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May 2009

by Gerard MacCrossman

Talent on their Doorstep

Photo of doctor and patient courtesy of Scott and White

Scott & White offered
skills and found a work force
in its small Texas city.

Every big organization had small beginnings. For some, growth means leaving roots behind to serve a bigger market. Think H-E-B, which was founded in 1905 in Kerrville (current population 22,750), but moved its headquarters decades ago to San Antonio as it mushroomed from a single store to more than 300 grocery store locations in Texas and Mexico.

Scott & White Healthcare’s roots are just a few years older, but while the original two-doctor practice has morphed into a huge nonprofit organization with more than 7,000 employees, including 700 staff physicians and research doctors, its headquarters still are in Temple, Texas’ 45th largest city by population with about 55,000 residents. No longer is it simply doctors treating patients – now it’s hospitals, regional clinics, a medical school, a health care plan and even a credit union – almost a city in itself.

CEO Dr. Alfred Knight says Scott & White has learned over the years to be aggressive about recruiting skilled staff and teaching its existing employees new skills to meet patient needs.

And from a small beginning, Scott & White has created a high demand for more workers throughout the area.

Aggressive recruitment

While jobs are disappearing throughout the economy, hospitals continue to hire. Throughout the spring, Scott & White’s openings numbered 300 to 400. This is about half the openings during the same period in 2008, not because the number of employees is fewer, but because of changes implemented in the recruitment process. At about 17 percent, the organization’s employee turnover is below the 20 to 21 percent national average for health care, says Keith Minnis, Scott &White’s director of recruiting and retention.

On Cue

Watch video of Scott & White CEO Dr. Alfred Knight talking about the organization’s growth in Central Texas by visiting the T2 Summit online at

Dr. Alfred B. Knight, CEO at Scott & White Healthcare

“We took a look at our career and job fairs. We discovered 90 percent of our media advertising efforts were newspaper- related and focused on Central Texas,” he says. “This year, we began to market, advertise and physically go to career fairs in Kansas, Iowa and Oklahoma.”

The application process – particularly online recruitment – and Scott & White’s brand presence was expanded, too.

“A registered nurse [RN] can get a position in four days,” Minnis says. “We know we have to get an application in front of the hiring manager today. Otherwise we have lost that candidate. We have hardwired that process within the system to decrease our time to hire, time to fill and cost to hire.”

Internal candidates also are given an opportunity to move up the organization’s ladder – getting three days to apply for a job before it is advertised externally, he says.

“It’s a strong message to our work force: we want to invest in you, and look to you before looking for external candidates,” Minnis says.

Growing Your Own

Working with internal candidates has been key, according to Knight.

“We also learned at the very entry level in our organization that to entice a clerk to become a health care aide, then perhaps a licensed vocational nurse (LVN), then a RN, that they needed help while working full-time,” he says. “We have many of our entry-level employees on a track where they can work full-time, gain the skills needed to move all the way through to a masters in nursing on-site, and utilizing our affiliations with many great community colleges and universities throughout the state.”

Training medical staff comes in a broad range of programs: from entry-level medical care including certified medical associates (CMAs) and LVNs to degreed nurses through to physicians.

Mary Pat Lambden, academic advisor to students in the RN to Master of Science in Nursing program, says Scott & White is tightly allied to several nursing schools.

“We meet with them regularly,” she says. “Knowing when you come here that you have tuition reimbursement enhances recruitment. We also have a career ladder where nurses can advance by meeting certain criteria.”

Photo courtesy of Scott & White

Scott & White History

Scott & White Memorial Hospital was established in 1897 by Drs. Arthur C. Scott, Sr. and Raleigh R. White, Jr.

They also established a school of nursing there and continued to provide services for railroad workers. The hospital was first called Temple Sanitarium, but in 1922 the name was changed to Scott & White Hospital. It was converted to a nonprofit foundation on Dec. 23, 1949.

In December 1963, it moved to its present location, a 636-bed hospital and clinic, and has grown to fill more than one million square feet of space. Scott & White’s 50 satellite clinics span eight counties throughout Central Texas, making it the state’s largest multi-specialty group practice.

Offering opportunities to advance skills and training has proved effective for recruiting nursing staff.

“We have internships for new graduates in many areas,” Lambden says. “We provide new graduate nurses with continuing education and the necessary time where they can go from novice to more experienced in the clinical setting.”

There are positions for health care professionals across the career ladder. At the entry level, Scott & White’s hospitals and clinics compete with nursing home and private care operations for LVNs. In clinics scattered around Central Texas, the pace is more rapid than in nursing homes and similar facilities, making it tough to recruit nurses. So Scott & White has taken another route, collaborating with Temple College to train CMAs, who can perform a wider range of tasks than nursing aides.

“It’s an expanded job for clinical areas,” Lambden says. “During a 10-month online program, students do their didactic online and attend the clinic sessions on evenings or weekends, so they can continue working.”

The inaugural CMA class – all existing Scott & White employees – is under way. The majority of students are clinical employees who will earn higher pay upon completion.

Knight says the health care industry will continue to grow and will change radically during the next decade.

“There’s always going to be a need for the highest quality health care. It’s pretty solid,” he says. “Our approach to the work force is not to sit back and whine about not having quality, qualified employees.”

Unusually, Scott & White is physician-led, and it is unique among Texas health care organizations in that it employs all of its physicians. Knight says the health care work force will continue to evolve to enhance patient care while finding new efficiencies.

“To do that the work force must change,” he says. “It has to be elevated in sophisticated ways.”

That has meant adding partnerships over the years. Scott & White partners with Texas A&M’s Health Science Center College of Medicine to train physicians at its four-year medical school. A new partnership recently was signed with the University of Texas at Arlington for Scott & White staff to receive a discounted tuition rate in the RN to BSN program.

Sharing skills benefits Scott & White over time, too.

“We participate in a faculty-sharing program: employees who work here and teach at University of Mary Hardin-Baylor, Temple College and Central Texas College in Killeen, which houses Tarleton State University’s Central Texas campus,” Lambden says. “They have added an RN to BSN completion program serving approximately 400 students per semester.”

Preparing future scientists

Training isn’t reserved for Scott & White’s employees. A partnership with Temple College, the Temple Health and Bioscience District, area school districts and others has led to the creation of the Texas Bioscience Institute where students can study an enriched curriculum in math and science beginning in their junior year of high school.

“They also can do on-the-job training in our research labs,” Knight says. “At the end of two years, these students can have two years of college credits, an associate degree and a high school degree. There’s a waiting list for this kind of opportunity.” FN

Find out more about Scott & White’s educational opportunities at

Learn about the Texas Bioscience Institute at

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