The patient population that Bayhealth serves in Central Delaware is growing rapidly. But recruiting physicians can be a challenge sometimes given that Bayhealth isn’t located near any of the state’s major metropolitan areas.
“Our approach is to analyze where the biggest gaps are, because the needs are many, and then aggressively try to bring folks in to fill those gaps,” John Fink, MD, MSHQS, Bayhealth’s vice president for quality and medical affairs, said in an interview. Bayhealth is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
This calls for having the right resources to support physicians “so that when they come in, they can hit the ground running and, and get working,” he added.
Finding subspecialty physicians who are willing to cover some of the general medicine areas is a particular challenge. “Bayhealth appreciates that many of our specialists—such as our orthopaedic surgeons—are willing to help out in their general specialty in addition to providing subspecialty expertise,” Dr. Fink explained.
“For a place like us, we don't necessarily have a high enough demand for those subspecialties, and we still have a demand for general surgical and medical specialties,” he said.
In an interview, he described how Bayhealth has leveraged its residency program, loan repayment and onboarding measures to recruit and retain physicians and meet the needs of patients.
Meeting new priorities of doctors
Bayhealth—like other health systems—must balance the priorities and lifestyle demands of its physician workforce.
It used to be that physicians would work through the day then take call duty one out of every three or four nights. Work-life balance has shifted away from that historical model, observed Dr. Fink. “The idea of taking any call has been become more and more challenging for people who have demanding days. They’re shifting to prioritize their home life.”
Adult and pediatric hospitalists began this trend years ago. Now it’s happening in obstetrics and even surgery, where there’s the paradigm of having two separate teams.
“You have an ambulatory team and you have an inpatient team. Every full-time employee that you used to have for a physician or a clinician now requires two,” Dr. Fink said. “That’s extremely challenging from a workforce perspective,” given that there’s not enough physicians to even fill singular spots.
“Now we're looking for two people to fill one spot,” he said.
Additionally, as more physicians become employed and enter into agreements with health systems, they recognize the need to contribute to the operational and clinical leadership in that health system. Another ongoing challenge is the need to build a structure from a contract and workload standpoint to ensure that physicians have the time and ability to lead, said Dr. Fink, noting that “health systems and patients benefit when physicians take on these leadership roles.”
Launching strategic initiatives
To boost its recruitment of physicians, Bayhealth launched an aggressive market analysis to ensure that its benefits package was robust enough.
“As we see more and more physicians come on board, from a retention perspective we want somebody to be here a long time. One of the ways to do that is give them retirement benefits, making sure that we're generous in that respect,” said Dr. Fink. And “helping them understand that this is a good place to work and a good place to live for the long run.”
Bayhealth has also gotten creative with its physician leadership models and other clinical interest models. The goal is to make sure that physicians get to do what they want to do professionally while meeting the needs of the organization and the community.
There’s an equity piece to this as well, to make sure that there are equal opportunities across the board for new hires, Dr. Fink added.
From residency to retention
Starting a residency program four years ago was one key strategy to recruit and retain physicians at Bayhealth while meeting community health needs.
Bayhealth’s first class of family medicine residents graduated in 2023. Two out of eight graduates stayed at Bayhealth, which leaders there considered a big win.
One of those physicians, Kendall Barton, MD, credits the residency program for solidifying his passion for primary care and cultivating his love of small-town medicine in Dover, Delaware.
“This is an area that is so underserved, so when the community found out that we were bringing in over 20 physicians just in the first year, it was huge,” Dr. Barton said of the residency program.
In addition to family medicine, Bayhealth has residencies in internal medicine, emergency medicine and general surgery. To further grow its physician pool, Bayhealth also started a fellowship in hematology and oncology, and will be launching a fellowship in gastroenterology this fall.
Delaware's one of three states—including Alaska and Wyoming—in the country without a medical school. To compensate, Bayhealth partners with Drexel University and the Philadelphia College of Osteopathic Medicine on clinical rotations with students on a yearlong basis.
“We bring them down, hoping that this will seed our residencies … that they'll recognize this is a good place to be, and maybe after their own residency come back to us,” said Dr. Fink.
Offering loan repayment
Helping physicians pay their medical student loans is another recruiting tool Bayhealth employs because “we know physicians are coming out with tremendous debts,” said Dr. Fink. As a federally designated rural area, Bayhealth offers support with loan repayments. Some physicians have also been eligible for federal loan forgiveness by nature, working for Bayhealth as a nonprofit organization.
Loan repayment involves a partnership with the state and the organization that employs a physician. Physicians in primary care are eligible, as are other specialties such as psychiatry and obstetrics and gynecology.
“They have to work for a nonprofit organization like us, be a private practice physician and they have to be in an underserved community,” explained Dr. Fink. Those with Bayhealth must stay with the health system for several years to help repay their loan.
Hopefully, this is an appealing opportunity for doctors looking to get out of debt, he added.
AMA members can manage their finances and prepare for their futures in various ways with Laurel Road, an FDIC-insured digital banking platform. Learn more about loans doctors, residents, students and practices can take advantage of.
The standard of care in physician well-being recognition
Institutions in this article have been honored by the Joy in Medicine™ Health System Recognition Program.
Prioritizing physician well-being
In 2024, Bayhealth received a Silver-level designation from the AMA Joy in Medicine™ Health System Recognition Program, which empowers health systems to reduce burnout and build well-being so that physicians and their patients can thrive.
Dr. Fink sees this honor as an opportunity to further boost recruitment and retention of physicians.
Bayhealth’s recognition represents the tremendous amount of work it’s done over the past few years in building a well-being structure and other resources for doctors, he said.
Yet not all Bayhealth physicians are intimately aware of the critical steps the health system has taken to address doctor burnout, Dr. Fink noted. That is why Bayhealth is committed to doing a better job of communicating those resources to physicians it recruits, in addition to those already onsite, he said.
Embracing the power of technology
Telemedicine has also affected the sphere of work-life balance. Virtual care has transformed into an accepted and even necessary form of care, beginning with the COVID-19 public health emergency.
Many doctors “actually appreciate the opportunity to be able to do some more remote work and still deliver care,” said Dr. Fink.
To ease physicians’ burdens, Bayhealth wants to push forward with additional technologies such as ambient dictation. Doctors can start talking to a patient and the ambient technology automatically transcribes the notes.
Bayhealth has been piloting this technology in several areas, “making sure that it's up to speed enough to be what we want it to be and what the physicians need it to be,” said Dr. Fink.
Lending a helping hand
Once a physician is hired, Bayhealth works to find everyone a “buddy” to help them feel supported and engaged in their jobs.
This peer-support system is like a “big brother-big sister approach,” involving casual face-to-face meetings, said Dr. Fink.
“We’ll never put a brand-new doctor in a clinic by themselves,” he added. New physicians have someone to reach out to from a peer perspective to help with some of the little things, at least for those first couple months they're on board.
Fostering community
In discussing his seamless transition from the residency to the Bayhealth system, Dr. Barton mentioned that community engagement was the one of the most fulfilling parts of his job.
“You really are a community doctor here,” said Dr. Barton.
That connection is a primary reason why physicians stay at Bayhealth, said Dr. Fink. “As the largest provider in Central and Southern Delaware and the only health system in Kent County, people feel that commitment to the community and to the people themselves,” he said. “When docs feel that, it gives them a sense of purpose.”
