Case Study: Rural Oregon Health System Finds True Recruiting Partner in PS&D

Background: Rural Health System Had a Vision to Expand Primary Care and Specialty Service Lines

Sky Lakes Medical Center (SLMC) began as a small community hospital in the 1960s, the sole healthcare facility in an Oregon logging town called Klamath Falls. At the base of the Cascade mountain range, Sky Lakes (then Presbyterian Intercommunity Hospital) would grow swiftly every decade since, expanding into a campus that now includes a 176-bed main hospital, cancer care and total joint care centers, a wellness center and a residency program run in cooperation with Oregon Health & Science University.

This non-profit, acute-care health system is now one of the biggest employers in the city of 22,000, but its patient population is far more vast. SLMC is the only full-service hospital in a 75-mile radius and serves more than 80,000 people in southern Oregon and northern California.

While its footprint and facilities have grown, one thing has not kept pace: It’s number of physicians, specialists and advanced practice providers, or APPs. But the health system's leadership team remains committed to their vision: To expand Primary Care teams and specialty service lines. To always be able to say “yes” when people call to ask, “Can I get a doctor’s appointment?”

In 2023, Sky Lakes entered a fully integrated recruitment process outsourcing (RPO) agreement with Provider Solutions & Development (PS&D). A dedicated PS&D recruiting team became an extension of Sky Lakes’ existing recruiting department, and a partnership was born.

Challenges: Lack of Resources and National Reach, and Acute Primary Care Provider Shortage

When Sky Lakes approached PS&D, they had tried dozens of recruiting agencies, and a few delivered a specialist here and there. But none of them were bringing consistent candidates to the table. The health system’s biggest need — the bread and butter of Primary Care hires — wasn’t happening.

“We just didn’t have a lot of consistency,” says Bryan Fix, Chief Human Resources Officer (CHRO) at Sky Lakes. “We really wanted a true partner, and that’s what PS&D gave us that others couldn’t. We were dealing with contingency firms or agencies that wanted a couple big-hit paychecks, but they didn’t want to be in a partnership. And that’s what we really needed. Now we have a team we’re working with, and we know they have integrity, and our missions are aligned. PS&D is here to support us, and they care about the outcomes.”

There are many benefits to RPO partnerships. That’s why many healthcare organizations are beginning to embrace RPOs — they are collaborative, efficient and financially beneficial.

When PS&D recruiters Nathan Reed and Christian Anderson joined efforts with Sky Lakes’ hiring team, they became a true extension of the health system’s recruiting efforts. Nathan and Christian set to work, tapping into PS&D’s national network, a host of sourcing platforms and a vast candidate database built over two decades. They had countless conversations with providers about the abundant opportunities at Sky Lakes, where providers can grow their skillset quickly and practice at top-of-license.

It helped that Christian grew up in Klamath Falls, a city on the shores of Oregon’s largest freshwater lake. He and Nathan traveled there, to meet with Sky Lakes leadership and get to know their medical teams. As Christian walked in, he remembers seeing familiar faces - the receptionist, a foundation member — both of whom he went to high school with.

“I have a personal investment in finding providers for Sky Lakes,” Christian says. “I’m not looking for just any candidate. I’m looking for people who are going to be a good fit and stay there. These are the people who will be taking care of my Dad.”

Sky Lakes leadership appreciated the personal connection, and the dedication to fit. With a total Primary Care patient panel of 11,000, they knew they needed to bring in dozens of providers to reach their goal of 20,000 Primary Care patients by 2026.

While Sky Lakes leadership knew their growth plans were ambitious, they were committed to achieving them, with the ultimate aim of a healthier community.

“The need for our services was evident, and we knew we would be growing pretty rapidly,” says Bryan, CHRO. “It was a choice of building our own provider recruiting team and teaching them how to do it and making sure they’re good at it or partnering with an established, market-leading function that can ebb and flow as we grow. I felt like the reach that PS&D had was stronger than what we could build in the needed timeframe.”

Entering into the RPO agreement paid off. In the next two years, PS&D would hire 22 healthcare providers into Sky Lakes Medical Center — 14 APPs, two Family Medicine physicians and four specialists.

Solutions: Consulting on Hiring More APPs, Improving Processes, Championing Sky Lakes’ Brand

All involved say it was teamwork that made the dream work. PS&D learned and adapted based on regular touchpoints with Sky Lakes, and Sky Lakes made changes in response to advice from the PS&D recruiting team.

One of those changes was hiring APPs to fill a multitude of Primary Care openings.

“That has made a huge difference,” says Nathan, PS&D senior recruiter. “It’s given Sky Lakes room to breathe. Some of the positions were in drop-in / immediate care, and we advised them to open it up to candidates who’ve had ER nursing experience and new grads. We’ve seen good success with that. Sky Lakes has been a great partner in that way, trusting us as industry experts and letting us consult with them. It really opened up pipelines for us.”

Site visits were another area in which PS&D consulted with Sky Lakes. Recruiters advised them to create customized site visits with dinners at the homes of leadership team members and outings that showcased the provider’s hobbies or needs, whether that was school or house tours or a boat ride or biking excursion.

Dr. Erin Gonzales, Chief Medical Officer and Family Medicine physician, is one of the leaders who opens her home to candidates, and her husband is one of the chefs who cooks meals for gatherings, where candidates are able to get to know their potential team in a relaxed environment.

“The site visit experience is a prime example of something PS&D really gave us some great feedback on — that candidates really enjoy a home-cooked meal,” Dr. Gonzales says. “We’re not able to do that for everyone, particularly with the volume of candidates that we’ve got coming through now. But for specialists, we have made that a standard practice. And it’s lovely! It allows the candidate to see a different perspective of the community, and it allows us to witness the candidate in a more laid-back setting. Some people really want to see hiking and mountain biking trails. Other people want to go to our farmer’s market. They’re interested in the local food scene. Some want to know all about the schools, and they’re asking about childcare.”

