<description>&lt;div&gt;
&lt;p&gt;More physicians are turning to concierge and hybrid concierge models to shrink their panels and steady their finances, but the move carries legal exposure that's easy to miss until it becomes a problem.&lt;br&gt; &lt;br&gt;Ericka Adler, J.D., health care practice group manager at Roetzel &amp;amp; Andress, joins &lt;em&gt;Medical Economics&lt;/em&gt; Managing Editor Todd Shryock to walk through the rules that trip practices up: why a membership fee has to be tied to a service insurance doesn't already cover, how Medicare and commercial contracts can quietly prohibit what a practice is planning, and what physicians have to put in writing so patients are never left feeling like they have to pay up or walk. She also lays out the planning, market research and runway it takes to make the transition actually work.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Music Credits:&lt;br&gt;&lt;/strong&gt;Nightfall Reverie by KBH Production - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;/a&gt;&lt;br&gt;A Textbook Example by Skip Peck - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;br&gt;&lt;/a&gt;&lt;br&gt;&lt;strong&gt;Editor's note: Episode timestamps and transcript produced using AI tools.&lt;br&gt;&lt;br&gt;0:00 – 0:26&lt;/strong&gt; | Cold open Ericka Adler on why calling yourself a concierge practice doesn't let you cut legal corners.&lt;/p&gt;&lt;p&gt; &lt;strong&gt;0:26 – 1:33&lt;/strong&gt; | Introduction Austin Littrell previews the episode and the legal considerations behind concierge medicine.&lt;/p&gt;&lt;p&gt; &lt;strong&gt;1:33 – 1:53&lt;/strong&gt; | Meet Ericka Adler Todd Shryock introduces the guest and the topic.&lt;br&gt; &lt;br&gt;&lt;strong&gt;1:53 – 3:07&lt;/strong&gt; | Choosing the right entity Why entity selection for a concierge practice is no different than for any medical practice, and how state law drives the choice.&lt;br&gt; &lt;br&gt;&lt;strong&gt;3:07 – 5:36&lt;/strong&gt; | Hybrid vs. cash-only, from a legal view In a hybrid model the membership fee has to cover something insurance doesn't, and what counts as "not covered" changes year to year.&lt;br&gt; &lt;br&gt;&lt;strong&gt;5:36 – 9:02&lt;/strong&gt; | What physicians overlook in the switch Proper notice, terminating contracts and why you can't force insured patients to pay a concierge fee to stay.&lt;br&gt; &lt;br&gt;&lt;strong&gt;9:02 – 11:43&lt;/strong&gt; | The Medicare problem Annual physicals are covered now, 24/7 access may already be required, and old membership documents can leave you charging for things you no longer can.&lt;br&gt; &lt;br&gt;&lt;strong&gt;11:43 – 14:12&lt;/strong&gt; | The patient contract What the agreement has to spell out: the fee, what it covers, proration and what happens when a patient dies, moves or leaves.&lt;br&gt; &lt;br&gt;&lt;strong&gt;14:12 – 15:03&lt;/strong&gt; | P2 Management Minute Keith Reynolds shares practice management tactics and invites listener submissions.&lt;br&gt; &lt;br&gt;&lt;strong&gt;15:03 – 16:48&lt;/strong&gt; | The documents you still need Informed consent, HIPAA, financial forms and good faith estimates all still apply, no matter the specialty.&lt;br&gt; &lt;br&gt;&lt;strong&gt;16:48 – 18:30&lt;/strong&gt; | Risks unique to concierge How a cash-based practice's exposure differs from a hybrid model that still bills insurance.&lt;br&gt; &lt;br&gt;&lt;strong&gt;18:30 – 21:25&lt;/strong&gt; | The 24/7 access marketing trap Why "24/7 access" can't be the basis of a hybrid membership fee when most plans already require equal treatment.&lt;br&gt; &lt;br&gt;&lt;strong&gt;21:25 – 25:29&lt;/strong&gt; | Planning, patients and market research Giving patients runway, avoiding abandonment and making sure your community can actually afford the fee.&lt;br&gt; &lt;br&gt;&lt;strong&gt;25:29 – 28:27&lt;/strong&gt; | Building the transition the right way The financial, marketing and legal steps to take in order, plus the private equity money moving into concierge care.&lt;br&gt; &lt;br&gt;&lt;strong&gt;28:27 – 28:42&lt;/strong&gt; | Closing thoughts and outro Todd thanks Ericka and Austin wraps the episode.&lt;/p&gt;&lt;/div&gt;</description>

As more physicians weigh a move to concierge or hybrid practices, health care attorney Ericka Adler breaks down the contract and Medicare traps that can turn a panel-shrinking strategy into a legal problem.

