[Infographic Guide] 5 Physician Practice Trends to Watch

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The landscape in which physicians practice is constantly evolving, requiring physicians, administrators, and recruiters to adapt. While the COVID-19 pandemic was something no one could have predicted, it has accelerated many of the physician practice trends that were already underway in the healthcare industry. Rising physician burnout, renewed interest in rural healthcare, and sustained demand for telemedicine by patients and providers are just a few of the shifts that the industry will need to accommodate. Certainly, some of these trends will impact advanced practice provider and physician recruitment as well. Whether you are an administrator, physician recruiter, a physician, or an advanced practice provider, here are five physician practice trends to watch.

1. More Than Half of Physicians Report Burnout

48% of Generation X, 38% of Millenials, and 39% of Baby Boomers are burned out.

Female physicians are more burned out than their male counterparts, reporting 48% and 37% respectively. Yet 28% of physicians report that their employer does not offer a program to mitigate burnout.

Due to COVID-19, 54% of physicians plan to make an employment change. 36% of those respondents are considering early retirement or leaving medicine altogether and another 50% are considering leaving their current employer for another.

Sources: September 2020 Modern Healthcare Article, January 2020 Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide, February 2021 Jackson Physician Search Physician Retention Survey Results White Paper

2. More Physicians are Employed

For the first time, less than 50% of doctors work for a private practice and close to 40% work for a hospital, or fully or partially hospital-owned practice.

57% of women and 47% of men are employed.

Family Medicine Physicians:

  • 58% are employed
  • 39% own their own practice
  • 3% are independent contractors

General Surgeons :

  • 53% are employed
  • 42% own their own practice
  • 5% are independent contractors

OBGYNs:

  • 46% are employed
  • 48% own their own practice
  • 6% are independent contractors

Radiologists:

  • 37% are employed
  • 54% own their own practice
  • 9% are independent contractors

21% of residents are planning on owning their own practice, 28% are seeking employment, and 20% are considering both options. Recent graduates often seek larger organizations that can offer secure employment.

Increase in Physician Practice Acquisitions During COVID: From January 2019 to January 2021 there was a 21% increase in the number of physician practices owned by corporations or hospitals.

Sources: 2020 AMA Physician Practice Benchmark Survey, May 2021 Advisory Board Article, June 2021 Physicians Advocacy Institute Study

3. More Physicians Considering Rural Healthcare

20% of the US population lives in rural locations, but only 11% of physicians practice there.

“We’ve seen a significant influx of candidates seeking physician jobs in the Midwest. Physicians want to come back to the Midwest to be near family, but there are others who are just looking for a slower pace of life, away from busier metropolitan markets.” – Carly Clem, Jackson Physician Search Regional Vice President of Recruiting

Source: February 2020 AAM Article, July 2021 Jackson Physician Search COVID Changed the Physician Job Market White Paper

4. More Physicians in Demand

The current AAMC numbers project a physician shortage of between 37,800-124,000 by 2034.

The physician specialties in the highest demand:

  • Primary Care
  • Internal Medicine
  • Emergency Medicine
  • Psychiatry
  • Obstetrics and Gynecology

Physician Shortage Estimates by Specialty

  • Primary Care – 48,000
  • Surgical Specialties – 30,200
  • Other Specialties – 35,600
  • Medical Specialties – 13,400

Sources: June 2021 AAMC The Complexities of Physician Supply and Demand: Projections From 2019 to 2034 Report, May 2021 St. George University Article

5. More Telemedicine

31% of healthcare leaders expect their use of telemedicine to increase in 2021.

86% patient satisfaction score for telehealth services.

Visit our thought leadership page for more helpful presentations, case studies, and infographics.

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[White Paper] COVID-19 Changed the Physician Job Market: What Happened and What’s Next for Physician Jobs?

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Ask how the COVID-19 pandemic impacted physicians and you’ll get as many answers as there are physicians. Each one has and continues to experience the pandemic differently, however some common themes emerge. From the battle-worn emergency medicine physicians and hospitalists who experienced COVID-19 up close in ERs and ICUs, to the primary care physicians and psychiatrists who seamlessly transitioned to telemedicine, to the surgeons who were forced to stop working altogether, physicians’ experiences with the pandemic will certainly influence how they move forward.

As we continue to recover, we asked:

  • Are physicians thinking differently about their careers because of COVID?
  • For those seeking change, what are their job prospects?
  • How did COVID impact the way healthcare organizations will now approach physician recruiting?

Physician Recruitment Continues to be as Dynamic as Ever

As the President of a national physician recruitment firm, I regularly check in with our teams of physician recruiters working all over the country to learn what’s happening in their specific markets. I recently interviewed the Regional Vice Presidents of Recruiting in each division to get their takes on how COVID is changing the physician job market.

These Jackson Physician Search VPs lead impressive teams, but they too are in the trenches, working daily with physicians and healthcare organizations in every imaginable setting—from big urban markets to some of the most rural parts of the country. After speaking with each of them at length, I can share that the news is positive for physicians seeking jobs. Physicians are in high demand, so it’s not surprising to hear that healthcare organizations are rolling out the red carpet to attract the best candidates.

Included within the paper are insights gleaned from speaking with four Regional Vice Presidents of Recruiting at Jackson Physician Search. I’ll not only share observations on the current market, but I’ll also provide actionable takeaways for both physicians seeking new opportunities and the organizations that seek to hire them.

