Leaning On Advanced Practice Providers to Meet Growing Mental Health Needs

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The increasing demand for mental health services, coupled with a slim supply of physicians trained to provide aid, has exacerbated the mental health crisis in the US. According to the Centers for Disease Control and Prevention (CDC), one in five American adults suffers from mental illness, and nearly one in five adolescents have had or are continuing to suffer from a mental illness. The state of mental health in the US is precarious, at best, and just when we need mental healthcare more than ever, like other medical specialties, we are faced with a serious shortage of psychiatrists. 

The situation seems bleak, but just as we have seen in other areas of healthcare, advanced practice providers (APPs) are proving to be a critical element in expanding access to care. Healthcare organizations of all types are taking notice and increasingly looking to hire advanced practice providers who specialize in mental health.  

Mental Healthcare: An Imbalance of Supply and Demand

The mental health crisis is the result of a perfect storm of circumstances: 1) rising levels of depression and anxiety due to the pandemic, social media usage, cultural changes, etc., 2) a nationwide opioid epidemic creating a large patient population in need of mental health services, 3) a significant portion (60%) of psychiatrists in the workforce are already over age 55, and 4) increasing physician burnout among psychiatrists causing them to reduce their hours or stop taking insurance and therefore see fewer patients. 

According to the AAMC, a third of Americans currently live in areas without access to a mental healthcare provider, and the data indicates this is likely to get worse. In 2021, 61.6% of active psychiatrists were over the age of 55. So, more than six in ten psychiatrists will reach retirement age in the next eight years. Research from Psychiatry Services predicts the US will see a shortage of between 14,280 and 31,091 psychiatrists by next year. This prediction, published in 2018, doesn’t even factor in the impact of the pandemic on both patient demand and physician burnout. 

There are clearly not enough psychiatrists to meet the demand for mental healthcare. So, who will treat the more than 50 million American adults battling a mental illness? 

Advanced Practice Providers to the Rescue 

The answer can be found in the very studies that show psychiatrists are already seeing fewer patients. In two separate studies, published by Health Affairs and reported on by Patient Engagement HIT, researchers found Psychiatric Mental Health Nurse Practitioners (PMHNPs) and Physician Assistants (PAs) are filling in the gaps where psychiatrists cannot meet patients’ needs. The first study tracked Medicare data which showed that while psychiatric visits declined by 29% from 2011 to 2019, visits with PMHNPs increased by 111%. By 2019, the percentage of PMHNPs treating Medicare beneficiaries grew by 162%. Researchers concluded PMHNPs see the same types of patients as psychiatrists, work in similar settings, as well as diagnose and treat in similar ways. 

The second study documented how changes that allowed APPs to prescribe buprenorphine significantly expanded access to medication-assisted therapy (MAT) for adults suffering from opioid use disorder. This study reinforces the takeaway of the former: advanced practice providers are helping to meet the mental health needs of patients when physicians cannot.  

Placement data from Jackson Physician Search also shows an increasing number of APPs are being hired. According to our internal data, we successfully placed four times as many Nurse Practitioners in 2022 as we did in 2020, and all mental health provider placements, including advanced practice providers specializing in mental healthcare, have increased by 85% in the same timeframe.

Now Hiring: Healthcare Organizations Seek Mental Health Advanced Practice Providers

Healthcare organizations of all types and sizes are considering how to better meet the mental health needs of their patients. According to a September MGMA STAT poll, 30% of medical practices are planning to add or expand behavioral health services at their organizations this year, and many of them will leverage advanced practice providers to do so. The MGMA poll found many are planning to integrate mental health services into a primary care setting. This approach allows patients to conveniently receive treatment for mental health issues in the same place they go for basic care. Several respondents specifically cited adding APPs to manage ADHD, anxiety, and depression evaluations. 

Incorporating advanced practice providers into the care team is already proving successful in rural areas, and it is not a new approach in the world of mental health. There are many benefits of hiring advanced practice providers, and organizations of all types leverage them to support physicians and meet patient demand. Advanced practice providers have been known to increase patient satisfaction, boost their organizations’ bottom lines, and reduce the burden on physicians, which in turn decreases burnout and improves retention. These outcomes are valuable, of course, but when it comes to mental healthcare, the expanded access that advanced practice providers bring is more than nice to have — it’s a must-have. Advanced practice providers who specialize in mental health are a critical part of the solution if the industry hopes to meet the rising demand for services that is sure to continue in the coming years.  

Could your organization benefit from adding an advanced practice provider specializing in mental healthcare? The recruitment team at Jackson Physician Search has the national reach and regional expertise to connect you with the best APP candidates for the job. Reach out today to learn more. 

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4 Ways Telehealth Can Impact Physician Recruitment

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Some of your patients no longer want to see you…at least, not in person. The pandemic may have initially forced the widespread adoption of telehealth, but patients and providers alike have continued to enjoy its benefits. In April of 2020, telehealth usage in the US was 78 times higher than it had been prior to March of 2020. More than two years later, telehealth usage has settled at a level that is still 38 times greater than it was pre-pandemic. Now, organizations are grappling with the many ways demand for telehealth might impact the traditional healthcare delivery model–including what it might mean for physician recruitment.  