Off the Chart: A Business of Medicine Podcast

S1 Ep166: Considering concierge? Know the legal traps first, with Ericka Adler, J.D.

<description>&lt;div&gt;
&lt;p&gt;Physician compensation has never been simple, but in 2026 it is especially fraught. Medical groups and health systems are contending with workforce shortages, flat or declining reimbursement, rising operating costs and the regulatory limits that come with employed and affiliated models all at once — and a competitive offer, on its own, no longer closes the deal. &lt;br&gt;&lt;em&gt;&lt;br&gt;Medical Economics&lt;/em&gt; Associate Editor Austin Littrell sits down with &lt;a href="https://www.pyapc.com/team-member/tynan-kugler/"&gt;Tynan Kugler, M.P.H., MBA, CVA, a principal in PYA's consulting practice&lt;/a&gt;, to break down the four forces pulling physician pay in competing directions and what physicians and organizations tend to get wrong about how compensation actually gets built.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Music Credits:&lt;/strong&gt;&lt;br&gt;Rooftops by Buurd - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;/a&gt;&lt;br&gt;A Textbook Example by Skip Peck - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;br&gt;&lt;/a&gt;&lt;br&gt;&lt;strong&gt;Editor's note: Episode timestamps and transcript produced using AI tools.&lt;br&gt;&lt;br&gt;0:00 – 0:32 | Cold open&lt;/strong&gt; — Kugler on the central problem: once compensation is set it creates a floor, and that floor is very hard to step back down.&lt;br&gt; &lt;strong&gt;0:32 – 1:26 | Introduction&lt;/strong&gt; — Austin Littrell welcomes listeners back from the Fourth of July weekend and previews the episode.&lt;br&gt; &lt;strong&gt;1:26 – 9:04 | The four forces&lt;/strong&gt; — Supply-and-demand imbalance, the shift to employment and affiliation, reimbursement pressure and the productivity-versus-value tension. Kugler walks through how each is pulling on physician pay, plus the 2026 Medicare conversion factor and the coming 2027 unbundling of global obstetric codes.&lt;br&gt; &lt;strong&gt;9:04 – 13:22 | Competitive pay without runaway costs&lt;/strong&gt; — Why the strongest groups redesign their models instead of raising salaries each year: hybrid base-plus-incentive structures, quality and access measures, shorter guarantee periods and smarter advanced practice provider strategy.&lt;br&gt; &lt;strong&gt;13:22 – 17:22 | Why pay is so hard to walk back&lt;/strong&gt; — Compensation sets a floor that keeps ratcheting up. With demand outstripping supply, flat reimbursement and regulatory limits on changing contract terms, employers have little room to pull pay back down.&lt;br&gt; &lt;strong&gt;17:22 – 18:13 | P2 Management Minute&lt;/strong&gt; — Keith Reynolds shares practice management tips and invites listeners to send in their own workflow ideas.&lt;br&gt; &lt;strong&gt;18:13 – 21:59 | Where there's room to move&lt;/strong&gt; — Base pay and productivity metrics are the least flexible, because they track market data most closely. The give tends to live in quality incentives and recruitment tools like signing bonuses and forgivable loans.&lt;br&gt; &lt;strong&gt;21:59 – 27:58 | How an offer actually gets evaluated&lt;/strong&gt; — Most systems work from a board-approved compensation philosophy, then run each physician's facts through it. Kugler contrasts three cases — a physician new to a market, a resident coming out of training and an owner leaving private practice — and walks through how benchmarking decides whether an offer is supportable.&lt;br&gt; &lt;strong&gt;27:58 – 29:17 | Closing thoughts&lt;/strong&gt; — Not all roles are equal, alignment matters as much as the number and compensation is complicated. Kugler's parting advice: know what you need going in.&lt;br&gt; &lt;strong&gt;29:17 – End | Outro&lt;/strong&gt; — Austin Littrell wraps the episode.&lt;/p&gt;&lt;/div&gt;</description>

PYA's Tynan Kugler breaks down the four forces pulling physician pay in competing directions, and why getting the underlying compensation model wrong can be expensive and legally complicated to undo.