Six Takeaways

  1. After a temporary dip, demand for physicians is once again high as patient volumes begin to return to pre-COVID levels while an increased number of physicians report they plan to retire or change jobs.
  2. More physicians than typical are leaving large metropolitan areas and considering jobs in alternative markets.
  3. Interest in telemedicine continues to increase, but its future is uncertain as post-COVID reimbursement rates are still to be determined.
  4. Heightened physician demand has yet to cause significant changes to base compensation and signing bonuses, but the lingering effects of the pandemic will likely shift other aspects of physician compensation.
  5. Virtual interviews and site visits are here to stay as both parties benefit from the convenience and time saved.
  6. Flexibility and an open mind are still critical in the physician job search for both physicians and those who seek to hire them.

Download the Paper to Get Important Insights about the Current Physician Job Market 

For more information about how your healthcare organization can use this paper to improve your physician recruitment results, contact Jackson Physician Search today. Our team is made up of healthcare industry professionals who have spent decades recruiting physicians, physician leaders, and advanced practice providers for healthcare organizations coast-to-coast.

About Jackson Physician Search

Jackson Physician Search is an established industry leader in physician recruitment and pioneered the recruitment methodologies standard in the industry today. The firm specializes in the permanent recruitment of physicians, physician leaders and advanced practice providers for hospitals, health systems, academic medical centers and medical groups across the United States. Headquartered in Alpharetta, Ga., the company is recognized for its track record of results built on client trust and transparency of processes and fees. Jackson Physician Search is part of the Jackson Healthcare® family of companies.

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[Infographic Guide] Five Benefits of Hiring Advanced Practice Providers

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Recently we discussed how advanced practice providers could be a solution to the growing physician shortage. Next, learn some of the benefits of adding APPs to your staff.

1. Increases Patient Satisfaction

More than 90% of patients trust advanced practice providers (APPs) and believe that they perform high-quality care, according to an article by Wolters Kluwer, a global provider of professional information. Patients also feel that they will get more time with an APP versus a physician.

Healthcare facilities that staff APPs may have a shorter appointment wait time, which directly results in higher patient satisfaction scores and an increase in patients referring your practice to friends and family.

2. Boosts the Bottom Line

APPs see the same number of patients as physicians, while costing your facility less to employ. It is not uncommon for a Physician Assistant to bring in revenue worth several times their salary, resulting in approximately $300K in additional revenue for your facility.

The use of APPs can provide physicians the opportunity to concentrate on higher revenue-producing procedures and services or procedures not in APP’s purview.

3. Reduces Physician Burnout

According to a survey by SullivanCotter, 79% of physicians agree that APPs help reduce physician burnout.

By including APPs in your medical staffing plan, you allow physicians to focus on the services that interest them the most, as well as increased flexibility in scheduling which can decrease feelings of burnout.

During the height of the COVID-19 pandemic, many government regulations were lifted. This increased autonomy for APPs and took some pressure off of physicians. Without their help during this dire time, the physician burnout rate could have been even more severe.

4. Improves Physician Retention

According to the 2021 Medscape Physician Lifestyle & Happiness Report, 47% of physicians would take a pay cut for a better work-life balance. Perhaps employing APPs could provide your physicians with more harmony in their personal lives, resulting in happier physicians who will stay with your facility long-term.

5. Expands Clinical Services and Patient Access to Care

APPs often undergo broad training which allows them to be flexible and knowledgeable in many different settings. This skill set could allow your organization to expand its service offering.

Staggering schedules between physicians and APPs could grant your facility the ability to obtain new patients during off-times. Consider hiring APPs to supplement resident duty hour restrictions or to man a satellite office.

Visit our thought leadership page for more helpful presentations, case studies, and infographics.

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Are Advanced Practice Providers a Solution to the Growing Physician Shortage?

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One of the silver linings of the COVID-19 pandemic was the way in which it renewed public appreciation for healthcare providers. Among those on the frontlines, a sense of “we’re all in this together” developed, helping to lift spirits when they needed it most.

Of course, it wasn’t only physicians fighting COVID on the frontlines. Nurse practitioners (NPs), and physician assistants (PAs) were called on in new ways. Governors and state legislators passed measures to loosen restrictions placed on these advanced practice providers (APPs). As a result, they were empowered to do everything in their ability to test, diagnose, and treat patients in emergency rooms, COVID units, and ICUs around the country. Now, more are wondering if APPs are underutilized. Could they be a viable solution to the growing physician shortage – or at least fill more of the gaps?

While there’s no doubt that APPs can help to meet patient demand, debate has intensified around the appropriate scope of practice and level of supervision. As vaccine rollout continues and the volume of COVID-19 cases falls, the temporary measures boosting the autonomy of NPs and PAs are beginning to expire. Will this debate impact the demand for advanced practice providers? It’s highly unlikely.

Scope of Practice Debate Carries On

Even pre-COVID, experts pointed to APPs as a key component in minimizing the impact of the physician shortage, one that is expected to reach a deficit of 139,000 doctors by 2033. As the aging population requires increasing healthcare services, APPs are able to offer continuity of care to patients during a temporary physician vacancy. Nurse practitioners and physician assistants are trained to provide many of the same services as physicians, often at a lower cost to the insurer and lower overhead for the practice.

The suggestion that PAs and NPs can replace physicians in certain care settings has long been a point of contention. Representing the concerns of physicians around the country, the American Medical Association has fought scope of practice expansion at the state and federal level for over 30 years and shows no signs of conceding.

Certainly, physicians have more education and training than APPs. However, on the other side of the debate, some say the regulations that prevent APPs from performing the services they have been trained to do unnecessarily limits access to care to the detriment of the population.

Despite the ongoing debate around scope of practice, many physicians are more than happy to share the patient load with NPs and PAs, just as many APPs are content with the status quo on scope of practice and supervision requirements. Patients, too, are happier when APPs are part of a care team. Many patients feel that these providers take more time with them during a visit and are more empathetic than their physicians.

Regardless of where you land on the debate, organizations must ultimately determine the best staffing mix for their particular environment. In most cases, a combination of physicians and APPs will be necessary to provide optimal care for patients.

