How new companies are disrupting traditional physician placement in hospitals


Written by Mary Ann Roser

As technology continues to shape the delivery of health care, hospitals have been slow to board the tech train to fill a critical need: physician staff.

Hospitals have long used headhunters and employment agencies to recruit medical staff, either to cover shifts ona temporary basis — locum tenens — or for permanent positions, including physician leadership jobs. Competition for doctors is fierce as hospitals face a tsunami of retirements and ongoing shortages. The American Association of Medical Colleges projects a shortfall of 42,600 to 121,300 physicians by 2030, a time when the U.S. population is projected to grow by 11 percent and the over-65 crowd of high medical consumers by 50 percent.

Enter the disrupters.


One of the first to challenge traditional employment agencies is New York-based Nomad Health. It launched in mid-2016 to address hospital demand for physicians, from digital natives in their 20s to retirees seeking part-time work. Officials at Nomad said the company makes it easier for doctors and hospitals to find each other.

“There’s a huge appetite for a better solution,” said Alexi Nazem, M.D., Nomad CEO and co-founder, “No one was happy with the status quo.”

As an internal medicine physician, he once spent 10 months filling out paperwork for a three-day locum tenens position, Nazem said. He saw how technology could provide a better way.

The Nomad Way vs. Traditional Agencies

Nomad is an online marketplace that cuts out the broker, or “middleman,” he said. It uses an algorithm to match a hospital’s needs to a physician’s qualifications, availability and preferences — like a dating site for doctors and hospitals.

Nomad vets physicians, but hospitals must verify the information, he said.


Michael Douglas, who’s on the board of the National Association of Physician Recruiters and chief operating officer of the Texas-based staffing agency THMED, said he’s familiar with Nomad and believe it offers significant cost saving benefits to clients who have the time and resources to fully invest in their staffing projects. But, he said, Nomad might not be seen as offering a full suite of personnel recruitment tools that traditional staffing agencies would promote as valuable to a recruitment staff.

“Clients pay us to do all of the heavy lifting for them,” including interviewing the physician’s spouse to make sure the partner is willing to relocate for example, Douglas said.

However, hospitals can see significant cost savings with Nomad. Traditional staffing agencies typically charge 30 percent to 40 percent of a physician’s pay rate for a placement, Douglas said. Nomad charges 15 percent, Nazem said. Nomad’s fees also are transparent, unlike agencies, which don’t disclose them, he added.

“We want to be the one-stop shop for clinicians, and we want to be the one-stop shop for hospitals,” Nazem said.


The company works with physicians in 14 states, including Texas, and is growing, in part because of its appeal to younger physicians who are digital natives, Nazem said. The average age of a Nomad physician is 34, but older physicians, too, use the platform. Retired obstetrician/gynecologist Richard Rothwell of Abilene, who turns 72 in July, said he signed up to pick up a few shifts. He found the process simpler and faster than the agencies he’s used in the five years since he retired.

In addition, he had been out of the workforce for two years, and the malpractice insurance with the agency he approached wouldn’t cover him because of his time out of practice, Rothwell said. Nomad didn’t have a similar rule with its malpractice provider, and coverage is baked into each placement.

“They’re much more flexible, much easier,” Rothwell said.

Others in the Market


Carey Goryl, executive director of the Association of Staff Physician Recruiters, says companies that want to get rid of the middleman are popping up frequently.

“There’s no magic Easter egg or silver bullet out there,” said Goryl, whose organization works with in-house recruiters at hospitals and other health care organizations. “Time will tell” whether big changes are ahead for physician recruitment, and if so, which models endure, she said.

What Hospitals Need to Know

Goryl said hospitals need to be aware that today’s doctors are different from retiring boomers. They not only are more technologically adept, but they also want a greater work-life balance, which costs hospitals more.

“To replace one full-time, retiring physician, it will take at least 1.5 FTEs in the new generation because they are not going to work 80 hours a week or give all of their time to being on call,” she said.

Further, recruiters at hospitals, whether they work with an agency or a company like Nomad, need a deep understanding of the culture and the team for which they are recruiting to make a good match.

“We want to fill (the position) once,” she said. “We don’t want to fill it every six months.”

Douglas, who works out of his agency’s Dallas office, said he increasingly gets hospital requests for physicians who are familiar with a specified electronic medical record system.

“A lot of our clients are looking for physicians who are much more tech savvy,” he said.

By the same token, hospitals need to pay more attention than ever to their digital presence, Goryl said. “Those new physicians — they are looking at your website, they arelooking at your social media and they are looking at sites like Glassdoor and thinking ... 'Do I fit into their culture?’"

The hospitals that understand that will have a leg up, she said, and, “then, hopefully, the physicians will come looking for you.”


THA HealthShare Solutions magazine