S1 Ep165: The four forces reshaping physician pay, with Tynan Kugler of PYA

<description>&lt;div&gt;
&lt;p&gt;For the first time in years, physician compensation and productivity have moved in opposite directions — pay is up, encounter volume is down — and practice leaders are trying to work out what it means heading into a turbulent year. &lt;em&gt;Physicians Practice&lt;/em&gt; Managing Editor Keith Reynolds sits down with Andy Swanson, chief customer success officer at the Medical Group Management Association (MGMA), to unpack the group's latest &lt;a href="https://www.mgma.com/2026-provider-compensation"&gt;provider compensation and productivity data report&lt;/a&gt; and the forces behind the split. They dig into why encounters are falling while acuity and pay climb, whether rising compensation against flat reimbursement can hold, and how the new Medicare efficiency adjustment — a 2.5% cut to the work RVU value of roughly 7,700 codes — will land hardest on procedural specialties.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Music Credits:&lt;/strong&gt;&lt;br&gt;Paper Cranes by Buurd - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;/a&gt;&lt;br&gt;A Textbook Example by Skip Peck - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;br&gt;&lt;/a&gt;&lt;br&gt;&lt;strong&gt;Editor's note: Episode timestamps and transcript produced using AI tools.&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;0:00 – 0:25 | Cold open&lt;/strong&gt; — Swanson sets up the central tension: if costs keep climbing while reimbursement stays flat or falls, the current path isn't sustainable.&lt;br&gt; &lt;strong&gt;0:25 – 1:10 | Introduction&lt;/strong&gt; — Austin Littrell previews the episode and the guest.&lt;br&gt; &lt;strong&gt;1:10 – 1:39 | Welcome and setup&lt;/strong&gt; — Keith Reynolds welcomes Swanson and introduces MGMA's latest provider compensation and productivity data report.&lt;br&gt; &lt;strong&gt;1:39 – 3:15 | What's behind the split&lt;/strong&gt; — Encounters are down but carry higher acuity, and compensation rose roughly 1.5% to 3% even as work RVUs slipped. Swanson cautions against reading the volume dip as lower physician effort.&lt;br&gt; &lt;strong&gt;3:15 – 4:29 | Can the split last?&lt;/strong&gt; — Two long-term problems: pay can't rise indefinitely as production falls, and rising costs against flat or negative reimbursement eventually hit a breaking point.&lt;br&gt; &lt;strong&gt;4:29 – 6:50 | The Medicare efficiency adjustment&lt;/strong&gt; — A 2.5% cut to the work RVU value of about 7,700 codes hits procedural specialties hardest. Swanson explains how to benchmark around it and defend against the paper-only reimbursement hit.&lt;br&gt; &lt;strong&gt;6:50 – 9:19 | Recruiting into the squeeze&lt;/strong&gt; — Cutting starting salaries in hard-to-recruit specialties won't land top candidates. Swanson makes the case for schedule management and smarter APP staffing ratios instead.&lt;br&gt; &lt;strong&gt;9:19 – 10:25 | P2 Management Minute&lt;/strong&gt; — Keith Reynolds shares practice management tips and invites listeners to send in their own workflow ideas.&lt;br&gt; &lt;strong&gt;10:25 – 12:12 | Is burnout the new baseline?&lt;/strong&gt; — Swanson says the industry has hit a new baseline, with one in three doctors citing burnout as a reason to leave, and argues it's still unsustainable.&lt;br&gt; &lt;strong&gt;12:12 – 14:43 | Why AI's payoff is so uneven&lt;/strong&gt; — The clear win has been ambient scribes at the bedside. Swanson urges patience on the next wave of gains and pushes back on the industry's short attention span.&lt;br&gt; &lt;strong&gt;14:43 – 14:57 | A quick aside on the OpenAI IPO&lt;/strong&gt; — A brief, lighter exchange. (Swanson: no personal investment advice.)&lt;br&gt; &lt;strong&gt;14:57 – 17:37 | The one number beyond work RVUs&lt;/strong&gt; — Total visit volume. Swanson makes the "back to the future" case for panel size and encounters, and a rethink of base-plus-production pay models as APPs absorb more volume.&lt;br&gt; &lt;strong&gt;17:37 – 18:30 | Closing thoughts&lt;/strong&gt; — Swanson expects 2026 baselines to be wonky and is already looking ahead to 2027.&lt;br&gt; &lt;strong&gt;18:30 – End | Outro&lt;/strong&gt; — Austin Littrell wraps the episode with a Fourth of July send-off.&lt;/p&gt;&lt;/div&gt;</description>

For the first time in years, physician pay and productivity have split, and a new Medicare efficiency adjustment is about to make 2026 a hard year to benchmark, schedule and recruit.

