter responding to the study. According to the report, in the second half of 2013, 79 percent of recruiters described the labor market as candidate-driven, up 12 percent from a year ago.

The executive and managerial market continues to be so candidate-driven, because the talent pool remains weak. As the economy rebounds, average candidates simply will not do - employers want star players to help them move their businesses forward. This leaves top performers at a strong advantage. Multiple job offers provide these candidates with more bargaining power and the ability to reject less desirable work agreements. According to the study, 49 percent of candidates refused job offers as a result of accepting an offer with another company, up 16 percent from the first half of 2013.

MRINetwork recruiters report several reasons for why more jobs are being turned down:

1. Qualified candidates are hard to find and also difficult to move. New jobs are not offering high enough salaries or enough benefits to incent a move.
   
2. Top candidates are interviewing with multiple companies and have multiple offers to consider.
   
3. Good candidates are becoming more difficult and demanding. Employers haven't caught up yet. They still think they can get a great candidate cheap.
   
4. Employers are taking too long to complete the interviewing process.

With rejected job offers on the rise, the candidate-driven market points to several things:

1. Employer branding is more important than ever to entice star talent. "Companies should be re-visiting, from the top down, why their company is a great place to work, and why not," said an MRINetwork recruiter.
   
2. It is now crucial that employers find ways to streamline the hiring process to avoid losing their top picks. One recruiter noted, "Slow hiring processes give candidates access to more options and more time to rethink their reasons for making a change."
   
3. Salary and benefit packages need to be aggressive, not simply market-competitive. Another recruiter added, "More employers need to consider offering a higher salary if their benefits are not as competitive with those currently provided to the candidate. Many employers looking to hire have cut back on benefits and this isn't being covered by increased salaries."
   
4. Counteroffers are a reality, especially when it comes to top performers. Since exceptional candidates are frequently recruited from other companies, prospective employers should be prepared to offer a salary and benefits package that the current employer is not likely to beat.

The good news is that more employers are realizing the executive and managerial market is candidate-driven. According to the study, 25 percent of employers are presenting job offers within two weeks of the first interview, up 6 percent from the first half of 2013.

While the study results demonstrate that hiring trends are highly favorable towards top performers in the executive and managerial space, the data is not representative of overall hiring, which the Federal Reserve noted in its most recent Beige Book, is holding steady or increasing at a measured pace. Even still the results are encouraging, showing consistent signs of economic recovery.

Organizations Begin to Backfill and Restart Hiring

"Everyone is hearing about continued debt concerns in Europe, but when it comes to not hiring in America, it’s used as an excuse not to hire, rather than a reason,” notes Rob Romaine, president ofMRINetwork. “Except for companies with heavy exposure to the European market, businesses are making hiring decisions based on the customers walking through their front door, not uncertainty surrounding sovereign debt an ocean away.”

A recent survey of MRINetwork recruiters noted an increase over the last six months of employers backfilling positions that had been left unfilled for two years or more. As one respondent said, “I believe [employers] cut so deeply over the past two years that productivity has suffered. Today, they are hiring out of necessity and a belief that the economy has begun to turn.”

The evidence that the economy has turned is mounting. According to the Bureau of Economic Analysis, the U.S. economy grew at an annualized rate of 2.8 percent during the fourth quarter of 2011, the fourth consecutive increase. Total GDP growth in 2011 measured 1.7 percent, not a rapid rate of growth, but a far cry from projections of a double-dip recession.

Such growth numbers are, compared to past periods of recovery, rather weak. Yet, most important is where the growth is coming from. In 2011, MRINetwork saw placements in the construction space grow by nearly 50 percent, industrial placements by more than 30 percent and consumer products and services by more than 20 percent.

“Increased hiring of senior-level talent in these sectors is promising for the general economy,” says Romaine. “It indicates a confidence and a willingness by employers to invest in talent across broad swaths of the economy despite headwinds that still persist.”

But just as employers seem to be ramping up their hunt for senior talent, the availability of such talent may be shrinking as well. Over the last six months, employers have continued to increase their use of counter-offers, hoping to retain top talent long enough to backfill their positions. In highly technical fields, such as chemical engineering or biotechnology, employers have been forced to sweeten counter-offers because there simply aren’t as many candidates as there are job openings.