Is Telehealth Here to Stay?

The demand for telehealth is unlikely to decrease. Patients are thrilled with the time savings, and in many cases, they feel the overall telehealth experience is equal to or better than the experience of seeing a provider in person. A recent survey from a virtual care provider found 58% of clinicians said they expect virtual primary care visits to exceed in-person visits within the next five years, a prediction that bodes well for the nearly two-thirds of clinician respondents who said telehealth suits their lifestyles better than in-person care. 

Despite the overwhelming popularity and undeniable benefits of telehealth, its future remains uncertain due to the still-temporary waivers allowing providers to treat patients across state lines. It’s also not clear if the Centers for Medicare and Medicaid Services will continue to reimburse telehealth appointments at the same rate as in-person visits long-term. 

That said, the success of telehealth in expanding access to healthcare, coupled with the high patient demand make it unlikely that telehealth is going to fade away. So, if telehealth is here to stay, what impact will it have on physician recruitment? 

1. Telemedicine Training

As healthcare organizations continue to modify care delivery to meet patient needs, it is likely more physician jobs will include some aspect of telemedicine. Medical schools are developing curriculum to train students in telemedicine, and professional organizations such as the AMA now offer resources to establish telehealth best practices. 

As organizations look to hire physicians, they will increasingly evaluate if the candidate has adequate training in telemedicine. How is their “webside” manner? Are they comfortable navigating telehealth technology and diagnosing via screens? The weight of these questions certainly depends on how big of role telemedicine will play in the physician’s job, but organizations will likely place increasing importance on telemedicine training.

In a 2021 MGMA Stat poll, just 15% of medical practices said their clinicians are trained in “webside” manner for virtual visits. One would expect this percentage to increase considerably in the coming years as more and more programs become available to enhance competencies in this critical area.  

2. Telehealth as a Recruiting Tool

Despite the way many were forced into practicing telemedicine, some physicians felt the benefits right away and even developed a preference for it. In the aforementioned survey, two out of three respondents said they prefer virtual-only or hybrid work. In a Jackson Physician Search whitepaper exploring the impact of COVID on the physician job market, physician recruitment leaders noted an increase in physicians seeking jobs that would allow them to practice telemedicine full or part-time. For this reason, telehealth can serve organizations as a powerful recruiting tool. 

Anecdotal evidence suggests physician job ads referencing telehealth in the title receive more interest than those without, so if the role you are hiring for will require or allow for the physician to practice telemedicine, make sure to feature it prominently in the job ad. Be sure to ask your candidates about their interest in telehealth, and if it is of particular interest to them, aim to include some number of telehealth days per week into the offer.    

3. Telehealth in Physician Onboarding 

Organizations will increasingly aim to find physician candidates with training in the practice of telemedicine, but even if they do, these new hires will still need to be trained on the organization’s telehealth technology and protocols. Thus, at the organizational level, telehealth training will become an essential part of physician onboarding. 

Incorporating telehealth training into the onboarding process will ensure providers have a complete understanding of the technology, processes, and expectations regarding telehealth at the organization. With so much to cover, organizations must consider which department will own this step of the onboarding process. Someone from the IT department may need to spend time with new hires going over the technology, while a manager or other physician leader will be tasked with going over protocols related to patient care. The method will vary by organization, but telehealth training must be added to the physician onboarding checklist. 

4. Telehealth Options as a Benefit

Once a perk primarily for cubicle-dwellers, telehealth makes remote work possible for physicians and other healthcare providers. With physician burnout an ongoing industry concern, allowing physicians the chance to work from home–at least some of the time–may help them find a better work-life balance and improve physician job satisfaction, resulting in higher physician retention rates. 

A June 2022 MGMA Stat Poll asked practice managers if they had added employee benefits in 2022, and if so, which ones. Nearly half of the poll respondents said they had expanded benefits in an effort to retain and attract talent, and among the top ten benefits added was the ability to work remotely. 

Telehealth is here to stay and will continue to change healthcare delivery models in a number of ways. The full impact of telehealth on physician recruitment is still unknown, but the four points discussed here are worth considering as you develop your physician recruitment plan. If you need help thinking through the best way to leverage telehealth as a recruiting tool, a Jackson Physician Search Recruitment Consultant would be happy to advise. Contact us today. 

 

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How to Retain Physicians Through Medical Practice Mergers and Acquisitions

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News of the acquisition didn’t come as a surprise to Dr. K. He had suspected the practice was in trouble, and yet, it didn’t make the new reality any easier to accept. So much for his fast track to becoming a partner, he thought. All the reasons he had for choosing an independent practice–autonomy, a voice in decision-making, limitless earning potential–he feared was at risk of disappearing. Would he be just another cog in the wheel at the new healthcare organization? Everything was about to change, and he wasn’t sure he wanted to stick around to see how it would all work out.  