S1 Ep164: Pay is up, productivity is down. Is it sustainable? With Andy Swanson of MGMA

<description>&lt;div&gt;
&lt;p&gt;For years, Medicare and Medicaid effectively excluded coverage for the medications proven to treat obesity. That is starting to change. In 2026, CMS rolled out two new programs, the Medicare GLP-1 Bridge and the Medicaid-focused BALANCE Model, that open access to GLP-1 drugs for eligible beneficiaries and signal a shift toward treating obesity as a complex chronic disease. &lt;/p&gt;&lt;p&gt;In this episode, &lt;em&gt;Medical Economics&lt;/em&gt; Senior Editor Richard Payerchin speaks with Tracy Zvenyach, vice president for advocacy and research at the Obesity Action Coalition, about what those programs do and what they mean for primary care. Zvenyach explains how the two programs differ, the central role physicians will play in determining eligibility and why CMS's move represents a real policy shift after years of debate. She also digs into the persistent problem of drug pricing, where compounded GLP-1 drugs fit in, the place of metabolic and bariatric surgery in comprehensive care and the weight bias and stigma that still shape how patients are treated across the health care system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Music Credits:&lt;/strong&gt;&lt;br&gt;Cherry Blossom Memories by Cephas - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;/a&gt;&lt;br&gt;A Textbook Example by Skip Peck - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;br&gt;&lt;/a&gt;&lt;br&gt;&lt;strong&gt;Editor's note: Episode timestamps and transcript produced using AI tools.&lt;br&gt;&lt;br&gt;0:00 – 0:26 | Sponsor message &lt;/strong&gt;&lt;a href="https://www.copic.com/"&gt;Copic medical liability insurance&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;0:26 – 0:53 | Cold open&lt;/strong&gt; Zvenyach previews the throughline of the episode: the workarounds patients rely on are a direct result of a system that wasn't built to support people living with obesity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;0:53 – 1:42 | Introduction&lt;/strong&gt; Austin Littrell introduces the episode and guest, previewing the federal push to expand coverage of GLP-1 drugs and what it means for primary care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;1:42 – 2:50 | Meet Tracy Zvenyach and the OAC&lt;/strong&gt; Richard Payerchin opens the conversation, and Zvenyach introduces the Obesity Action Coalition, a national nonprofit focused on access to evidence-based obesity care and reducing weight bias and stigma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;2:50 – 4:19 | Is obesity finally treated as a disease?&lt;/strong&gt; Zvenyach reflects on 15 years of advocacy and says the old "eat less, move more" framing is fading as medical guidelines and policymakers increasingly recognize obesity as a complex chronic disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;4:19 – 6:46 | What primary care physicians are saying&lt;/strong&gt; Zvenyach describes a spectrum of clinician comfort with obesity medicine, from fully fluent to resistant, and says policy and coverage barriers make it hard for any of them to get patients the full range of treatments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;6:46 – 8:59 | What the BALANCE model does&lt;/strong&gt; Zvenyach explains the Medicaid-focused BALANCE model, which pairs GLP-1 access with a lifestyle support program at a negotiated $245 price, and notes the Medicare arm was recently split off into a separate program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;8:59 – 10:32 | BALANCE vs. the GLP-1 Bridge&lt;/strong&gt; The two programs share the same negotiated price and nearly identical clinical criteria, Zvenyach says, but are now split by population: Bridge covers Medicare from July 2026 through 2027, while BALANCE is a voluntary program for state Medicaid plans.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;10:32 – 12:30 | Eligibility and the physician's role&lt;/strong&gt; GLP-1 access won't be automatic. Zvenyach explains that clinicians must attest a patient meets BMI-based criteria, giving physicians a central role in identifying candidates for the programs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;12:30 – 13:21 | P2 Management Minute&lt;/strong&gt; Keith Reynolds shares practice management tips and invites listeners to submit their own workflow ideas.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;13:21 – 14:50 | Will there be enough time to prove it works?&lt;/strong&gt; With Bridge set to run only through 2027, Zvenyach explains CMS's plan to gather outcomes and cost data and potentially fold it into BALANCE in 2028, though carrying it forward depends on insurers opting in.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;14:50 – 17:31 | Why covering these drugs is a policy shift&lt;/strong&gt; Responding to the long debate over whether Medicare and Medicaid should pay for GLP-1 drugs, Zvenyach explains how prior administrations read the statute as barring coverage of "weight loss drugs," and argues these are obesity treatments, with weight loss being an outcome rather than the disease itself.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;17:31 – 19:47 | The drug pricing problem&lt;/strong&gt; Zvenyach summarizes the OAC's stance on antiobesity drug pricing: costs have fallen over the past 12 to 18 months, but coverage still isn't part of most standard benefits, leaving many patients unable to afford treatment even through alternative programs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;19:47 – 21:34 | Where compounded GLP-1s fit in&lt;/strong&gt; Zvenyach frames the rise of compounded GLP-1 drugs as a symptom of system failure, and urges patients to weigh the different safety and risk profile of compounded versus FDA-approved products while the OAC works to close the coverage gaps that push people toward them.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;21:34 – 23:15 | The role of surgery&lt;/strong&gt; Zvenyach makes the case for the full continuum of obesity care, including metabolic and bariatric surgery and newer endoscopic procedures, noting many patients need more than one type of intervention over the course of their treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;23:15 – 26:21 | Weight bias, stigma and people-first language&lt;/strong&gt; In her closing thoughts, Zvenyach points to weight bias and stigma as the root of many barriers, from exclusionary policy language to how exam rooms are equipped, and calls for people-first language and more respectful media representation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;26:21 – End | Outro&lt;/strong&gt; Austin Littrell thanks the guest and wraps the episode.&lt;/p&gt;&lt;/div&gt;</description>