Considerations When Hiring Advanced Practice Providers

 If there is still any doubt, a recent report by MGMA states that practices that utilize APPs continually perform better financially than practices that do not. Even with this data at hand, there are still several things to consider when hiring advanced practice providers:

  • How will your physicians feel about the hiring of APPs? Will they embrace the additional help or feel their hiring threatens physician jobs?
  • State regulations require APPs to have some level of supervision or collaboration with physicians. Will your physicians view hiring APPs as yet another responsibility added to their plate?
  • How will your organization measure the ROI on hiring APPs? While hiring advanced practice providers costs less than hiring physicians, in most cases, APPs are reimbursed at a lower rate. Determine how many patients the provider will need to see in order for hiring them to make financial sense.
  • Know the restrictions placed on APPs in your state and understand that the current status may change.
  • Engage APPs consistently for long-term retention. These providers need to feel they serve an important role as part of the patient care team and as part of the internal team culture. Including them on your website, encouraging them to lead meetings, invite their feedback on ways to improve operations and patient satisfaction, and provide time off to pursue additional education and CME courses.

While there is much to consider, hiring APPs can potentially give organizations a strategic advantage. The ideal staffing mix will vary by organization, but the addition of NPs and PAs can increase profitability, improve patient satisfaction, and even ease physician burnout caused by lengthy vacancies.

As a trusted recruitment partner, Jackson Physician Search can help you find the talent you need to optimize your staffing mix. Whether you are looking for a physician or advanced practice providers, our recruiters are ready to serve. Contact us today.

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7 Things to Know About Advanced Practice Providers

1. Who are Advanced Practice Providers?

Advanced Practice Providers (APPs) include Nurse Practitioners, Physician Assistants and Advanced Practice Registered Nurses (Clinical Nurse Specialists, Certified Registered Nurse Anesthetists, and Certified Nurse Midwives). While their salaries are similar, their training is different. NPs are registered nurses who have a master or doctorate degree, while PAs often have a medical training background such as surgical.

2. How Many Advanced Practice Providers Jobs are in the US?

Approximately 125,000 PAs are currently working in the US

Approximately 263,000 NPs are currently working in the US

3. …In the Future?

According to the Bureau of Labor Statistics Occupational Outlook, growth projections for advanced practice providers are much faster than the average for other professions. Projected growth for APRNs over the ten-year period 2019-2029 is 45%. Over the same period, physician assistant jobs are projected to grow by 31%.

4. How Much Do Advanced Practice Providers Jobs Pay?

The Occupational Outlook notes the median pay for Physician Assistants at $115,390 ($55.48 per hour) and for APRNs $117,670 ($56.57 per hour).

5. What Can Advanced Practice Providers Do?

Despite national accreditation, the services an APP is licensed to perform are dictated by state regulations. PAs require some kind of physician supervision in every state, though they do have prescribing privileges and a fair amount of autonomy. Many only consult their supervising physician when the PA deems it necessary.

Nurse Practitioners can practice independently and be reimbursed for services under CMS guidelines. In 22 states, NPs have full practice authority, meaning they have the ability to practice to the full extent of their education and training.  This map highlights states with temporary measures in place.

6. How are Advanced Practice Providers Reimbursed?

Services provided by APPs are typically reimbursed by Medicare at 85% of what would be paid for a physician performing the same service. “Incident-to” services may be paid at 100%. Because they bill independently, APPs allow a practice to increase its patient volume and grow revenue.

7. Why are Advanced Practice Providers So Important?

Advanced Practice Providers are essential to meeting the healthcare needs of an aging population and expanding access to healthcare in underserved areas. There are simply not enough physicians coming out of medical school to fill the healthcare needs of society, and while advanced practice providers cannot replace physicians or solve the physician shortage entirely, they can provide many services and free up physicians to focus on more complex conditions.

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Rural Healthcare Facing Mounting Physician Recruitment Challenges

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Rural healthcare organizations are facing ever-mounting financial, recruitment and patient care challenges in the “new normal.” Fortunately, the next wave of financial help is on the way. The U.S. Department of Health and Human Services (HHS) announced last week that $4 billion in COVID-19 relief funds were being released to safety-net hospitals, with $1 billion of that for 500 specialty rural hospitals, urban hospitals with certain rural designations from Medicare, as well as hospitals in smaller metro areas. HHS approximates that payments will range from $100,000 to $4.5 million for rural designated providers.

Clearly, this is good news for rural health facilities that are facing an uptick in COVID-19 cases, many of which were already financially struggling. Financial concerns aside, proper staffing planning is also key to providing adequate access to care, so the key going forward will be for rural healthcare administrators to continue to find innovative ways to attract physicians to their facilities. Let’s frame the issues impacting rural physician recruitment and outline a few strategies for success.

Physician Shortage Predicted to be More Extreme than Previous Estimates

The annual report published by the Association for American Medical Colleges (AAMC) has been highlighting the growing shortage of physicians, and the most recent numbers show the situation worsening. According to AAMC, the healthcare industry is facing a shortage of up to 139,000 physicians by 2033. Typical for these annual reports, Primary Care physicians are still seeing the most significant deficits with shortages up to 55,200, while surgical specialty shortages are expected to reach 28,700 over the next decade.

Further, as highlighted in the Jackson Physician Search The Realities of Physician Retirement Survey, up to 33% of practicing physicians are nearing or at retirement age. The stress and unknown elements surrounding the COVID-19 crisis has only exacerbated the desire for many physicians to consider pursuing an early full or partial retirement.

Typically, when people retire, they seek a quieter lifestyle that provides them with a chance to stretch out and enjoy the life they have worked so hard to build. Not surprisingly, 44% of physicians who responded to the survey stated that lifestyle is the main driver of their retirement decision.

