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Northern California physicians flock to Kaiser Permanente

The nation's largest medical group is growing, and it still has more applicants than it can place.

By — Posted Dec. 13, 2004

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In some areas of the country, groups may wait months to find a physician to fill an open slot, and their recruiting efforts can carry a pretty hefty price tag.

In Northern California, Kaiser Permanente receives an average of seven applications for every open physician slot at its flagship medical group.

For physicians in the region searching for safety in numbers, The Permanente Medical Group is the ultimate destination, as its 5,000-plus doctors make up the largest group in the nation. The group's growth in recent years has been eye-popping as well; it has hired more than 500 new physicians this year and more than 2,300 since Jan. 1, 2002.

"The majority of our hires are new hires," said Robert Pearl, MD, a plastic and reconstructive surgeon and executive director and CEO of The Permanente Medical Group. "We have a pattern going on where we hire about 500 to 550 full-time physicians every year and add a group of part-time people."

Kaiser Permanente's financial performance has allowed it to grow substantially over the last few years, as it reinvests its earnings in facilities and technology.

The Oakland, Calif.-based Kaiser Foundation Health Plan Inc., Kaiser Foundation Hospitals and their subsidiaries recorded net income of $996 million and revenue of $25.3 billion in 2003. In 2002, the organization reported net income of $70 million on revenue of $22.5 billion, as it recorded a charge of $442 million related to the transition to a more advanced electronic medical record system.

Kaiser Permanente boasts more than 8.2 million health plan members overall, about 3.2 million of which are in the Northern California region. There are eight regional medical groups that fall under the Kaiser umbrella, though each one operates independently.

The Northern California group has garnered so much interest from local physicians because of its quality reputation and the current economic realities facing the fee-for-service environment. Seeking approval from insurers for various tests or procedures, fighting for reimbursements and struggling to invest in technology because margins are so slim makes private practice a more frustrating endeavor these days, Dr. Pearl said.

On the other hand, an employed physician with The Permanente Medical Group does not have to endure an authorization process when deciding what is right for the patient, and the managed care hassles are no longer an issue.

"I've never had someone say, 'You can't do that MRI,' " said Craig Sadur, MD, an endocrinologist with The Permanente Medical Group in Pleasanton, Calif. Dr. Sadur joined Kaiser Permanente several years ago after a nine-year stint in private practice. "It certainly takes a burden off by not having to be so involved with the administrative work," he said.

Entire medical groups have even closed up shop and joined Kaiser Permanente, including three in the past 18 months. The downside to physician interest, however, is with the number of applicants, the competition for a job is fierce. There were 3,600 applicants for full-time positions last year alone, Dr. Pearl said.

"We've rejected quite a few," Dr. Pearl said. "We're looking for the top 10%."

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