Hiring a good doctor can be hard enough, but it's doubly difficult if your hospital is in the middle of nowhere and the closest big department store is 100 miles away.

That reality has been front and center for Kiley Floyd, the chief of Osborne County (Kan.) Memorial, a small critical access hospital in the northern part of the state. Convincing physicians to come aboard is challenging when they've never heard of the community, there are limited job opportunities for family members and it takes an hour to reach a larger facility.

"One of the things candidates ask me is 'How far is Walmart?' It's 100 miles," Floyd says. "So it's very difficult. If you can get a doctor who wants to do rural medicine, that's great. But you've got to convince their spouse that this is the place for them."

Osborne County Memorial tried using a larger-sized recruitment firm to fill some positions. But the price tag was hefty — about $50,000 per placement, Floyd says — and hires only stayed for a couple of years. It's gotten easier more recently, since Osborne County Memorial and 15 other hospitals in the region pooled their resources to find and share a headhunter.

Earlier this year, the Sunflower Health Network in Salina hired a full-time recruiter for its members. Participating hospitals pay a monthly fee of $125 to seek a midlevel practitioner, and $250 for doctors, along with a $10,000 to $15,000 placement fee if a match is found.

Sunflower's members already had been collaborating — on everything from joint purchasing to group health insurance — since the mid-1990s, when the network was formed, and it made sense to add recruiting to the mix, says Heather Fuller, Sunflower's executive director. Members even share a radiologist to help fill in when one goes on vacation.

"It's so expensive, just like anything else, for the critical access hospitals that don't have a lot of money," Fuller says. "They were being charged huge amounts from outside agencies and recruitment firms to get these doctors. So they thought, 'Why can't we work together on this, as we have on some of our other ventures and programs in the past?'"

The physician recruiter, Jill Mick, a native of Kansas, has ties to the community and nearby universities, and she is stationed in the Jayhawk state, rather than a big city in another part of the country. Since February, Mick has placed six doctors at member hospitals, most of whom came from nearby schools. Recruiting in the area has been key, she says, because candidates are familiar with the small towns.

Memorial Health System in Abilene once paid a recruiter for more than a year and a half to find a general surgeon, with no success, says CEO Mark Miller. Thanks to the Sunflower network, the hospital is close to signing up two physicians, after a short search, and is searching for a third.

Over at Osborne, with the help of Sunflower's program, the hospital has hired two doctors and a physician assistant. Even though Sunflower's members are competing for the same docs, they've remained professional about it, and participants know that winning the candidate is about making the best pitch.

Floyd thinks rurals everywhere need to find partners if they want to continue thriving. "Nobody can fly by themselves anymore. You cannot do it without help from your friends in this business," she says.