On top of that, 30% of physicians say that they are planning to work full- or part-time somewhere else. Consider ways to create those opportunities for pre-retirement physicians who are looking to slow down. While it may seem counter-intuitive, now could be the perfect time to lure physicians out of the chaotic urban and metro centers, and into a more laid-back and lifestyle-friendly rural environment.

Physicians Value Culture Fit

A common theme from physicians in today’s climate is how important organization culture and fit are in job satisfaction. Physicians that feel engaged in the work and have shared values with the organization are happier, more productive, and less susceptible to suffer feelings of burnout. The same proves true for community fit. In a Jackson Physician Search Rural Physician Recruitment Survey, physicians said community culture fit was more important than compensation when choosing to practice in a rural community. Dig into the Rural Survey for additional key findings to improve your recruitment success.

Rural health system administrators should be aggressively recruiting physician candidates now if their 2020-21 staffing planning requires more providers. At any given point in time, as many as 75% of physicians are passively exploring their career options. This means that they may not be actively applying to job opportunities, but they are more than willing to listen if something catches their attention. Reaching these passive candidates is critical for rural health systems, and now more than ever, the best way to reach physician candidates is via a well-conceived digital recruitment strategy.

Spend Time in the Digital World

Armed with the knowledge that overwhelming numbers support the fact that physicians, like most Americans, are extremely active on social media, Rural health system recruiters should have a strategy to meet physician candidates where they are – online. The American College of Physicians claims that over 70% of physicians are on Doximity, and over 30% are using social media for their professional networking.

Here are a few tips for using SEARCH as a framework for your digital recruitment strategy:

  • Segment – Instead of pushing out messaging content for the sake of it, target physicians who may not only be interested in your message but have the skillset you need, and are a cultural fit for your organization.
  • Engage – Here is where a rural system can shine. Publish content that highlights your brand and illustrates a sense of community that engages physicians, their peers, and colleagues.
  • Authentic – Make sure your digital outreach conveys a voice and tone that speaks to the culture you have built. Staying true to that consistent tone builds the foundation for physicians to be able to understand who you are and the values you espouse.
  • Relevant – Any digital content that you publish should be planned and well thought out to make it something relatable and important to your target audience.
  • Credible – Another way to set your rural health system or facility apart is by infusing credibility into your messaging. Create reasons why candidates would want to become a part of your organization by promoting your mission, values, and community value.
  • Habit – Cultivating a digital presence does not mean one and done. You could publish a piece of content that creates an “a-Ha” moment for your audience, but then if you disappear for six weeks, you have lost their engagement. Maximizing the digital opportunity is much like growing a vegetable garden. You don’t have to work on it every day, but if you don’t tend to it regularly enough, you will never experience the fruits of your labor.

The key is knowing that physicians are willing to listen, and now it is a matter of reaching them with your message.  If your rural health system needs support in developing or executing a digital recruitment strategy, consider partnering with the healthcare recruitment professionals at Jackson Physician Search. Our decades of experience has afforded us the ability to maintain a nationwide pool of candidates and to develop the technology and tools to help you fill your most challenging vacancies.

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Now More Than Ever, Physicians Should Practice Self-Care

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Globally, everyone is dealing with the effects of COVID-19, including stress and uncertainty.  One subject that isn’t discussed often enough is the mental trauma being experienced by the physicians and frontline healthcare workers.  Recently, Tony Stajduhar, President of Jackson Physician Search interviewed Dr. Russell Livingston, a psychiatric physician, to discuss ways that physicians can mitigate and overcome the trauma they are experiencing due to the current healthcare crisis.

“The pandemic is unique in that the entire nation, the world, in fact, is trying to cope with the exact same stressor,” Dr. Livingston explains.  “And in times of stress, human nature seeks to find more certainty, even when there is no indication that certainty is a realistic expectation.”

For example, it is still unclear how vulnerable physicians are to COVID-19. Even with the utilization of PPE, it is impossible for any of them to have certainty as to the level of risk they are facing, and by extension, the impact and risk potential for their loved ones.

According to Dr. Livingston, the type of psychological trauma you are experiencing, especially in the hardest-hit areas of the pandemic, is increasing the risk of burnout and is causing an emergence in symptoms of Post-traumatic stress disorder (PTSD). The dangers with this are two-fold. First, experiencing symptoms of PTSD causes physical and psychological damage. Feelings of depression, avoidance, lack of focus, feeling overwhelmed, can all have long term effects. Secondly, from a patient perspective, when physicians are experiencing the effects of PTSD, the quality of care suffers.

Mitigating the trauma being experienced by physicians and other healthcare providers at the frontlines of this pandemic is going to take a multi-faceted approach. You can implement mitigation strategies on an individual level, while hospitals and healthcare organizations can implement system-wide programs.

Steps Physicians Can Take to Mitigate Trauma Caused by the Pandemic

Dr. Livingston recommends that the first thing a physician should do is engage in reflection and do a self-inventory. As with a patient, it is critical to honestly assess whether prolonged exposure to trauma is manifesting in any physical or mental symptoms.  An honest approach to this exercise will help determine what strategies can be employed to mitigate stress.