Dr. K’s fears are valid. His professional life is changing, and the uncertainties surrounding that change have incited thoughts of leaving. How can his managers and other healthcare leaders calm his fears? With physician turnover already on the rise, it’s essential that healthcare organizations retain physicians if they hope to preserve continuity of care and ensure a successful merger or acquisition. So, what can leadership do to ease these transitions and avoid physician turnover during times of major changes?   

Practice Consolidation and Physician Employment Increasing

The AMA’s 2020 Physician Practice Benchmark Survey found less than half (49.1%) of patient care physicians are working in a private practice, a drop of almost 5 percentage points from 2018. This was the first time the number of private practice physicians dropped below 50%. For those that remain in private practice, the size of the practice is increasing. According to the survey, 17.2% of physicians were in practices with at least 50 physicians in 2020, up from 14.7% in 2018.

Driving these changes is the fact that private practices are increasingly being acquired by health systems or merging with other practices in order to grow or remain profitable. In a July 2021 MGMA Stat poll, 15% of respondents said their practice had completed an M&A (merger, sale, etc) in the past year. This figure was up from 12% just a year prior.

Private practice consolidation was on the rise well before COVID, but the pandemic certainly accelerated the trend. While growth was the main goal for some, the financial strain caused by shutting down followed by patient hesitancy to return for in-person care proved to be too much for other groups, leaving physicians grappling with major changes. 

Fears About Practice Mergers and Expansion

The fact that physicians are increasingly employed by bigger organizations often goes against what we know about the importance of autonomy and independence to many physicians. In the recent Rural Physician Recruitment and Staffing Survey from Jackson Physician Search, 40% of physicians ranked autonomy as the most important attribute of an employer’s culture. So, it’s understandable that many physicians are initially uncomfortable with mergers and acquisitions that may strip away their independence.

In addition to fears about losing autonomy, physicians may also have concerns about culture clash, learning a new EMR system, changes to patient volume, and differing compensation models that could reduce their income. Whether a practice is being acquired, merging with another practice, or bringing in new physicians, change-related stress is inevitable. Clear communication with physicians is essential to help them navigate the stress and begin to see the changes as opportunities.  

How to Talk to Physicians About Change

Each physician deserves to hear the news of a major change in a one-on-one conversation with their manager or another leader in the organization. Ideally, the conversation takes place in a non-threatening environment. Go for coffee or dinner with each physician and discuss what the future will look like, the reasons for making the change, and what improvements the change will bring to their day-to-day experience of being a doctor. 

This conversation should mark the beginning of an ongoing dialogue in which the physician feels encouraged to share their thoughts, concerns, and ideas regarding the implementation of planned changes. If appropriate, ask them to lead or co-lead some aspect of the transition. If the physician’s fears are related to compensation, you may need to dive deeper into the numbers to prove there will indeed continue to be enough patients (and revenue) for every physician at the practice. These conversations require transparency.

Clear Communication is Critical

What does this look like in practice? A 2018 case study from MGMA details the process of two independent practices merging with an established health system. The paper touches on the pros and cons of the merger and takes us through the various stages of integrating the two practices into the health system. While this specific merger was not without its challenges, the author of the study concluded that clear communication was critical throughout every step of the process. 

From the beginning, individual meetings were held to discuss the changes and invite input from incoming physicians on what future processes should look like post-merger. The author stressed that the earlier this type of communication begins, the better. 

The idea of change (rather than specific changes) is the primary driver of physician stress during a merger, so it is critical that leadership is transparent about the changes and proactive about addressing fears that arise as a result. Major transitions are unlikely to be seamless, but if leadership is transparent and willing to incorporate input from physician stakeholders, the organization is more likely to make it to the other side without significant physician turnover.  

If your organization is undergoing major change, it might be time to reevaluate your staffing requirements. Whether you need to bring in a new physician or provide your current team more support with an advanced practice provider, the team at Jackson Physician Search has the expertise to advise and assist. Contact a physician recruiter today to find out how we can help.

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3 Steps to Take Now to Address Future Physician Staffing Shortages

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In the latest annual survey from the American College of Healthcare Executives, health executives ranked “staffing shortages” as their number one concern for the first time since 2004, bumping “financial challenges” from the top spot. It’s not difficult to surmise what may have caused the shift. Perhaps the short-term staffing crisis brought on by the COVID-19 pandemic gave leaders a glimpse of what could happen long-term if provider and physician staffing shortages are not addressed. And compounding the problem, since the start of the pandemic, turnover among healthcare providers has gotten worse, heightening the concerns of healthcare leaders across the nation, and rightfully so. 

In the ACHE survey, the reference to “staffing shortages” encompasses staff of all types. In fact, healthcare executives listed nursing shortages as the most pressing concern. However, fears of the physician shortage are nothing new and remain top of mind. The latest data from the Association of American Medical Colleges projects a shortage of between 37,800 to 124,000 physicians by the year 2034. Thus, it seems staffing shortages at every level are weighing on the minds of healthcare leaders.  