Indeed, the unemployment rate for those with a bachelor’s degree or higher—perhaps the broadest definition of the skilled, professional workforce—fell in December to 4.1 percent, its lowest rate in nearly three years.

“A full-blown, double-dip recession in Europe could have a chilling effect on hiring in America. But, until it does impact the U.S. directly, businesses are beginning to return to more normal hiring patterns,” notes Romaine. “Companies are backfilling vacancies and investing in new positions. We are in the midst of the slow, but seemingly stable, rebound that had been projected.”

Over the past several months, private employment in the U.S. has begun to rebound in an increasingly strong way. Through all of 2011, the private sector averaged 160,000 new positions per month, exceeding the monthly rates of population growth (about 140,000) and labor force growth (only about 20,000).

The multispecialty practice: A unique practice model for challenging times

From DentalEconomics.com

John Weston

April 29, 2009

by John Weston, DDS
Accredited Fellow, AACD

For more on this topic, go to www.dentaleconomics.com and search using the following key words: multispecialty practice, diversification, specialists, staffing, Dr. John Weston.

Most dentists practice alone. In fact, the traditional model of dental practice is a single practitioner with a small staff in a stand-alone office. While there are advantages to this model, practitioners might be wise to consider other options. Group practices, for example, provide shared overhead, clinical coverage, and stability a solo practice does not offer. I like this model but would suggest an exciting and potentially more rewarding concept — the “multispecialty practice.”

This article will review the basic concepts that I believe have helped me build one of the most successful multispecialty, fee-for-service practices in the country. We have gathered certified specialists in every phase of adult dentistry at one location. This concept has helped keep our practice strong, financially healthy, and uniquely competitive.

Like investing in the stock market, diversification in a dental practice is one key to success. Most dentists refer to specialists for procedures they do not like or which prove too complicated.

We have taken this philosophy a step further by bringing skilled specialists directly into our practice. As a result, we increased the ability to treat patients, and allowed more time for me to do the cosmetic and elective procedures I enjoy most.

The concept

General dentists are referring less often. We may see this trend accelerate during an economic recession. As a result, some specialists may be significantly less busy. You might also be surprised to find they would be open to the idea of a satellite office — a sort of “second home” in which they are valued for their skills, and would appreciate the opportunity to serve patients in an environment where quality is the focus.

At our practice, in-house specialists see patients without worrying about scheduling, supplies, staff, collections, recall, or any of the other systems required to treat patients in their office.

The tangible is the paycheck, but a significant intangible is the professional stimulation between colleagues. Our doctors find it rewarding to be part of a team. There is a completeness of care by having the records, referring doctor, and treating specialists all in one location. I will often visit the specialty care area during my patients' surgeries to confirm placement of implants and other details.

Patients appreciate this, the specialists enjoy the interaction, and I learn something every time. Often, we will sedate a patient and complete all of the patient's specialty or restorative needs in one visit. I can supervise the entire effort, which is extremely rewarding.

How to begin

Finding providers who match your style and philosophy is important. Start by looking for quality-conscious doctors who are not in your immediate referral area. During the introduction call, I ask if they would consider working one day a week with us where quality is the No. 1 focus. Through the years, we have staffed our specialist positions with those who already own a practice and are excited about the opportunity to work one day a week with us. I emphasize our goal of providing a high-quality, low-stress environment.

My advice is for offices to start small. Look at areas in your practice in which you are referring out a lot of treatment, and start by hiring a specialist to support that need. This does not mean you have to bring every procedure in-house. It may be good to continue some referrals to local specialists, thus maintaining those relationships.

Periodontics and oral surgery are good specialties with which to start. In the beginning, I ask the doctor to bring any specialized instruments or equipment beyond the basics. As things progress, I do not hesitate to purchase the proper instruments and supplies for a specialist. The investment quickly pays off and the doctor is happier knowing he or she has the best.

