My thoughts...
Always, direct contact works best. Call the people you want to work for, tell them, ask how to get in the door. (This assumes you know where you'd like to work.)
If you want corporate positions, start by logging into the corporate websites and uploading your resume. In a lot of cases, other than temp agencies, this is required to get into a corporate job.
If you want to work for a govt job (like a hospital) contact them to find out if you can fill out the forms online or if you need to come in. Often, it is required to actually show up at a hospital to apply for a job.
Faxing your resume to lots of people is cheap to do, but usually ignored by large businesses. Gotta get in their database and they consider this your job. Enter it on their website. Don't hesitate to get your resume in their queue.
Recruiters can help, but they do take their cut. They can also demoralize you intentionally to try to keep you from working outside their network. They take some of the hassle, but at a cost.
Tell your friends your looking. Sometimes they're looking to hire.
Go to professional meetings. I'm a programmer and I go to a lot of user group meetings. Sometimes, I'm looking to hire and if I see someone I can get along with...