The good doctor: hospitals invest heavily in recruiting top medical talent because it's healthy for their bottom lines.

• Author: Martin, Edward
• Position: Health Care

Growing up in Missouri, John Bechtel excelled in math and science. He went to college to study engineering, but engineers seemed to spend too much time behind desks. "I wanted something more humanitarian." Now, more than 10 years later, he stands in the hallway of UNC Hospitals in Chapel Hill, scanning the chart of a middle-age woman. He orders medication to quell her vomiting. "She has just started radiation. She was just one of the unlucky ones. She was a nonsmoker, but she got lung cancer, and now it's metastasized to her brain."

This is not the predictable, precise profession he once pictured himself in, but Bechtel mingles medicine with technology as a radiation oncologist, bombarding cancers with precisely targeted jolts of radiation from a massive linear accelerator. Still a year from completing his five-year residency, he is for all practical purposes already employed, with a contract from the private practice he will join next June that guarantees him a hefty salary -- offers for new radiologists in North Carolina start at about $250,000 a year -- and the chance to become a partner in only two years.

Such are the stakes in physician recruiting, the relentless pursuit by hospitals, private practices, pharmaceutical companies and others of top doctors and young ones they believe might be among the best someday. If this were sports, Bechtel would be a first-round draft pick. Veteran all-stars, including many of those on the list that begins on page 48, can command much more. The rankings -- compiled for BUSINESS NORTH CAROLINA by Consumers' Checkbook Inc., a Washington, D.C.-based nonprofit -- were derived from surveys that asked doctors in the state's three largest metro areas whom they would turn to if they or their families needed treatment.

As a recruiting tool, it takes money, lots of money, to turn heads. Nationwide, to attract experienced cardiologists -- those that have practiced at least three years -- you can expect to pay an average of $434,607 a year, according to the 370-member National Association of Physician Recruiters, based in Orlando, Fla. But money isn't everything. Increasingly, recruiting is influenced by intangibles -- time off, lifestyle, continued schooling, retirement plans, a chance to own a piece of the business.

"We've seen salaries for top radiologists go from about $200,000 a year to $400,000 and now sometimes $600,000, with 20 weeks vacation and two days a week in which they look only at scans on the Internet -- they can do that at home," says Julie Phillips of APC Medical Resources LLC in Raleigh, which recruits doctors nationwide. "We had a heck for-profit hospital has recruited about 100 physicians since the early '90s when a study concluded that Randolph County's top health priority was getting more and better doctors.

North Carolina's more than 140 hospitals are the principal recruiters, either through in-house staff or...