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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Telehealth Continues to Grow in Popularity – Is it Time to Add it to Your Skill Set?

One of the things that the COVID-19 pandemic has shown us is that patients are willing to adapt in order to continue receiving medical care.

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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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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 and reflective of American society in general.  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 welcome, 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.

It is safe to say that any healthcare organization that doesn’t conduct periodic sensitivity, diversity, or other bias-related training sessions will not have an inclusive workplace environment.  But these 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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Creating a Culture of Physician Wellness

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Physician burnout has been a topic of conversation for several years now, but a related topic that is not garnering nearly enough attention is physician wellness.  According to the National Institute of Health, part of the reason is that physician wellness or physician well-being is not clearly defined or measured.  With the spotlight on the issue of physician burnout, now is the perfect time for healthcare administrators to focus attention on creating a culture of wellness within their physician group.

An article published by the New England Journal of Medicine cited a culture of wellness as one of three drivers that contribute to higher professional fulfillment, along with the efficiency of practice, and personal resilience.  The article cites the culture of wellness and the efficiency of practice as organizational responsibilities in addressing burnout, while personal resilience is the responsibility of the individual physician.  Let’s look at ways healthcare organizations can begin creating physician wellness efforts as an approach toward reducing burnout.

Understand what a Culture of Wellness Means

As defined, a culture of wellness includes a set of values, attitudes, and behaviors promoting personal and professional growth, the practice of self-care, and compassion for colleagues, patients, and the individual.  Once healthcare organizations recognize the importance of physician wellness, they are more likely to measure and attend to it with resources and accountability.

Recognize Burnout in Your Organization

While 98% of healthcare administrators recognize that burnout is a problem, most perceive it to be a greater problem outside of their own organization. To understand the levels of burnout within your organization, it has to be measured periodically via the Maslach Burnout Inventory or another similar tool.  It is always better to know how much burnout is impacting your staff and work toward finding solutions.

Designate a Wellness “Owner” 

One key way that organizations can prove that they are taking physician wellness seriously is by designating an individual to own wellness efforts. Having someone who can champion the effort and also have accountability for the development of the plan and associated results, demonstrates a level of seriousness that facilitates physician “buy-in.”

Focus on Continuous Improvement in Workflows 

As important as measuring your internal levels of physician burnout are towards understanding the scope of the problem, it is equally important to understand the contributing factors. Organizationally, it is critical to recognize inefficiencies in workflows and other factors that are causing your physicians the most frustration. For some, it is excessive time spent on EMR’s, for others, it might be appropriate time off after unusually long or difficult shifts. The best way to get a handle on the issues causing the biggest challenges for your staff is by talking about them. Encouraging open and honest dialogue can shine a light on things that need to be changed, but also lead to physician-led solutions.

Skills Building

Everyone handles stressors differently. Some physicians seem immune to pressure situations, while others internalize them and struggle in silence.  Being resilient is a critical characteristic for anyone who has a stressful occupation. The good news is that resiliency can be learned. Putting resources toward developing resiliency skills in your physician staff and implementing other interventions like a strong mentorship program can help your team handle the pressures of the job while facilitating important dialogue and creative solutions.

Creating a culture of wellness requires resources and accountability throughout clinical and administrative leadership. It is not unreasonable to expect that your physicians should attend to their own well-being, although providing them with the tools and resources to do that is critical to a successful approach.  Clearly, strategies to reduce physician burnout are dominating national studies of practicing physicians and physicians in training.  As more research and data becomes available about successful physician wellness programs, discussions about integrating a more balanced approach to combating physician burnout will be more prevalent.

Jackson Physician Search is comprised of a team of professionals with decades of healthcare industry experience.  Contact us today to find out how our expertise and nationwide reach can work for you.

 

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Staying Ahead of Physician Retirements

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Much of the recent discussions regarding the impending physician shortage include the reality that by 2020, one in three physicians will be of retirement age.  Couple that with the associated costs incurred with each physician vacancy, and it is clear that hospital and healthcare system administrators need to get out in front of their physician retirements.  Jackson Physician Search recently conducted a survey of physicians and administrators regarding their thoughts about retirement and how that will impact physician staffing levels.  The survey was followed up by the publication of a white paper outlining retirement perceptions of both groups of respondents.

One thing that was clear throughout the survey results is that physician perception about retirement varies greatly from administrator’s perception of the same.  Here are a few ways that administrators can better prepare for physician retirements.

