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Our Recession Challenge: Reinvent the Business -- Fast

By Will Drescher, CEO, Locum Leaders, Alpharetta, Ga.
I started my temporary medical staffing company, Locum Leaders, right before the market crashed in late 2008. (Our name comes from locum tenens, a Latin term meaning "to hold the place of," which the healthcare industry uses to describe temporary physicians.) Soon after, hospitals began slashing budgets, doctors began putting off retirement, and demand for temporary employees decreased dramatically.

On top of that, demand for elective surgeries plummeted, so there was less demand for anesthesiologists, which was our firm's specialty. A lot of anesthesiologists who might have worked with us under better economic conditions decided they were better off staying put in their current jobs. Many of our competitors in the locum tenens industry, especially those firms that specialized in supplying anesthesiologists, were shrinking or going out of business.

I Changed the Firm's Specialty
During this period, we continued calling hospitals to inquire about temporary positions for anesthesiologists. They usually didn't want anesthesiologists, but quite often asked if we could find them hospitalists.

Hospitalists are a relatively new category of primary care doctors that work in a hospital, rather than in an office or private practice. I didn't know a lot about the specialty, but felt we better learn more about these doctors and why they were in demand.

In our research, we found studies showing that hospitalists were managing hospitalized patients with better outcomes and at lower cost. Hospital industry data showed us that the number of hospitalist programs across the country had doubled in just a few years. These factors, combined with an already acute shortage of primary care doctors in the U.S., meant that hospitalist demand was outstripping supply. We saw an opportunity, and we seized it.

Halfway through our first year, I shifted our strategy away from anesthesiology staffing and focused our team 100 percent on recruiting and booking hospitalists. It was an easy decision based on the needs of our clients, but I also knew we faced a steep learning curve in this new specialty.

Our recruiters had to learn about the kind of training required of hospitalists and understand the varied role these doctors play in different hospitals. Some of our clients use hospitalists for very general duties, while others require hospitalists trained in specialized procedures. We also needed to learn the scheduling nuances of the specialty. We found, for example, that some hospitalists only work nights, while others put in 12 hr days and still pick up extra work on weekends.

From a business development perspective, we had to build new relationships and work with different hiring managers than the ones we worked with in anesthesiology.

We quickly discovered that many hospitals outsource their hospitalist programs to third-party management companies. These outsourcing companies employ thousands of hospitalists across the country, so signing contracts with them became a critical component in our growth strategy.

Our exclusive focus in hospital medicine helped us land those contracts and more new business. It also meant turning down opportunities to book other types of specialists, but it was worth it.

I Hired a Hospitalist to Help Retrain My Staff
Having moved away from our roots in anesthesiology, I set a new goal for Locum Leaders to become the industry leader in hospitalist staffing. But to build a leadership position, I felt we needed to know more about the specialty than any of our competitors.

In essence, we had to become hospitalist experts.

To help us do this I hired a hospitalist as chief medical officer. He had previously been vice president of medical affairs for a major hospitalist management company, and he gave our employees in-depth training about the profession. For example, we learned hospitalists have varying levels of comfort and experience in the ICU, performing tasks like managing vents, intubation, and central line placement. He also worked one-on-one and consultatively with our clients, drawing on his own experience as a medical director for several hospitalist programs.

Locum Leaders is the only national locum tenens firm to hire a hospitalist CMO. It was a big investment -- requiring us to defer for a while on additional recruiters and sales people -- but it paid off: Our resident hospitalist has given us greater credibility with hospitals and with his peers in the medical community.

We're ready to expand
As soon as we changed specialties, our company began to grow. We felt we had reached a turning point when we attended a national meeting of hospitalists in May 2009 and ended up signing several contracts with large clients. Since we switched to focusing all of our energy on hospitalists in January 2009, we've more than doubled our five-person staff. Our revenues for 2009 were $3.5 million. This year, we project revenues of $10 million. With growth we've been able to fund a new division that specializes in psychiatry, another specialty in which hospitals have a huge need for temporary doctors.

The key for our company was acting quickly once we identified the problem, and being flexible and willing to go outside of our comfort zone. It's never fun to have to reinvent your own business, but sometimes it's necessary. Have you had to do the same at your company? Let me know what you went through in the comments.

-- As told to Harper Willis

The U.S. Chamber of Commerce recently named Locum Leaders as a 2010 Blue Ribbon Small Business Award winner.

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