Hospitalists (see sidebar) specialize in the general care of hospital patients, collaborating with the primary care physician during the patient's stay. Getting the program up and running has been part of Alter's job. Originally, she said, the hospital planned to contract with a company to provide the services of these physicians, but decided last summer to go in a different direction.

"Once we decided, in August, everything came together rapidly," she said.

In addition, Alter said, "There are some others we hope will join us in the summer."

Besides recruiting the physicians, Alter worked with a nurse practitioner, Deborah Veronck AFNP, who began work in the Emergency Department last week. Veronck is from Macon County "She wanted to come home," Alter said. "She contacted me."

As a nurse practitioner, Verdonck is a "pioneer" of sorts in Angel's emergency room. "We have not had one in our emergency department before," Alter said. "She can take care of the less critical patients. It's important for patient satisfaction."

Alter came to Angel from a hospital in Pennsylvania, where she had worked in public relations and marketing, and as director of occupational health and employee health. She says she studied pre-med in college and originally planned to become a doctor herself. When that didn't work out, she became a respiratory therapist. Though she later went into administration, she feels her clinical experience gave her insights that are important in her present position. Her background, she says, gave her an appreciation for what physicians go through and helps her relate to them better.

"I have a great deal of respect for physicians and what they do. And, I like to see people come here and be as happy as my husband and I are."

Her happiness with Franklin makes it easy for her to sell the community.

"During my second (job) interview with board members and the medical staff, I remember saying, 'There's so much here!' Coming in fresh, I believe I have that ability to see it. I tell physicians, 'Here's what attracted my husband and I. Here's why we're here. Here are my experiences.'"

To get physicians to look at Franklin, Alter uses a number of tools. Some are different from those that recruiters depended on in the past.

"I use a lot of internet-based ads. I have a lot of photos on one site," Alter said, explaining, "You have to have an edge." Because her object is to reach clients who will love the area, she uses photos of local physicians doing the activities they enjoy the most, such as riding bicycles.

Using the web allows Alter to post lots of photographs that illustrate the beauty and quality of life the area offers. It helps that both she and her husband Ken are photographers.

The ads clearly work - they caught the eye of two of the doctors who will be coming to Angel soon.

To get the word out, Alter also uses fliers that emphasize the point: "Everything is better in the mountains." One flier features a photo of Drs. Doug and Shana Egge and their children at the Greenway.

"I want people to know this is a family-friendly area," Alter said.

Besides advertising, Alter also maintains contacts with residency programs and goes to some career fairs for residents. At the first one she attended, she set up a large photo of a waterfall taken by her husband. The lit display drew crowds.

One of the search firms she works with also makes use of the Alters' photographs. "The firm knows the area and what we are looking for. It serves as a first point of contact."

Once Alter makes contact with an interested physician, the next step is scheduling a telephone call. She says this first conversation will take up to 1-1/2 hours, but is a critical step in the process. "It's important for me to get to know the physician, and for the physician to know what we have here. It's a matter of making sure that the person is a fit. The physician has to be as good a fit for the community as we are for the physician," she said.

This important conversation helps Alter design an itinerary for the next step in the process, the physician's visit. For example, she'll arrange for a whitewater enthusiast to meet a fellow physician-kayaker and go on an outing. The spouses get equally thoughtful treatment because it is important for the whole family to feel they will fit into the community. The children are considered, too. Alter arranged for the 3-year-old son of one visiting physician to see his hero, Thomas the Tank. She also sets up visits to schools and says the school system has been extremely accommodating.

Next, the physician gets to check out the hospital. Alter makes this part sound easy: "The hospital tends to sell itself. The physicians are impressed by the technology, the cleanliness and attractiveness."

"Everybody is part of the recruitment team," Alter said. She wrote an article on this subject for the journal of the Association of Staff Physician Recruiters, which she serves as a board member. She says both the hospital and the community are big factors in a physician's decision. And they are doing a good job, Alter believes.

"'Everyone is so nice' is what I hear," she said.

She discovered that for herself soon after she moved to town. For the first four months, Ken was still living in Pennsylvania, so she was alone. She attended the Folk Festival on her first weekend and says that, though she knew no one, everyone made her feel welcome.

Alter gives special credit to the AMC physicians, their spouses and the staff of Angel Medical Center for the success she's had.

"My job is made much easier by the people I work with," she said. "They all play a part in it."

There is still plenty of work to be done. Angel is recruiting physicians in the fields of primary care, orthopedics, urology, general surgery and emergency medicine. And Alter is eager for them to discover that, in the mountains, "everything is better."