St. Peter's Hospital has recruited a number of specialists in recent months, focusing on its new four-story patient wing as a selling point and attempting to work more closely with doctors already in practice here to identify the biggest needs and fill them quickly.

The hospital, which has been criticized at times for failing to recruit specialists in a timely manner, has landed several doctors in various fields, among them a pair of cardiologists, a gastroenterologist, a pathologist and a family-practice physician.

Officials say that among other things, the new $43 million patient wing, completed this spring, has made the job of recruiting much easier.

In addition to private patient rooms, the four-story tower includes a surgery wing, medical and oncology rooms and a birthing center. A concurrent remodel of parts of the hospital led to an expanded emergency room and intensive care unit.

"The patient wing is huge (for recruiting)," said Rick Hays, president of the hospital's board of directors. "All that state-of-the-art expansion is an attention-grabber, there's no two ways about it. So that's been very helpful in getting people to take another look. In any business when you come to recruiting, there's only so much value to the quality of life. And then you've got to move onto something else."

St. Peter's CEO John Solheim agreed.

"You look at equipment, we have almost all of the state-of-the-art equipment you can imagine, and that plays well," he said. "Then you go to facilities, we have a new medical office building (under construction across Broadway from the hospital) that will help us attract doctors.

"They want more exam rooms, they want to be close to the hospital. It's those things that they click off that the board's been really ahead of in getting that infrastructure. The scenery alone doesn't compete with the tools they need to do their job."

Two of the new recruits are a husband-and-wife team of cardiologists who began working at St. Peter's in mid-July. Carla Kingsley and John Ribic said they finally reached a point in life where it was possible to leave Ohio.

"We have been coming to Montana for the past decade, spending between two and four weeks each summer here," Ribic said. "But because of other responsibilities we weren't able to make (the move) until now."

Ribic said there are only a few cities in Montana that have the top equipment to allow the doctors to practice cardiology "the way we were used to in Ohio." Kingsley added that the new patient wing at the hospital was a selling point.

"It certainly made it a little more attractive to us," she said. "We probably would have come anyway, but this makes it much better."

But beyond the hospital, Ribic said he and his wife noticed differences in the city in the past several years, too.

"We've found dramatic changes over the past four years," he said. "The city is more upscale and it's been a pleasant surprise for us."

The search for cardiologists lasted just a month, according to hospital officials, though Ribic and Kingsley needed additional time to close their Ohio practice and move west.

"Instead of spending all their vacations here, they can live it," Solheim said.

Defining demand

For the past several months, a committee of administrators and doctors have met regularly to develop and refine a "most-wanted" list of specialists and other physicians needed in the community.

Some decisions are no-brainers, said David Lechner, a family practicioner and president of the St. Peter's Medical Group, representing the 35 doctors employed by the hospital. (A total of around 120 doctors have credentials at the hospital; those not employed by St. Peter's have private practices.)

For instance, everyone agreed there was a need to recruit a gastroenterologist to replace one who left.

"It was the highest priority for the medical staff. We've got the open position, we've got all the right staff, we have all the equipment - we just need to plug him in and go," Lechner said.

The search lasted a year, but gastroenterologist Michael Lee, coming to Helena from White Plains, N.Y., will start seeing patients here in a little over a week.

Other positions are a bit more troublesome. For example, neurosurgery. Lechner said that on the face of it, some people believe the capital city's hospital should have a neurosurgeon on staff, and they resent having to travel to Great Falls or Missoula for certain procedures.

But it's not that simple, Lechner said. For one thing, national statistics show a demand for .7 neurosurgeons per 100,000 people in a service area, a benchmark Helena doesn't reach.

Plus, Lechner said, "it would be a completely new service line we've never had at the hospital before."

As such, it would require not only a substantial salary commitment to the new doctor, but major investments in new equipment and training for nurses and other support staff who likely haven't worked with a neurosurgeon before.

Plus, a neurosurgeon might be seen as competition by orthopedic surgeons already in practice here, since both specialists perform certain spinal operations.

"Now you're threatening an existing structure - how does that piece work?" Lechner asked.

He said a neurosurgeon is currently not one of the top four specialties being recruited at St. Peter's.

Solheim said the hospital uses a biannual community survey to determine needs, in addition to asking doctors already in town how far out they're booked and how busy their practices are.

"Then we sit down with the doctors and try to get what is the right mix of physicians to come here," he said. "There's an art to coming to that conclusion, but our goal, from the board of directors, within reason, is recruiting those specialties where we have a gap."

Selling the city

Kendra Lenhardt, the hospital's physician liaison, spends her days working on all phases of recruiting doctors, from placing ads on Web sites and in professional journals to setting up sightseeing tours and arranging symphony tickets for prospective specialists in town for interviews. She agreed that the new wing has made her job much easier.

"They see that the hospital is willing to spend money on technology, and on advancing and improving for the community," she said. "Doctors like to see the technology."

Lenhardt said that in addition to selling potential doctors on the hospital, she often spends just as much time selling spouses on the community. She fields lots of questions about the arts, she said, and uses her contacts as a born-and-raised Helenan to find things for families to do.

"I find out what they like to do, and I show them we have it," she said.

Solheim said the market for physicians is national, and physicians at St. Peter's can earn around the national average for their various specialties here. So other factors come into play. Each visit by a recruit, in addition to meetings with doctors and staff, includes a real estate tour and some activities outside of work, whether it's a night at the theater or a day on the Missouri River.

"The issue is there are many opportunities (for doctors)," Solheim said. "It's a lifestyle choice, it's chemistry, it's the classic things. But usually if we can get them out here, they get off the plane, it's beautiful, we have a great airport that welcomes them with decent flights in and out, helps set the tone.

"Our odds are very good, once we get them here, that we can recruit them."

The hospital offers recruits a choice between employment and private practice. Some like the autonomy of having their own shop, while others - like Ribic and Kingsley - choose the employment route, allowing the hospital to deal with issues like billing and hiring staff so they can concentrate on practicing medicine.

Solheim said while the hospital is fairly confident in recruiting the people who make it to the point of visiting here, the visit isn't perfunctory.

"It's very structured, because we have to live with each other so there are a lot of candid discussions," he said. "It's not all glitzy stuff that we show them. We talk candidly about issues and they talk about what they want.

"Sometimes they mesh - most of the time they do - but other times it isn't a good fit. It's not just a show and tell, it's really (asking), 'What do you want to do, what does your spouse want to do, what do you want for your practice and is it a good fit?'

"We want them to stay. The worst thing is if they come and turn over."

Solheim said the hospital's turnover rate, around 5 percent annually, is below national and state averages.

The two specialties at the top of the list currently are a rheumatologist, for which the hospital has been searching for two years, and a urologist, which has been a five-month-and-counting search.

"It's extremely competitive, you can't stress that enough," Hays said. "It's just amazing how many options these people have. On the rheumatologist, we're down to the final wire, and we're neck-and-neck with another hospital, and that is so typical.

"If anything, it's surprising me that it's only two horses in this race. It's not unusual to be down to where a person has multiple choices and we're trying our best to figure out how we can woo them here."

Reporter John Harrington: 447-4080 or john.harrington@helenair.com