Two new federal programs are opening Medicare and Medicaid coverage for GLP-1 obesity drugs, and Tracy Zvenyach of the Obesity Action Coalition explains what it means for primary care physicians and their patients.

S1 Ep163: What physicians need to know about Medicare's new obesity drug coverage, with Tracy Zvenyach, Ph.D., M.S., RN, of the Obesity Action Coalition

<description>&lt;div&gt;
&lt;p&gt;Health care hiring is in a strange place. Clinical job applications jumped 10% at the start of 2026, yet the gap between open positions and actual hires keeps widening, a sign that getting candidates in the door is only half the battle. &lt;br&gt;In this episode, &lt;em&gt;Medical Economics &lt;/em&gt;Managing Editor Todd Shryock speaks with Trent Cotton, head of talent insights at iCIMS, about what the data reveals and what physician practices can do with it. &lt;br&gt;Cotton explains why so many candidates drop out between the application and the offer, how smaller practices can out-recruit enterprise hospital systems by competing on candidate experience and why pay transparency in a job posting keeps the hiring funnel clean. He also digs into the friction that drives applicants away, the two factors that most influence whether staff stay and where AI genuinely belongs in hiring, from automated scheduling to the conversations that should always stay human.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Music Credits:&lt;/strong&gt;&lt;br&gt;Steady State of Mind by Yigit Atilla - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;/a&gt;&lt;br&gt;A Textbook Example by Skip Peck - &lt;a href="http://stock.adobe.com/"&gt;stock.adobe.com&lt;br&gt;&lt;/a&gt;&lt;br&gt;&lt;strong&gt;Editor's note: Episode timestamps and transcript produced using AI tools.&lt;br&gt;&lt;br&gt;0:00 – 0:26 | Sponsor message &lt;/strong&gt;&lt;a href="https://www.copic.com/"&gt;Copic medical liability insurance&lt;/a&gt;.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;0:26 – 0:57 | Cold open&lt;/strong&gt; Cotton frames the question driving the episode: how do practices fast-track top talent from hello to hire?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;0:57 – 1:39 | Introduction&lt;/strong&gt; Austin Littrell introduces the episode and guest, previewing what the latest data reveals about health care hiring and how physician practices can compete for talent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;1:39 – 3:14 | What's behind the surge in clinical applications&lt;/strong&gt; Todd Shryock opens the conversation, and Cotton explains the January jump in clinical applications, tying it to post-pandemic turnover leveling off and clinicians looking for better compensation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;3:14 – 4:35 | Why hires lag behind openings&lt;/strong&gt; Clinical openings are up far more than actual hires. Cotton points to a steep drop-off after the application, the gap between recruiter and hiring-manager interviews and the bureaucracy of offer approvals, with the fastest-moving practices winning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;4:35 – 5:57 | How a small practice out-recruits a hospital system&lt;/strong&gt; Cotton's answer is candidate experience. He argues smaller practices win by making hiring feel personal and frictionless, citing survey data that 60% of candidates abandon applications that are too long, opaque on pay or unclear on qualifications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;5:57 – 8:17 | Compensation and the case for pay transparency&lt;/strong&gt; Cotton says the data doesn't show practices have regained leverage on pay, and makes the case for listing compensation in the posting: it keeps the top of the funnel clean and avoids wasting everyone's time, even as he acknowledges why some employers hesitate to post pay.