There is no magic cure for addressing the stress and trauma being experienced by physicians and frontline healthcare professionals throughout the COVID-19 pandemic. However, as with any other wellness strategy, the most important things that anyone can commit to are the big three: Sleep, Nutrition, and Exercise! Physicians already know this, but the challenge is committing to making the behavioral change required to get the expected results.  Here are a few things to consider:

  1. Sleep, nutrition, and exercise should be addressed in total, rather than as three distinct strategies. All three work in concert to improve wellness, so only focusing on one or two will not drive the results that are needed.  When considering exercise, walking can be beneficial, but reducing the symptoms of trauma and anxiety requires 30 to 45 minutes of aerobic activity, at least three times per week.  Further, it is critical to modify any personal habits that interfere with one’s ability to adequately address this approach to improving wellness.
  2. For many, Yoga and Meditation can be effective strategies to help balance mental wellness. Practicing yoga improves overall fitness and flexibility, while meditation can promote emotional improvement through deep relaxation techniques in as little as ten-minute intervals.
  3. During periods of extreme stress and anxiety, one often overlooked strategy is to engage in a creative activity. Inherently, the act of creating art relieves stress and stimulates areas of the brain which promote a sense of balance. Studies have shown that engaging in creative endeavors increases the production of dopamine, thereby encouraging a feeling of well-being.
  4. As a physician, your expectation is that when individuals need medical treatment, they will rely on you to help them. That same logic applies to physicians who have or are suffering from mental trauma caused by the pandemic. Sometimes, the above-noted strategies aren’t enough to mitigate the stress and anxiety you are feeling. Never hesitate to seek professional help if you are unable to overcome the trauma you have experienced. Trained mental health professionals can help you cope and provide you with additional resources to address your mental well-being.

System-wide Approaches to Stress Mitigation

Proactively, hospital and health system administrators should be addressing the physical and psychological trauma the pandemic has created for their staff.

“There is a tremendous benefit for hospitals to set up structures that afford physicians the opportunity for self-care,” according to Dr. Livingston.  “Administrators can encourage and even facilitate the concept of having physicians and other staff create individual plans for self-care.”

He further explains that in many cases, Human Resources can take the lead in helping staff develop their own self-care plans. In other cases, a consultant, such as Dr. Livingston can help an organization create an environment where the staff is comfortable talking about their feelings. Specific strategies can be implemented, such as affording and encouraging staff to take time out of their day to participate in self-care activities. These may include activity breaks for walking or listening to music, or meditation.  A healthy organizational culture will promote and reward behaviors that model these activities, rather than discourage them.

According to Dr. Livingston, it should be commonplace for healthcare organizations to have a model or system for debriefing during extremely traumatizing times, such as the current pandemic.  It is important for individuals to acknowledge that they are being exposed to traumatic situations and that it is okay to talk about it.  Old school thinking will drive the argument that affording employees extra time for mindfulness breaks and walking sessions is bad for productivity. Researchers argue that the opposite is true and that employees who engage in self-care activities are more productive and provide higher quality work.

What Can Physicians do When Self-care Systems are Not in Place

Any physician that is in a workplace where systems of self-care do not exist or aren’t fully functional should feel empowered to try and effect change in the workplace.  There is enough research-based evidence available to support bringing the concepts of self-care forward for discussion. Demonstrating that it will have a positive impact on the entire staff can be a compelling argument.

Dr. Livingston cautions physicians who are trying to influence these positive changes in the workplace to not try to do it alone. He encourages individuals to never worry alone, and in a case such as this, it makes sense to reach out and involve colleagues and other providers to help get the process started.  Change is more readily accepted when it comes from within and bubbles up rather than decreed from the top down.

The last point Dr. Livingston makes on the topic of engendering change towards an environment of self-care is to take a realistic approach when the push back is too great.

“In this current environment, where demand for physicians is so great,” he explains. “Physicians have more job opportunities than many occupations.”

He further explains that because healthcare entities have so much competition to fill physician vacancies, they are more invested in retention than in the past. Because of this, positive changes may be more readily accepted. However, Livingston says that if administrators are unwilling to consider reasonable proposals, physicians may have to engage in self-reflection of a different kind. If changes of this nature are unwelcome, a physician is fully justified in considering whether a career change is needed. Physicians have opportunities available to them, and it is reasonable to seek an employment setting that is more aligned with their own culture and values. Clearly, a healthier provider translates to a higher quality of care being provided. If a compelling argument has been articulated, and leadership is still unwilling to advance a self-care initiative, you can control your future.

If you want to explore new opportunities, contact the recruitment professionals at Jackson Physician Search. Our team of healthcare industry experts have the experience and nationwide reach to help you land the job that is best suited to your work/life balance.

 

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Planning to Keep Telehealth Post-COVID-19? Four Skills to Look for When Recruiting Physicians.

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The COVID-19 pandemic has taught us that people will always find ways to adapt to meet their needs. The same can be said for patients seeking healthcare, as evidenced by the 4,347% increase in telehealth insurance claims nationally. In March 2019, telehealth insurance claims comprised 0.17% of medical claims compared to March 2020 totals of 7.52%. Clearly, as patients become more comfortable with telehealth for non-emergent health matters, providers are beginning to plan for continued telehealth services for life beyond the pandemic.

A recent article in Forbes magazine cited research that stated 59% of consumers reported that they are more likely to use telehealth services now than previously. Plus, a surprising 33% indicated that they would be willing to leave their current physician for a provider who offered telehealth access.

Some states are currently working on legislation that would make the temporary payment increases for telehealth services permanent and CMS administrator Seema Verma recently discussed extending the pay rates.

With so many consumers willingly adopting new technologies, healthcare providers should be considering telehealth experience when recruiting physicians to fill vacancies. Telehealth has proven to be a benefit for patients during the pandemic allowing them to receive care without the need for travel. Any time you can remove a barrier to accessing healthcare it is a benefit to physicians and patients. Let’s look at the characteristics of a physician that is well-suited to be successful in providing telehealth services.