Understand what is driving the retirement discussion for physicians.

Administrators responded that the average age for retirement at their facility was 65, which is in line with U.S. Census data reporting 63 years of age. Administrators also cited that the main driver for physician retirement was lifestyle (48%), but that the second driver was for health reasons (15%). Physicians, on the other hand, cited lifestyle (44%) as the top reason, but stated financial stability (23%) second, and burnout (20%) was third.

Facilitate the Retirement Conversation.

Contemplating retirement is a big deal for anyone, physicians included.  When asked, 80% recognize that it is their responsibility to initiate the retirement conversation, but only 52% responded that they feel comfortable doing so. Overwhelmingly, administrators responded that they felt comfortable having the retirement discussion with their physicians. That is an important consideration to keep in mind. Knowing which of your physicians are nearing retirement age with the understanding that they may not be comfortable talking about it, a good strategy should be to create an environment where they can openly discuss their plans. Some organizations use surveys. Others have HR provide talking points to assist the physicians in starting the retirement conversation. However it is done; the important factor is to make it a collaborative, comfortable conversation.

Don’t Get Caught by Short Notice.

We all know how long it can take to fill a physician vacancy and how much each vacancy can cost.  One area of great divergence between physician responses and administrator responses concerns the amount of prior notice to be given before a retirement.  Almost 50% of administrators stated that the ideal advance notice was one to three years, while 40% of physicians claimed 6 months or less was sufficient.  With that much of a discrepancy, clearly, proactively having retirement discussions are just as important as developing an ongoing recruitment effort to have available candidates in the pipeline.

Create a Win-Win Retirement Transition Plan.

Up to 40% of administrators responded that they considered full retirement the top priority for physicians.  Surprisingly, only 17% of physicians indicated that they were planning to fully retire, and almost 28% stated that they would work full or part-time somewhere else.  Again, this divergence of opinion re-emphasizes the importance of open and honest retirement conversations. Administrators can be proactive and work on creating a transition plan for each physician’s retirement. Whether it is an offer of flexible part-time hours, taking on telemedicine duties that can be managed around their schedule, or even non-clinical duties as available.  Another important piece of information that came out of the survey is that 50% of physicians stated that they would consider employer-sponsored incentives to start an early retirement process.  That type of proactive approach could be utilized to the organization’s benefit and help to avoid any retirement surprises. When asked if they offered any type of proactive, employer-sponsored early retirement benefits, nearly 95% of administrators responded in the negative.

Retirement is going to be an important topic over the next several years for a large portion of the current physician workforce.  Administrators should take the opportunity to review the Jackson Physician Search Retirement Survey White Paper and formulate a collaborative strategy with their physicians.  Having a clear understanding of each party’s intentions can ease any unexpected vacancies and also allow for a more comfortable transition for the retiring physicians.

If your organization needs the assistance of a trusted physician recruitment partner or wants to tap into the knowledge of experienced healthcare industry professionals, reach out to Jackson Physician Search today.

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What To Consider When Choosing a Practice Setting

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When you were first dreaming about becoming a doctor, there is a good chance that most of the dream was just about helping and healing people without much thought to where it would occur.  Now that your dream has become a reality, you are probably amazed at how many options you have regarding a practice setting.  You have worked extremely hard to get where you are, so it is important to choose a practice setting that fits your personality and gives you the best opportunity to live out your dream.  Let’s look at several the things you should consider when choosing a practice setting.

Market Demographics

Many physicians who grew up in a small town or a rural community want to practice medicine in a rural setting.  Others who grew up in the city may just want to spend more time enjoying nature in wide-open spaces.  While there may not be a large variety of practice settings to choose from, many doctors favor the pace and lifestyle benefits that a rural community can provide.

Physicians who choose to practice in urban or more metropolitan areas will have many more practice options to choose from. In larger metro areas, doctors will experience more growth opportunities, higher patient volumes, and also have more access to support than those in rural communities.

Employment Model

Most recently, the trend for physicians is to leave their self-employed practice setting for a hospital or large system setting.  While some physicians are considering a return to private practice, the overall demand for practicing physicians is driving up the number of opportunities available in hospital settings and large private practice partnerships.

Many physicians prefer working in a hospital setting as a way to ensure a stable income with greater opportunities to earn bonuses and negotiate more favorable work hours. In a partnership setting, physicians are bridging the gap between being self-employed and the stability of a hospital setting. As a partner or at a minimum on a partnership track, physicians have a greater say in how the practice operates, fostering patient relationships, and contributing to the workplace culture.