Our oral surgeon and periodontist have been with us for more than 10 years and have no plans to leave. The endodontic and orthodontic positions tend to rotate every few years. We currently have an excellent prosthodontist one day per week who plans to stay indefinitely. When specialists do leave, they usually help us find replacements, and they have a good knowledge of other specialists in the area. In one case, we actually contract directly with a group practice and not the doctor. This ensures our specialty coverage will not be interrupted.

Staffing and scheduling

The goal is to fill chairs during operating hours. You are paying the overhead whether you have a patient in the chair or not. Adding a specialist one day per week is ideal but you may need to start with half days until the demand rises. When we hire a new specialist, we know in advance what days we are looking to fill, and this becomes part of the signed agreement. The team also understands the importance of having full chairs every day.

As an example, Friday was once a quiet day in my office. Now we have at least one or two periodontists, a prosthodontist, and a general dentist, as well as two to three hygienists. Friday has now become a very productive day — all without my being there. A key factor is balancing scheduling with demand. A day when the main producer is out of the office is a perfect day to add a provider. We also always open up extra days to our specialists when others are on vacation.

Most patients who see our specialists are referred from within the practice. It is amazing how complete treatment planning becomes when it stays in the practice. We still get referrals directly from other GPs, and encourage this. When this happens, we are essentially acting as a specialty practice. It is extremely important to make sure the patient gets back to the referring doctor so we don't lose the referral source.

Compensation

Our specialists are all contract 1099 employees and the IRS requires they meet 21 criteria to be independent contractors. Most of these are self-fulfilling, if they have a primary practice location and satellite with you a day per week. Your tax attorney can make sure you are in compliance. We use standard “at will” employee contracts that allow either party to terminate with proper notice if things are not working out. All pay is based on a percent of collections, not production.

From my perspective, this is the best way to properly compensate providers. Production is easier to track but is not real money until it is collected. You want your providers engaged in the process and completing treatment that is agreed upon by patients who will pay their bills. Collections are real money — the stuff with which you pay your bills.

Compensation for restorative providers can run anywhere from 30% to 36% plus a 50% lab bill. Connecting a doctor to lab bills is important because they are conscious of remakes and quality issues. Compensation for endo, ortho, perio, and OS can run anywhere from 45% to 50%.

Just make sure implant and grafting procedures are priced properly to ensure accurate profit margins. Start on the lower end of the percentages so you have room to absorb initial costs and reward good providers.

Quality

A key factor for our success has been a focus on quality. From the first phone call and front-office experience to every point of contact throughout the practice, we focus on an amazing customer experience. We call these encounters “moments of truth.” Patients show up for appointments and pay bills when they feel a practice takes care of them. In addition, offering specialty care within your office goes along with a “patient-centered” focus and can add incredible value.

The office should never appear stressed, overworked, or understaffed. The expression “never let them see you sweat” goes a long way, and takes proper training. Attitude is not everything but almost. We hire team members based on attitude, and train them to our product. Never let a big resume fool you into hiring someone who does not seem right.

Conclusion

The goal in this competitive market is to stand out, find a niche, or distinguish your practice in some way. What causes a patient to drive past 25 other dental offices to visit yours? In our situation, we are the only fee-for-service, multispecialty practice in our city. We have a local, national, and international clientele which travels to our practice for high-quality care and a “one-stop” philosophy.

Simply stated, we provide top quality multidisciplinary care quickly and conveniently. The benefits and improvement in care for our patients far outweigh any challenges we faced in making this happen. Our ability to offer state-of-the-art care by certified specialists in one location is a successful model that, when properly implemented, could also help your practice stand out as unique.

Dr. John Weston, a Fellow in the American Academy of Cosmetic Dentistry, is director of Scripps Center for Dental Care, a unique multispecialty center located on the Scripps Memorial Hospital Campus, La Jolla, Calif. He writes and lectures nationally and internationally about cosmetic dental procedures. Reach Dr. Weston at DrJohnFWeston@aol.com.

Found at http://www.dentaleconomics.com/display_article/360604/54/ARTCL/none/Feat/The-multispecialty-practice:-A-unique-practice-model-for-challenging-time?dcmp=rss