just curious, but since you mentioned your area is poor, busy, traumas, and there are many others in the area, do you mean its difficult to compete with the nearby places with better payor mix
there are more than 6 different entities in my area that you can work for..
all are going to offer you ~400k, 6-8 weeks vacation, nebulous end of year bonus, full time call taking... i have had offers from them all and they are all pretty much the same.
what separates them is what the job actually entails...
one place is a big academic place and you know your going to be busy, doing traumas, but academic like (cush) hours/resources..
most other places are smaller hospital systems/groups where call is usually from home, traumas happen but not major ones, where a crani would be a big deal
some hospitals/systems are in nicer, affluent, safe areas, some are in horrible areas..
we had the combination of busy and serious in-house call, horrible area, yet resources/infrastructure stretched like that of a small-medium private hospital..
compared to the work environment of our competitors, you had to come to us looking to do call/trauma/serious stuff in a S hole no-name hospital
lots of people took jobs with lighter call and nicer hospitals/areas
lots of people took the academic job with the better-defined hours
And that was from a pool of not a lot of people to begin with..
For me it was my home hospital servicing my hometown so that was my connection, and there was the opportunity for true partnership.