Recruiting health care providers is continuous work, Stevens Community Medical Center chief executive officer Jason Breuer said. But it's not because SCMC is a revolving door for providers. It's because the organization is always seeking to expand service in response to community needs, Breuer said.

While SCMC does not have a history of high turnover, there is always turnover in the medical world that causes a need to recruit, Breuer said. For example, on average a family practice doctor will stay at an organization for four to seven years, Breuer said.

In SCMC's case planned retirements affect recruitment and so does the shrinking pool of medical school graduates and those interested in practicing in rural areas, Breuer said.

SCMC has successfully recruited at least six providers in the past 18 months. The most recent hire is orthopedic surgeon Dr. Paul Havel.

SCMC doesn't recruit on its own, it has help.

"We have at least 15 firms that can work for us and try to fill a position," Breuer said. The organization may be working with a number of those firms at any given time.

The recruitment firms are generally of two categories: Firms that SCMC pays to recruit and firms that SCMC pays only if the recruitment is successful.

Breuer said the type of firm SCMC may use can depend on the position it needs to fill.

The organization uses its community needs assessment to target areas for recruitment. A community needs assessment is formally conducted every three years. The assessment identifies health service needs in the community. Needs that are practical and possible may be a focus of recruitment, Breuer said.

The organization also internally identifies needs to determine what types of positions to recruit for.

SCMC is recruiting while dozens of other rural health care facilities are also recruiting. Each will be using a strategy or strategies to recruit a health care provider.

"There are all different kinds of strategies," Breuer said.

Organizations may offer loan forgiveness, a sign-on bonus, assistance with moving, payment for continuing education costs and other options to recruits, Breuer said.

SCMC has used all of those options to recruit providers, Breuer said.

Those options can help retain a provider because loan forgiveness payments can be tied to years of service, for example, Breuer said.

"(Doctors) are coming out with hundreds of thousands of dollars in student loan debt," Breuer said.

Assistance with loans can be an attractive incentive to providers, he said.

But recruiting strategy consists of more than what options an organization can offer. It's also about what the community can offer.

One strategy is to identify the features that make the community attractive, Breuer said.

"What kind of lifestyle do you offer," Breuer said.

This area has opportunities for hunting and fishing and other outdoor activities, he said. It also offers a relaxed pace.

The mix of industry and business along with the University of Minnesota Morris, offer jobs for spouses of health care providers, Breuer said.

The area also has strong schools, Breuer said.

Three recent hires at SCMC all mentioned their interest in working and living in a rural area as important in choosing SCMC, said Angie Cole Olson marketing director at SCMC. And, "they were all heavily recruited," she said.

SCMC wants potential recruits to visit the facility and the community.

"You want to bring them here (for interview and site visit)," Breuer said. "It's an opportunity to show them the what the community is about and what the organization is about."

Recruiting firms help to screen potential recruits who may not have the proper certification or cannot obtain the required certification. The firms can also help screen recruits on other factors.

"If (recruits) have a (particular) interest you want to find out that interest before they get here," Breuer said.

If a potential recruit needs "to be 15 minutes from a shopping mall, that's not going to happen here," Breuer said. "Even if they are a great candidate," it's likely not worth the time to invest in a visit, Breuer said.

"If someone is coming to a rural area they are going to have to know that we don't have the conveniences of a large city," Breuer said.

The health care organization itself must be attractive to recruits.

"Physicians have to know they will see patients," Breuer said. So, SCMC needs to make sure there is a need and available patients for that provider.

"I do think they get to know patients and people within the community," Cole Olson said of another attraction to working at SCMC.

With recruitment and retention, providers want to know that the organization is responsive to changes within the medical world, that quality care is emphasized and that providers can have a voice in services and projects pursued by the organization, Breuer said.

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