  1. Recruit tech-savvy physicians. For anyone working throughout the pandemic via telecommuting, technical skills are critical. From troubleshooting video-conference call snafus to resetting your home router or Wi-Fi adapter, for many of us, the transition has been a challenge. Now, consider those issues if you were trying to consult with a patient about a medical matter. The only way to engender confidence and a feeling of assurance is to have a physician who can seamlessly handle the technical aspects of a telehealth consultation. Doctors do not need a minor in computer science to accompany their medical degree but having a comfort level with evolving telehealth services is crucial for their success.
  2. Look for physicians with outstanding communication skills. Technical skills are important, but the most critical aspect of a successful telehealth physician is the ability to communicate effectively with the patient. Screen for physicians who demonstrate superior listening skills. The telehealth provider must glean as much information from the patient as possible, without having the ability to perform a physical exam. Listening skills and an ability to ask appropriate questions are critical to a successful virtual visit.
  3. Don’t overlook the importance of being organized and thorough. Back in the days of the written prescription pad, many jokes were made about the quality of a physician’s handwriting. In the emerging world of telehealth, the ability to compose documentation is even more critical than in a typical outpatient situation but it’s done electronically. Telehealth physicians have to be able to articulate, almost verbatim, what the patient is saying. This requires an ability to construct clear and concise notes of the patient visit, as the documentation serves as a diagnostic tool and an audit trail. This is even more critical if the physician is working remotely and is away from the traditional doctor’s office. With no day-to-day administrative support, the physician will need to be able to handle some extra responsibilities.
  4. Experience matters.When recruiting a physician that is going to be providing telehealth services, the type of post-residency background he or she has will make a difference. A physician conducting telehealth visits will not have an abundance of resources at his or her disposal, and a physician who has had extensive experience may have a better understanding of what it takes to perform with limited resources. The physician must be comfortable making a diagnosis without the support of a team. Experience in a variety of settings can be an important consideration when recruiting your next physician.

It is safe to assume that life after the COVID-19 pandemic is going to be permanently altered. Healthcare administrators are quickly learning to adapt to the new normal, including adjusting their physician recruitment strategies and planning for the continued evolution of telehealth technologies and services.

If you need a strategic recruitment partner to help you navigate the post-pandemic healthcare world, Jackson Physician Search is ready to help every step of the way.  Contact our experienced recruitment professionals today to learn more about how we can make a difference.

 

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Advanced Practice Providers Serve a Critical Role in Patient Care and the Primary Care Shortage

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There is no questioning the importance of Advanced Practice Providers (APPs) in modern healthcare. The roles of Nurse practitioners (NPs) and physician assistants (PAs) came into existence in the 1960s as a way to mitigate the impact of the emerging primary care physician shortage. Today, these care providers are even more prevalent in healthcare. In fact, it’s a common occurrence for patients to be offered an appointment with an NP or PA as a way to get into the office sooner.

Considering the expanding role that APPs have in our primary care system, healthcare administrators are beginning to focus on their recruitment and retention in the same manner as physicians. Let’s look at some of the differences between APPs and primary care physicians in terms of education, training, and scope of practice, as well as how to increase access to care by recruiting these professionals as part of your staffing plan.

Education and Training Requirements

Interestingly, there is lack of consistency for the education, training, licensure, certification, and scope of practice for APPs.  Each of these areas varies significantly from one state to the next.  Nurse Practitioners generally achieve education and clinical training at the master’s or doctorate level, along with the completion of at least 1,000 hours of clinical practice in a focused area.  The specialized focus is typically in pediatrics, adult, or geriatric medicine.  Oversight for NPs is provided by the state nursing boards.  To demonstrate how NPs are treated differently between the states, nearly half have laws allowing NPs to practice independently without oversight.  All states allow NPs to have prescription writing authority, even for controlled substances.

Physician Assistants are typically trained alongside medical students, for two years before receiving their master’s degree.  Before graduating, PA students will have completed 2,000 hours of supervised practice.  While state nursing boards regulate NPs, the PAs come under the jurisdiction of the state medical board, and have to practice under a supervising physician.  As with NPs, prescribing authority is afforded to PAs; however, Kentucky is the lone state that doesn’t allow PAs to prescribe controlled substances.

Contrasting this training to a typical family physician illustrates one of the reasons why we have a primary care physician shortage.  A family practice physician completes 15,000 hours of clinical work through five years of additional training and residency.  In that same amount of time and cost, more than 3 NPs could be trained.

Scope of Practice

NPs and PAs have a significant overlap in scope of service when compared to their physician counterparts.  For example, in VA hospitals, nearly half of all inpatient services are performed by APPs.  Administrators within the VA system are relying heavily on NPs and PAs and recognize that there are only minor differences in a patient’s perception of care.  Another area where APPs are being relied upon are in rural and underserved communities.  A study published in 2015 by the National Institutes of Health cited NPs are more likely to deliver care in inner cities and rural settings than primary care physicians.  Additionally, the study concluded that an increase in the numbers of primary care NPs would serve to expand access to primary care for vulnerable populations.

Recruiting APPs

According to the Bureau of Labor Statistics, demand for NPs and PAs will not be slowing down anytime soon.  Both occupations are still listed in the top ten fastest-growing occupations and are expected to grow by up to 30% through 2028.  This demand is a sign that healthcare administrators need to treat the recruitment of APPs the same as they do physicians.  Here are a few ways that administrators can proactively attract APPs to their organizations.