While some circumstances contributing to provider and physician staffing shortages are out of your control, there are steps healthcare leaders can take now to reduce the impact of nationwide physician shortages at their organizations.

Focus on Physician Retention

While your instinct may be to prioritize recruitment strategies in response to potential physician shortages, the first line of defense is to retain your existing staff. Ideally, organizations have a formal physician retention program designed to support physicians, but the reality is that most do not. According to the JPS whitepaper: On the Verge of a Physician Turnover Epidemic, only 5% of employers report having a formal physician retention program. If your organization is among the majority that does not, the following data points may provide a good place to start. 

In a recent Rural Recruitment Survey by Jackson Physician Search and LocumTenens.com, physicians were asked what would make them stay with their employers for the next five years. The overwhelming top response was “increased compensation or bonuses,” followed by “the ability to work part-time or flexible hours.” Bonuses may not be in the budget, but when weighed against the cost of a physician vacancy plus recruitment costs for a single physician, it may be worth it to explore the possibility. 

Flexibility may also seem out of reach, or perhaps it feels counterintuitive to respond to staffing shortages by giving employees the option to decrease their hours. However, by giving employees what they need, you are more likely to retain them, and a part-time physician is better than no physician at all.  

Bonuses and flexible schedules may help retain physicians, but they should be part of a broader physician retention plan that includes a personalized physician onboarding program, ongoing efforts to improve physician job satisfaction, and giving physicians a clear path to increased compensation, bonuses, and leadership opportunities. Offering this type of ongoing support will make you an employer of choice and differentiate you from other organizations.

Takeaway: 

Don’t put so much attention on hiring new employees that you neglect the needs of the ones you already have. Ask questions about what they like or don’t like about their jobs. How could circumstances improve? What would they need to stay on for another year, five years, or even ten?

If you’ve asked the right questions and used a variety of channels–surveys, one-on-ones, small group discussions–you should have a good idea of what your physicians need from you. Now is the time to respond with action. Take steps–even if small–to give employees what they need in order to stay. 

Revisit Medical Staffing Plan

Now that you’re making efforts to retain your current staff, it’s time to think about recruitment. However, first, you must have a clear idea of exactly who, what, and when you need to hire. For this information, you need to revisit (or create) your medical staffing plan. 

Your medical staffing plan should first consider the projected departures of current staff–that is, the timeline of upcoming physician retirements as well as the number of physicians approaching the average tenure for your organization (and therefore likely to leave). Other known upcoming absences such as parental leave and sabbaticals should also be noted and factored into recruitment needs.  

Of course, your staffing needs don’t stem only from attrition but also from the anticipated growth of your organization. When revisiting the medical staffing plan, look at community needs and organizational goals. How many and what kind of staff will the organization need to meet the demand and hit those targets?

As you gain a clearer picture of who you need to recruit, also consider the potential of your current staff. Who among them may be ready to step into a leadership role? This type of succession planning will help you determine what kind of physicians or advanced practice providers you need to hire. 

Takeaway:

Consider your recruitment needs from every angle by revisiting your medical staffing plan, which should account for projected departures, anticipated growth, internal potential, and changes in care delivery. Leverage this information to outline a recruitment timeline detailing what type of provider you will need to hire and when. 

Identify a Physician Recruitment Partner

The aforementioned steps are fairly straightforward, and yet, effective execution can be challenging–especially when you already have so much on your plate. Now is not the time to just do what you can and hope for the best. If your organization hopes to minimize the impact of future staffing shortages, you need a permanent physician recruitment partner to serve as an extension of your team. A full-service physician recruitment firm can help you create a recruitment timeline based on your medical staffing plan and the market data on time-to- fill for various physician specialties. Recruiters may even have creative alternatives for those positions that seem impossible to fill.     

Takeaway:

Whether you have open positions now or are just starting to consider your future physician staffing needs, it’s time to talk to a recruitment firm and find out how they may be able to help you with your specific situation.  

 

The Jackson Physician Search Recruitment Team has a track record of success at healthcare organizations of all sizes and types throughout the nation. We have four regional offices staffed with recruiters who understand the nuances of the market in your part of the country. Contact us today and we will put you in touch with the team in your region.

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Why Every Rural Healthcare Organization Should Recruit Advanced Practice Providers

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The 2022 Rural Physician Recruitment and Staffing Survey from Jackson Physician Search and LocumTenens.com gave rural organizations yet another reason to feel optimistic about their physician recruitment efforts. The data indicates 90% of physicians are open to rural opportunities if the conditions are well-aligned with their most important wants and needs.

While it’s certainly encouraging that physicians appear to be more open to rural opportunities than they have been in the past, the demand for care is also intensifying–putting increased stress on rural physicians.

Fortunately, rural healthcare organizations do not have to depend solely on full-time physicians to serve their communities. The aforementioned study found advanced practice providers (APPs) are also increasingly open to rural job opportunities.

While nearly half of rural healthcare organizations already employ at least one APP, this new data suggests organizations should consider expanding their care teams with a mix of physicians and APPs. A well-balanced rural staffing mix ensures patients have adequate access to high-quality care without overloading providers and putting them at risk for burnout, while also potentially reducing the cost of care.