Based on PS&D’s advice, Sky Lakes’ in-house recruiter has created site visit itineraries for all candidates based on their interests: the outdoors, the family, the food, etc. This has been a gamechanger for the health system in terms of making an excellent impression and ending most site visits with a signed contract or an intent to sign.

Finally, Sky Lakes’ CHRO Bryan says PS&D has championed the health system’s brand in such an accurate and engaging way that new hires feel like an ideal fit.

“There’s a real value in having a dedicated recruitment partner that is selling your organization every day to the market. PS&D has done a great job of representing our brand. They know who we are and they know what kind of people fit our environment. Both in the workplace, the work culture and the community, and I think that is really, really important. PS&D also has a willingness to be innovative, try new things and explore what’s possible.”

Results: Primary Care Expansion, Increased Specialty Access, Less Locums Spend

With 22 hires in two years, Sky Lakes’ Primary Care challenges are starting to recede. The health system’s total patient panel has been able to increase by 45%, or from 11,000 to 16,000.

“We get calls every day, people asking, 'Hey, are you accepting new patients?’ And for a long time, the answer was no, because we didn’t have enough providers,” Dr. Gonzales says. “But now the answer is finally yes. We’re still waiting for a couple more APPs to come through onboarding. And then we’ll be able to officially announce that we are accepting new patients. We’re close. We’re closer than we’ve ever been.”

The tide is also turning for specialty service lines. The addition of an Otolaryngologist meant re-opening a dormant ENT panel. Now families don’t have to drive hours away to the nearest large hospital so their child can get a tonsillectomy.

An incoming Neurologist hire will turn a department of one into a team of two, doubling the capacity and access for patients who were used to waiting sometimes a year to get an appointment. The addition of a Pulmonary Critical Care physician means critically ill patients are receiving top-of-the-line care.

Within the first two years of Sky Lakes’ RPO partnership, PS&D has:

• Screened 549 candidates
• Presented 192 forward
• Moved 121 to the interview stage
• Sent offers out to 49 providers
• Signed 22 (6 physicians, 14 APPs)

All of this means much less spend on locum tenens, which brings in providers as independent contractors. Locum tenens physicians often earn significantly more than their permanently employed counterparts, making them a costly solution for health systems.

Dr. Gonzales says the partnership with PS&D just makes sense.

“We recognize that we are a healthcare system. We are not a recruiting system. We’re good at providing healthcare to patients. We’re not necessarily equipped with the national reach or the resources to get people here,” she says. “But we knew we really needed to ramp up our recruiting because we had this vision of expanding Primary Care, and we’ve done so quite successfully since we started partnering with PS&D.”

Another shift that was subtle yet impactful? Dr. Gonzales says the influx of providers has boosted morale.

“It’s given the medical staff hope that we can recruit to Klamath Falls,” she says. “The mantra before we started working with PS&D was, 'Oh, we can’t recruit here. We’re just a small town. We’re just a rural setting.’ But what we’ve realized in the last few years is, we can recruit here if we find people who are the right fit. PS&D has shown us that it is possible.”

Sky Lakes: Top Benefits of Working with PS&D

1. Consulting on Best Practices: From re-imagining the site visit to hiring more APPs in Primary Care, PS&D continues to offer Sky Lakes best practices and guidance based on what we know works. Because we hire for dozens of health systems across the country, our breadth of experience allows us to be nimble and innovative — and offer those solutions and insights to our partners.
2. Physician/APP Hiring Expertise: PS&D understands how physician and APP hiring is different from other healthcare recruitment. We have access to hundreds of job boards, and we deliver national marketing efforts, so Sky Lakes jobs reach far and wide. We do the same for all our clients, allowing us to discover the right talent for each role, each team and each location we recruit for.
3. Brand Champion: Every partner PS&D has is one-of-a-kind. We meet with our clients, get to know their teams and tour their facilities. We study what makes them different, and what types of physicians and APPs thrive there. This becomes our roadmap for finding ideal candidates, who won’t just take the job, they’ll put down roots in the community.

Impact of Partnership

• Total Primary Care patient panel increase of 45%
• Decrease in spend on Locum Tenens providers
• Re-opening of ENT service line
• Doubling Neurology service line
• Site visit enhancements

PS&D and Sky Lakes: Shared Goals, One Team

The story of Sky Lakes Medical Center and Provider Solutions & Development is one of shared risk, trust built and progress made, together. It’s about two organizations creating one cohesive team with a common goal: To increase healthcare access in Klamath Falls.

For PS&D’s Christian, it’s been a true full circle experience. He was born at Sky Lakes Medical Center, and now he is recruiting for the doctors and APPs who care for his own family.

“We are their team, and they’re our team,” Christian says. “As for the functionality of it, trust is the biggest thing.”

Sky Lakes remains one of the last independent, not-for-profit health systems in the Pacific Northwest — a point of pride for the medical center.

“Our focus is 100% on our community and creating a better environment for future generations,” says Bryan, Sky Lakes’ CHRO. “That means we do the work to be much more than a hospital or healthcare system. We want to be a catalyst for positive change, and when you can engage people around that mission and do that in a teaching environment that stays energetic and fresh, that’s a pretty exciting place to be. And I think our partners at PS&D understand that about us. They do a good job of helping people see that.”

PS&D works with healthcare organizations of all kinds to solve recruiting challenges big and small. If you’re ready to build a lasting partnership that helps you reach your provider recruitment goals, from marketing to sourcing to interviewing and beyond, PS&D is here to help. Reach out today.

Learn more about Sky Lakes and explore their open positions.