  • Work with local or regional university systems. You often hear of healthcare systems establishing relationships with medical schools to provide opportunities for student doctors.  This same approach should be developed for APPs.  Bringing advanced practice students into your clinical setting provides you with a perfect opportunity to evaluate how their skills and personality translates to your care team.  In the long run, if they are a good fit, you have an excellent opportunity to retain them upon graduation.
  • Work with your state’s professional associations. The American Association of Nurse Practitioners (AANP) and the American Academy of Physician Assistants are two organizations that healthcare administrators should have an established relationship.  Most states have chapters that support graduating and experienced APPs in their job search.
  • Have a social media strategy. While physicians tend to rely more on physician-specific job boards and websites like Doximity, APPs are more prone to utilize traditional social media sites.  Many APPs are very active on professional networking sites, such as LinkedIn.  Understanding this critical difference between how physicians and APPs use social media can help administrators more effectively tailor their recruitment strategy.
  • Be creative with scheduling. Like physicians, APPs value work/life balance and are more attracted to positions that allow flexibility.  Healthcare administrators who are expanding their utilization of APPs, need to be creative in developing part-time positions, building in Telemedicine hours, and finding other ways to offer flexibility and variety into their APP schedules.
  • Work with a recruitment partner. Finding a trusted recruitment partner has been an essential component of physician recruitment for healthcare administrators for years.  As demand for APPs continues to rise, it is becoming increasingly more important for healthcare organizations to expand their reach in finding qualified candidates.  Recruitment firms have access to candidates that administrators may not otherwise reach for their vacancy.  Finding a recruitment partner that has a nationwide candidate pool, plus the technology and means to cast a wider net, can be the answer to your hard-to-fill vacancies.

Jackson Physician Search can be the trusted recruitment partner that your organization needs.  Whether you are looking for physicians or advanced practice providers, our team of experienced healthcare recruiters can help you reach more qualified candidates.  Contact us today.

 

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The first thing most healthcare administrators think about when considering the current physician shortage is, “How are we going to recruit to fill vacancies?”

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How to Drive Retention by Creating an Inclusive Workplace

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The first thing most healthcare administrators think about when considering the current physician shortage is, “How are we going to recruit to fill vacancies?”  That is certainly a valid question, but it is one that needs to be asked in tandem with, “How are we going to retain the physicians we already have?”  According to Gallup research, workplace culture is one of the leading drivers of physician retention, and healthcare organizations that ignore that fact are setting themselves up for a steady stream of physician vacancies.

Over the past several decades, physicians graduating from medical school are increasingly diverse and come from a wide range of ethnicities, religions, and world views.  This level of diversity in our healthcare system is an achievement.  But a diverse workplace doesn’t necessarily mean an inclusive one, and that is an important distinction.  An inclusive environment is supported by a workplace culture where the collective group of employees all feel welcomed, valued, and included.  With the role that culture plays in retention, let’s review some strategies that will contribute to a more inclusive work environment.

Instill a top-down approach.

In healthcare organizations where the executives and other higher-level administrators are too far removed from what is happening in the trenches, there is no way of gaining a full appreciation of the actual workplace culture that exists.  A prime example of this was illustrated in the results of a study conducted by Jackson Physician Search, where significant differences were found in how executives and physicians rated their workplace culture.  For example, in response to a statement about physicians always being treated with respect, only 48% of physicians agreed versus 78% of the executives.  Administrators and other leaders have to be personally invested in fostering a culture of inclusion and engagement in their organization.

It’s more than a one-hour sensitivity training.

Healthcare organizations that do not conduct periodic sensitivity, diversity, or other bias-related training sessions are less likely to have an inclusive workplace environment.  But these types of training sessions are only part of the solution.  Utilizing a one-hour training class to check a box is not getting it done.  As alluded to with our top-down approach, sensitivity, and other training sessions have to be used to develop proactive, actionable items that can be implemented throughout the organization.  The classes are a tool to help educate leadership and staff at all levels about behaviors that are inappropriate.  A proactive result from the training might include a mechanism for reporting bias or a strategy for how to deal with employees who exhibit harmful behavior.  Another way a healthcare organization can demonstrate a true commitment to inclusion would be in the formation of an employee-driven inclusion committee. Most likely, your organization has a celebrations committee, forming one that is dedicated to driving a more inclusive workplace is a strong first step.

Give everyone a voice.

If you don’t have a clear picture of what type of culture exists in your workplace, it is important to find out before it is too late.  A Mayo Clinic study on physician burnout and well-being cited workplace culture as a major factor in physicians leaving to find a better opportunity.  Creating an environment where all staff is encouraged to respond to workplace surveys or participate in focus groups is the only true way to understand workplace culture.  It is critical for healthcare administrators to think about the type of culture that will keep staff engaged, drive them to better performance, and support the organizational brand. A few keys for managing this include:

  • Conduct a full audit or assessment to gain a data-driven measure of the environment.
  • Identify gaps regarding inclusiveness and bias.
  • Collect, measure, and report on the data.
  • Develop strategies and set goals, and publish them.
  • Communicate why you want an inclusive culture and how it impacts the bottom line.

Celebrate Your Diversity.

We have already suggested the formation of an inclusion committee, but even if you aren’t prepared to take that step, you can still celebrate the diversity within your workplace.  It is important to remember that it is as much about celebrating and recognizing diversity as it is about removing bias.  From creating breast pumping rooms to having meditation or prayer rooms, employing physicians and other staff from such diverse backgrounds means that unique solutions are needed.  Another strategy to combat unintentional bias is with a more creative pot luck program. Let’s face it, your hospital or health system has regular pot luck luncheons, we all do.  These informal gatherings provide the perfect opportunity to center them around a different ethnic or cultural background.  Encourage your teams to discover new recipes and post fun cultural facts that will help everyone to appreciate and gain a better understanding of varying cultures.

Encourage Gratitude.