If your organization needs additional clinical providers, keep reading to learn more about the many benefits APPs can bring to your community and to your facility.

Rural Healthcare Organizations are Already Utilizing Advanced Practice Providers.

According to data from the National Conference of State Legislatures, non-physician primary care providers such as nurse practitioners and physician assistants make up 46% of all providers at rural, federally qualified health centers. As mentioned, other data shows nearly half of all rural primary care practices employ at least one NP, and one in four rural healthcare providers are nurse practitioners.

Takeaway: Citizens in rural communities are already receiving care from advanced practice providers and are not likely to resist the addition of non-physician providers if it means easier access to care. In fact, a full 11% of patients in rural areas were seen exclusively by these providers.

Advanced Practice Providers are Eager to Work in Rural Medicine.

Advanced practice providers in the 2022 rural survey were highly likely to say they would consider practicing in rural locations on a full-time, permanent basis or as a locum tenens provider. As for what conditions would motivate them, like physicians, the most common answer was ”higher compensation, bonuses and benefits” followed by “the ability to work part-time or work flexible hours.”

Advanced practice providers in the survey were nearly three times as likely as physicians to say the opportunity to use telehealth would prompt them to consider a rural job (45% vs. 17%). They were also more likely to be motivated by loan repayment (43% vs 18%) and the chance to spend more time with patients (33% vs. 15%).

Takeaway: Advanced practice providers are attracted to high compensation and flexibility, but the chance to use telehealth and/or loan repayment may help to seal the deal. 

Advanced Practice Providers Proved Their Value Long Ago.

The COVID-19 pandemic created an urgent demand for healthcare services for which the US was unprepared. In response to the shortage of healthcare providers, federal COVID-19 legislation broadened the scope of practice for advanced practice providers, where it was also permitted by the state. Nurse practitioners, physician assistants, and other APPs were ready to answer the call, and now, some say their success is proof the expansion should be permanent.

Regardless of the scope of practice debate, few would dispute the importance of advanced practice providers in the delivery of patient care. Whether working independently or alongside a physician, advanced practice providers increase access to care, while easing the burden on physicians and increasing revenue at healthcare organizations. It’s been reported that APPs bring significant cost savings to an organization—up to 30%.

Takeaway: It may be time to rethink what healthcare delivery looks like at your organization. APPs are trained to perform many of the same duties as physicians, often at a lower cost. They have the potential to be a key part of the healthcare staffing mix at any organization. 

Care Teams with Physicians and APPs Promote Work-life Balance.

For COVID-weary healthcare providers, work-life balance has never been more important. In the 2022 rural survey, both physicians and APPs ranked “improved work-life balance” among the top three factors that would prompt them to consider practicing in a rural location.

Better work-life balance is certainly in reach with a team-based approach to healthcare delivery. The presence of APPs allows for more flexibility in scheduling, providing better work-life balance for all providers. A collaborative care team where everyone performs to the full extent of their training will free up physicians to focus attention where most needed, give advanced practice providers appropriate autonomy, and help to mitigate burnout among all providers all while improving healthcare outcomes within a community.

Takeaway: What was once the responsibility of one, overworked physician might now be shared between a physician and nurse practitioner or a nurse practitioner and physician assistant under the supervision (if required) of a practicing physician. A flexible staffing mix will expand your candidate options and make your organization more attractive to potential candidates as you recruit.  

Technology Facilitates Well-balanced Clinical Care Teams. 

COVID-19 expedited the adoption of telehealth even in rural communities. According to a report from Rural Health Information Hub, though there are still barriers to usage, the adoption of telehealth is increasing in rural areas. The report goes as far as to say that the use of telehealth to provide specialty services is more feasible than staffing rural organizations with specialty and subspecialty providers. Thus, telehealth allows organizations to expand care teams to include physicians working remotely. An on-site APP may work virtually with an off-site specialist to coordinate patient care.

Takeaway: Telehealth and virtual meetings enable a team-based approach to healthcare that eases staffing challenges and expands access to care. 

Advanced Practice Providers Create Stability Within the Care Team.

Half of the advanced practice providers who responded to the 2022 rural study said they planned to work at least 16 more years before retiring. This suggests the potential for longevity and consistency when incorporating APPs into your rural healthcare staffing mix. This is especially pertinent considering that 2 in 5 physicians are nearing retirement, with the figure being even higher in rural healthcare.

APPs are also more likely to have ties to a rural community. Among the survey respondents, 38% had grown up in a rural community and 33% said they had extended family in the same area they work.

Takeaway: Advanced practice providers are less likely than physicians to be nearing retirement and are more likely to have roots in rural areas. Thus, it may be easier to attract advanced practice providers to your rural location, and once you do, they are likely to stay for a longer tenure, bringing stability to the care team and your patients.

Leveraging Locum Tenens Providers Ease the Burden for All. 