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;8:17 – 10:55 | The non-clinical side&lt;/strong&gt; Non-clinical applications are outpacing both openings and hires. Cotton attributes the slow pace to the same screening and scheduling bottlenecks, and urges understaffed practices to build a pipeline now, re-engaging strong past applicants before the candidate pool tightens.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;10:55 – 11:47 | P2 Management Minute&lt;/strong&gt; Keith Reynolds shares practice management tips and invites listeners to submit their own workflow ideas.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;11:47 – 13:44 | Removing friction from hiring&lt;/strong&gt; Cotton defines friction as any point where candidates drop off, and explains how AI-driven skills matching and job simulations are reshaping the process, including a notable shift among Gen Z candidates who now prefer assessments to compete on skills rather than résumés.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;13:44 – 14:46 | What drives retention&lt;/strong&gt; Retention comes down to two things, Cotton says: hiring for genuine skill fit and giving employees a visible career path, especially in high-volume and entry-level roles where people often leave simply because they can't see a future internally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;14:46 – 16:33 | Where AI belongs in hiring&lt;/strong&gt; Asked whether a hands-on practice has an edge over a hospital using AI, Cotton, a self-described AI advocate, says it depends entirely on where it's applied. He keeps the hiring-manager interview, the deeper recruiter conversation and the offer human, and automates much of the rest.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;16:33 – 17:28 | The next 12 to 18 months&lt;/strong&gt; Cotton points to growing concern about a shrinking candidate supply, and says recruiters are already getting creative, partnering with local universities to build talent pipelines and shape curriculum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;17:28 – 18:43 | Final advice and close&lt;/strong&gt; Cotton's parting advice: map your candidate journey, decide what only a human can do and what can be automated, then share that roadmap with applicants for transparency. Todd Shryock thanks Cotton.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;18:43 – End | Outro&lt;/strong&gt; Austin Littrell thanks the guest and wraps the episode.&lt;/p&gt;&lt;/div&gt;</description>

Clinical applications are climbing while hires lag behind, and Trent Cotton of iCIMS says the practices that win top talent are the ones that make hiring fast, personal and transparent.

S1 Ep162: From hello to hired, with Trent Cotton of iCIMS

<div>
Off the Chart: A Business of Medicine Podcast features lively and informative conversations with health care experts, opinion leaders and practicing physicians about the challenges facing doctors and medical practices. New episodes release every Monday and Thursday morning. Brought to you by Medical Economics and Physicians Practice.

Off the Chart: A Business of Medicine Podcast Staff

Hosts: Keith Reynolds, Austin Littrell 
Contributors: Chris Mazzolini, Todd Shryock, Richard Payerchin, Keith Reynolds, Austin Littrell 
Inquiries: Please email Hosts Keith Reynolds (<a href="mailto:kreynolds@mjhlifesciences.com">kreynolds@mjhlifesciences.com</a>) or Austin Littrell (<a href="mailto:alittrell@mjhlifesciences.com">alittrell@mjhlifesciences.com</a>) with feedback, questions, guest suggestions and more.

</div>

Off the Chart: A Business of Medicine Podcast

Details

Recent Episodes