Type of Organization

Much of your decision on the type of practice setting you want to work will be based on whether or not you want to work in a large or small setting. Obviously, if you want to be self-employed, you will be working in a smaller practice environment. If you choose to work in a large health system environment, you will have the luxury of having a stable flow of patients as well as access to a plethora of referring physicians.

If you are a specialist, you may want to practice in a single-specialty group that is independent or affiliated with a larger health system.  Others choose to practice in a larger group that has multiple specialties included within the organization.  This allows patients to have easier access to different specialists when necessary.

Working in a clinic setting may be the perfect choice for doctors who want to work in rural or underserved communities. Clinics typically offer a stable schedule with regular hours and even weekends off!  A downfall to working in a clinic environment is usually lower compensation and a lack of growth potential.

No one needs to tell you that a career as a physician is both rewarding and difficult.  The hard part of the equation is the main reason why it is so important for you to choose the right practice setting so you can achieve everything you dreamed of before becoming a doctor.  Finding a setting that affords you the opportunity to succeed and in an environment that fits your personal culture and values will lead to a long and personally healthy career.

Is it time for you to explore other opportunities and take your career to the next level?  Working with a Jackson Physician Search recruitment professional can be the jump start you need.  Contact our team of dedicated, industry experts today!

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Lifting the Regulatory Burden on Physicians

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The regulatory burden on physicians and others on the front lines of healthcare is intensifying. A new, comprehensive study echoes growing frustration with the amount of time providers spend pushing paper rather than treating patients.

According to the Medical Group Management Association’s 2018 Survey, an overwhelming 86% of respondents reported an increase in regulatory burden over the past 12 months. An even larger percentage (94%) said a reduction in regulatory burden would allow more resources to be allocated toward patient care.

The MGMA report is further evidence that regulatory overload has been mounting. Previously, the 2016 Jackson Healthcare Physician Trends Survey, revealed that 60% of physicians reported more administrative work under the Affordable Care Act, resulting in less time with patients. Medscape has reported that 57% of physicians spend more than 10 hours per week on paperwork, and numerous studies have found that administrative work contributes to physician stress and burnout.

This burden comes with a cost. An analysis by the American Hospital Association shows that providers spend nearly $39 billion a year solely on administrative activities related to regulatory compliance. An average-sized hospital dedicates 59 full-time equivalents (FTEs) to regulatory compliance. one-quarter of those employees are physicians, nurses and other health professionals who would otherwise be caring for patients.

Impact on Physicians in the Future

The administrative overload makes the challenge of recruiting and retaining physicians more daunting. According to a recent survey, regulations are among the top causes of physician burnout. And, 54% said increased administrative burden contributes to the changes in healthcare that are likely to lead them to retire over the next five years. Seven out of 10 are unwilling to recommend healthcare as a profession, adding to the concerns of young people about entering medicine.

What You Can Do to Lessen the Overload

Here are the steps you can take to counteract trends that may prompt physicians to choose early retirement or cause young people to avoid medicine because of concerns that paperwork will impact work/life balance or detract from patient care:

However, there are steps you can take to counteract these trends:

  • Embrace the role of physician assistants and nurse practitioners in your practices.
  • Implement telemedicine solutions to reach more patients more efficiently
  • Utilize clinical scribes to facilitate documentation, while the provider focuses on the patient
  • Evaluate your electronic health record systems to ensure they are compatible with workflow
  • Guard against burnout by making work/life balance a reality and offering interventions, as needed
  • Educate elected officials about the impact on patients, healthcare workers and the community

Use your Voice and Vote

With healthcare representing the largest economic driver in many communities, administrators and trustees have access to their congressional representatives and the responsibility to place the issue of regulatory relief on the top of their agendas.

As voters, everyone – administrators, providers, staff and patients – can make our voices heard at the ballot box. Take an opportunity to examine your congressional representatives’ position on these issues and support those who understand the severity of the burden and act on regulatory relief.

While the wheels of government turn slowly, it is important to listen to physicians and other providers and manage those things under you control. Understanding their daily experience and frustrations will lead to solutions that maximize patient care time, ensure they are doing work “at the top of their license,” and encourage committed individuals to choose – and stay in – medicine as the satisfying profession it is meant to be.

Contact us to explore how you can position your organization to find and keep physicians in a satisfying practice.

 

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