The occasional addition of a locum tenens provider on your care team allows providers to take time off, whether for an extended vacation or family leave, without disrupting patient care or placing additional burdens on existing members of the care team. Though administrators may worry about the expense of a locums provider, the benefits of maintaining patient access to care and keeping provider workloads stable typically outweigh the cost.

The other benefit of locum tenens usage is that it may serve as a recruitment tool. The Jackson Physician Search and LocumTenens.com rural physician recruitment and staffing survey found a majority of both physicians and advanced practice providers would be interested in trying out a rural location as a locums provider. If the experience is positive, they may be willing to stay.

Takeaway: Adding a locums provider to care teams when needed keeps both patients and providers happy. It may also serve as a “trial” for a provider undecided about whether or not rural practice is for them.

If your organization is struggling to recruit physicians or to meet growing patient demand, it is advised to strongly consider incorporating advanced practice providers into the staffing mix. For more details about how to formulate an effective recruitment strategy, please download our latest survey results.

If your rural health organization is considering adding a physician or advanced practice provider to your staffing mix, the Search Consultants at Jackson Physician Search would be happy to help. Contact us today.

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5 Ways to Improve Physician Job Satisfaction…Before It’s Too Late

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As Dr. L handed in her resignation letter, she felt a weight lifting off of her shoulders. The strain of the pandemic had certainly contributed to the load, but the stress began to mount long before 2020. She had grown weary of working around the clock, the endless hours of charting, and the administrators always asking for more, more, more. She only had so much to give, and by way of a resignation letter, she was letting them know she had nothing left. Dr. L wasn’t exactly sure what her next steps would be, but she knew she couldn’t go on as she had been. If the pandemic had taught her anything, it was that life is too short to be unhappy.

Unfortunately, Dr. L’s story is not unique. It reflects the current experience of thousands of physicians across the U.S. While their specific job complaints may vary, the result is the same. They are changing jobs, cutting their hours, or retiring from the profession completely–and for organizations still battling an unrelenting pandemic, the timing couldn’t be worse.

What, if anything, could Dr. L’s employer have done to make her think twice before calling it quits? Discovering the answer to this question has never been more important.

A Mass Exodus of Physicians

If your healthcare organization hasn’t felt the impact of the Great Resignation yet, chances are, it’s coming. In a July 2021 survey conducted by MGMA and Jackson Physician Search, nearly half of physicians said, over the past year, they had considered leaving their employer (48%) or taking early retirement (43%).

Considering an exit is one thing, but more recent data suggests this desire to quit or cut back is more than a passing thought. An October 2021 MGMA STAT poll found one in three medical practices saw a physician leave or retire early in 2021 due to burnout. According to a survey published in December 2021 in the Mayo Clinic Proceedings, one in five physicians report they are planning to leave their current practice in the next 24 months. One in three plan to reduce their hours.

Why are Physicians Leaving Their Jobs?

While it’s easy to point to COVID-19 as the reason for the mass exodus, those who monitor industry trends know that physician burnout is not a new problem. A 2019 article by the AMA reported burnout data for physicians, as well as the general population, between 2011 and 2017. While the levels of physician burnout improved over that time period, in 2017, 44% of physicians who took the survey reported at least one symptom of burnout. For perspective, during the same time period, 28% of the general population reported feeling burnout in their jobs. Fast forward to the present, and the levels of physician burnout are even higher. In the MGMA and Jackson Physician Search study, 61% of physicians reported they were currently experiencing burnout.

The correlation of increased physician burnout and the presence of COVID-19 is not to be discounted. However, physicians have long lamented their lack of independence, diminishing influence, lack of support, administrative burdens, pressure to produce, and of course, long hours. COVID didn’t create these problems, but like so many things, it has compounded them.

How to Improve Physician Job Satisfaction

The problems driving physicians to leave their jobs didn’t happen overnight, and there is no quick solution. That said, there are a few immediate actions healthcare administrators can take to help physicians feel heard in this moment of crisis and give them hope of improved circumstances.

1. Focus on Communication

“How are you holding up?” These five words, when asked regularly and followed by active listening, could be the difference between a physician who feels heard in the organization and one that feels like a cog in the wheel. In the MGMA and JPS survey, physicians ranked 2-way communication as the most important driver of their own job satisfaction.

While it’s nice to be asked how they’re doing, physicians need more from leadership than casual conversations about their professional well-being. In the blog post, 4 Ways to Improve Communication and Increase Physician Engagement, we discuss the importance of talking to physicians, encouraging honesty, inviting participation and solutions, and measuring results. Focus on improving communication between physicians and management, and you will address a core need that too many healthcare employers are not meeting.

2. Reward and Recognize

While money can’t solve all problems, it can certainly help. In the aforementioned survey, 85% of physicians said additional compensation was very or somewhat important to their job satisfaction. If at all possible, consider rewarding your physicians for their perseverance with a performance bonus or salary bump. The amount may not be as important as the recognition itself.