Most healthcare organizations have some form of gratitude program.  Is it effective?  How many of your physicians make an effort to formally recognize others?  A well-constructed and properly intentioned gratitude program is one that encourages anyone to recognize anyone else at any time. Whether it is a patient recognizing their doctor or nurse, a doctor recognizing maintenance staff, or a nurse highlighting a security guard, gratitude should always be more than a “program.”  Having a culture that fosters the expression of gratitude can be a powerful part of a healthy workplace environment.  It is also a means to understand and eliminate unconscious bias that may exist by learning who is being recognized and how often.  Wouldn’t it be helpful to learn which departments are engaged with the recognition program and which aren’t?  Or if physicians were being recognized by staff, but they weren’t reciprocating that appreciation in return.  Using these tools to identify gaps and taking actions to address them is a valuable exercise in developing a healthier workplace.

If you need help finding ways to recruit and retain physicians for your vacancies, partner with a firm that was founded on decades of healthcare industry success. Contact the professionals at Jackson Physician Search today.

 

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Physician Workforce Trends to Watch in 2020

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The Association of American Medical Colleges publishes an annual report outlining the state of physician supply and demand, and their most recent study completed in 2019 confirmed that the United States may see a shortage of nearly 122,000 physicians by 2032.  In addition to an overall shortage of primary care physicians, Oncology and Surgery are projected to be the hardest hit specialties.  Strictly looking at the data regarding oncology, new cancer cases are projected to increase by 42% within five years, while the number of oncologists is only expected to increase by 28%.  More than ever before, hospitals and medical system administrators are being forced to place greater emphasis on physician recruitment and retention. Let’s look at some of the factors that are contributing to physician demand challenges.

The Aging Population.

Americans are living longer than ever, and those over the age of 65 are projected to grow by 50%. An aging population means that more individuals are managing chronic and age-related conditions.  At the same time, more than one-third of all physicians will be 65 or older by 2030.

The Residency Conundrum.

Even though medical schools are increasing their class sizes, the number of available residency slots have not increased commensurately.  Legislation to increase Medicare-supported residency slots by 15,000 over five years has been stalled in the U.S. Congress for the past two years.

Burnout and Flexible Scheduling.

As physicians suffer from burnout and stress at higher levels than in the past, many are negotiating reduced and more flexible scheduling to create better work/life balance.   As many as 78% of physicians report experiencing burnout, and when they combat the stress by reducing their work hours, the effect is a reduction in the number of full-time physician equivalents.

Increased Regulation.

In a 2019 MGMA survey, 76% of respondents cited increasing regulatory burdens as impacting their ability to practice medicine. More than half stated that the forced administrative overload is contributing to their likelihood of retirement within five years.

As the documented physician shortage continues to worsen, here are several solutions that can be enacted to ease the burden.

Lifting Residency Caps.

With the unfortunate state of gridlock in Washington, D.C., Congress could pass the bipartisan legislation that eases the limits on the number of residency slots.  As written, the legislation calls for an additional 3,000 residency slots each year for five years as a means to increase the number of practicing physicians.

Improve the licensing process for international med school grads.

With almost 25% of today’s physician workforce comprised of international medical school graduates, the archaic and cumbersome licensure process should be streamlined for efficiency. While relying on lawmakers to pass legislation to simplify the licensing process is unlikely at best, if the gridlock loosens, this would be a logical step.

Competition breeds creative compensation models.

Let’s face it, competition for physician services is fierce.  Salaries are on the rise, but even that isn’t guaranteeing recruitment success.  Administrators are becoming increasingly creative by including flexible scheduling, reduced or no call hours, signing bonuses, and student loan forgiveness to attract candidates to ongoing vacancies.

Increase non-physician utilization and technology.

Anyone who has tried to schedule a primary care appointment recently has most assuredly been offered a visit with a physician’s assistant or nurse practitioner to get into the office sooner.  Healthcare administrators are working hard to balance their staffing with an increased mix of “non-physician” practitioners.  In concert with that, technology innovations are supplementing the monitoring and management of chronic conditions to reduce the need for frequent office visits.

Speaking of technology and other changes that are impacting healthcare delivery and practice settings, let’s review a few trends that may affect physician career planning.

The Rise of Hospital and Large System Employment.

During the age of buyouts and mergers over the past decade, the percentage of physicians employed by hospitals and health systems has grown significantly.  Even though buyout mania has abated to a degree, there is still a large percentage of doctors who are employed by a health system, and fewer who are independent or a part of a small group practice.

Concierge Medicine.

Physician burnout is well-documented, and one of the ways frustrated doctors are alleviating the burdensome relationship with insurance reimbursements is by turning to a concierge-style practice. Concierge medicine is a private, subscription-based practice that is growing by as much as 6% annually. According to Concierge Medicine Today, a national trade publication, there are estimates of up to 20,000 physicians practicing concierge medicine.

Telehealth Acceptance and Growth.

More than half of all U.S. hospitals currently have a telehealth program, and almost 90% of healthcare administrators in a recent survey responded that their organizations have already begun developing a telemedicine program.  With telehealth initiatives on the rise, research indicates that almost 74% of patients in the U.S. would be comfortable utilizing technology to communicate with their physician instead of scheduling an in-person office visit.  Currently, about 30% of patients are already using computers or mobile devices to monitor their medical or diagnostic information.

Consumerism.

Ever since the Affordable Care Act ushered in the age of high-deductible healthcare plans, patients are forced to treat their healthcare decisions as they would any other consumer-based transaction.  Today’s healthcare consumers are putting more effort into making informed decisions and shopping for services.  This has led to more competition in the healthcare marketplace, and in response, providers have to inspire loyalty and keep their patients engaged as a retail outlet would with any customer.  Patients are now prone to post and read online reviews about a provider and are demanding more transparent pricing. All of this is increasingly being used to determine where a patient seeks care or if they will leave one provider for another.

This has been the first installment in a new Jackson Physician Search Series on the career outlook for practicing physicians.  In our next installment, we will do a deep dive into what career options are available in the healthcare environment today.

If you are looking for your next career move, contact the experienced recruitment professionals at Jackson Physician Search today.

 

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