While additional compensation may be the preferred form of recognition for a job well done, if that’s not possible, find other ways to recognize the efforts of your physicians. Time off, paid sabbaticals, and reduced call are all ways to reward a job well done and improve job satisfaction. Of course, if your physicians are stretched thin to meet patient demand, these types of rewards may also prove to be impossible. If this is the case, consider a formal letter of recognition from leadership to acknowledge the physician’s extraordinary efforts and provide assurance of the steps being taken to improve circumstances.

3. Review and Modify Burdensome Administrative Processes

If you are listening to physicians, you will most likely learn that some of their frustration stems from the excessive administrative burdens placed upon them. In the 2022 Medscape Physician Burnout and Depression Report, “too many bureaucratic tasks” topped the list of burnout causes with 60% of physicians listing it as a cause. In the MGMA and JPS survey, 72% of physicians said reducing the administrative burden in their jobs was very or somewhat important to improving satisfaction. If employers hope to retain physicians, they must be willing to review and modify the processes creating undue strain on physicians.

4. Implement a Physician Retention Plan

The job of a physician is tough, and employers must anticipate the challenges they will face and have a plan to support them every step of the way. It begins with offering a personalized physician onboarding program and provides a clear path to increased compensation, bonuses, and leadership opportunities. This type of planning should be the basis of a formal physician retention program, something offered by only 5% of employers, according to the JPS whitepaper: On the Verge of a Physician Turnover Epidemic.

5. Recruit Support

If your physicians are stretched thin, the most helpful thing healthcare administration can do may be to hire providers who can support the current team. Whether that’s rounding out the care team with advanced practice providers or recruiting additional physicians, partner with a national physician recruitment firm to help you develop a medical staffing plan that ensures your practice has enough providers to adequately support the community demand.

Improving job satisfaction for physicians is critical to stopping the recent wave of resignations and retirements. While organizations are scrambling to recruit replacements, they are missing opportunities to address the circumstances of their current physicians, likely causing job satisfaction at the organization to further decline.

In the case of Dr. L, if her manager had acknowledged the need for change and taken steps to improve the situation, she may have given the job another chance. After all, most physicians don’t want to uproot their lives and start over in a different job. If the current employer is willing to make changes, the physician will be more willing to stay.

If you are struggling to recruit and retain physicians to support your current team, Jackson Physician Search would love the opportunity to help. Contact us today.

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Physician Compensation and Hiring Trends: What to Expect in 2022

As healthcare professionals gear up to begin year three of a global pandemic, what can administrators expect in terms of demand for physician services and compensation for their unending efforts?

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Physician Compensation and Hiring Trends: What to Expect in 2022

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What a year…again. As healthcare professionals gear up to begin year three of a global pandemic, what can administrators expect in terms of demand for physician services and compensation for their unending efforts?

While no one can say exactly what 2022 will bring in terms of the pandemic, without a doubt, the need for healthcare providers will persist. Long before COVID, a looming physician shortage threatened access to care, and the pandemic only worsened the problem, increasing physician burnout and sending many marching toward early physician retirement. As a result, organizations around the country are ramping up physician recruitment efforts.

The basics of supply and demand suggest the members of a shrinking workforce can name their price. While there is some truth in this assumption, healthcare organizations simply can’t pay physicians more than they take in. Still, most employers are doing whatever possible to offer attractive compensation packages that will win the talent they so desperately need.

It doesn’t take a crystal ball to predict that healthcare hiring and compensation will continue to trend upward, but what else can administrators and physicians expect in the months ahead? We asked two Vice Presidents of Recruiting for Jackson Physician Search to tell us a little about what they are seeing and hearing from clients and candidates with respect to physician job openings and compensation. If you are actively recruiting physicians, you’ll want to take note of these physician hiring and compensation trends in 2022.

Increased Retirements and Turnover Causing Healthcare Organizations to Open More Searches

“We are seeing a record number of new organizations retaining us for recruitment support,” says Tara Osseck, Regional VP of Recruiting for Jackson Physician Search’s Midwest Division. “We also have longstanding clients opening up a higher volume of searches than in years past. Some are hiring with the expectation of growth, but also, of course, in response to provider attrition. We see a little bit of everything driving recruitment, so we are busier than ever.”

Osseck’s observation of increased business at Jackson Physician Search reflects the fact that healthcare organizations are hiring in record numbers. Back in March of 2021, an MGMA STAT poll reported 72% of medical practices were hiring physicians. Since then, an October of 2021 STAT poll found one in three medical practices saw a physician leave or retire early in 2021 due to burnout. These physicians must be replaced, and of course, any growth the organization expects must also be accounted for with additional hiring. Medical staff planning has never been more important – or more difficult. Organizations know they need to hire physicians, but the when and who can be overwhelming.

In a Tighter Market, Healthcare Organizations are Extending More Competitive Offers

The volume of physician job openings is increasing, and yet, the number of residents coming out of training remains similar to previous years. In order to win talent from this limited pool, organizations will be forced to make more competitive offers, especially as they increasingly feel the impact of the physician shortage.

“While compensation is dependent on specialty and location, we’re seeing some offers starting to outpace the industry benchmarks,” Osseck explains. ”It’s not always enough to be in line with the MGMA or Sullivan & Cotter data. Organizations often need to go beyond those figures in order to set their offers apart.”

Another MGMA STAT poll supports Osseck’s observation. In June of 2021, one in three practices reported adding or expanding bonuses as a means of attracting and retaining physicians. Inflation is also driving increases. In December of 2021, 50% of practices said they are budgeting more than usual for cost-of-living adjustments in 2022.

Regional challenges with the housing market are also impacting physician compensation. Helen Falkner, VP of Recruiting for the Western Division explains:

“As housing costs rise around the country – and housing availability becomes a challenge – some organizations are including a temporary housing stipend in the initial offer to ease the burden of relocation for new physicians. This is likely to become the standard – especially in areas with extreme housing challenges – until the housing market begins to reverse or at least stabilize.”

Increased Value of Work-life Balance

Increased salaries, bonuses, and cost-of-living adjustments are appreciated, but money isn’t the only thing physicians want. Following the 2020 spring shutdown, recruiters saw an increase in physicians prioritizing work-life balance and autonomy. In a JPS whitepaper covering the impact of COVID-19 on physician jobs, several VPs of Recruiting reported seeing physicians prioritizing quality of life, proximity to family, and better work-life balance. While money will always matter, this shift in priorities seems to be more than a passing trend.

Some organizations will be surprised to learn that the most competitive offer isn’t always the one with the biggest number. Benefits such as four-day workweeks, minimal or no call, or the ability to practice via telehealth are increasingly the deciding factors for physicians weighing offers. Organizations are getting creative with additional paid time off – offering scheduled sabbaticals or dedicated time for physicians to participate in medical missions, either local or abroad.

“In our efforts to find physicians, we have to constantly ask ourselves, ‘What is going to make a physician apply to this job over some other job? Why should they consider this location when they were dead set on something else?’” says Falkner. “Historically, the answer to that question is some sort of eye-catching compensation. So, we highlight the signing bonus or loan repayment in the job ad, but more and more, it’s also a shorter workweek or the opportunity to practice via telehealth that can make the difference.”

The job ad must catch attention, but when it comes time to craft an offer, both Falkner and Osseck discussed the importance of customizing it to meet the specific needs of the candidate. The physician interview process gives candidates the chance to be clear about their priorities. If an organization is listening, they will know what to offer to win the physician’s acceptance.

Rebalancing the Ratio of Compensation to Productivity and Its Importance

While trends from the previous year often inform compensation plans for the future, the circumstances of 2020 were cause for exception. For example, the MGMA data shows physician compensation was relatively flat in 2020, but the dip in productivity – forced by the lockdown and patient hesitancy to seek treatment – caused the ratio of compensation to wRVUs to appear much higher than years passed. Thus, organizations won’t likely use the 2020 ratios as a benchmark for future expectations.

That said, the circumstances of 2020 caused providers once happy to accept a productivity-based compensation model to rethink the security of those plans. The pandemic put physicians in a situation where they had very little control over their own productivity, causing many to feel productivity and wRVUs should carry less weight in the compensation plan. As physicians have increasing power in the job market, we may see less emphasis on wRVUs in physician compensation models.

“Most compensation plans specify a minimum salary regardless of productivity,” Falkner explains. “But of course, the expectation to see a certain number of patients is still there. Then, of course, there are bonus opportunities beyond that. Productivity bonuses are still common, but we are increasingly seeing bonuses for quality, retention, or even access to care.”

Begin to See the Impact of the Shift to Value-based Care

Also contributing to the declining importance of wRVUs is the increased attention on value-based care. Studies show this model benefits the provider, the patient, and the health of the overall population, and yet, moving from fee-for-service reimbursement to value-based care has proven to be complicated.

While both Helen and Tara said they are seeing more clients incorporating a quality component to compensation packages, productivity continues to be the most significant factor, in part because it is easiest to measure, but also because it continues to be the basis of how organizations are reimbursed.

The unique circumstances of the moment may provide some momentum for value-based care, however. An article from consulting firm Deloitte explores how fee-for-service reimbursement and productivity-based compensation are intertwined. The author proposes that shifting the focus to quality of care rather than quantity could not only improve patient outcomes but also bring more meaning to physicians’ work and help reduce burnout.

Better Times Ahead?

The pandemic has pushed physicians to their limits, and an increased number of them are seeking to improve their circumstances with new employers. Healthcare organizations are working with physician recruitment firms to attract these candidates with the promise of better employment opportunities. Of course, what constitutes “better” is relative. Organizations must customize offers to win talent, and more importantly, they must deliver on promises made if they hope to retain their physicians.

“There’s a sense among some of the physicians I speak to that they are just another cog in the wheel and their entire worth is based on how many patients they can see in a day,” explains Osseck. “Organizations are experimenting with compensation models to counter this mentality. Ultimately, though, physician job satisfaction comes down to more than the compensation package. It will require a well thought out physician retention program – something most organizations are still lacking.”

While no one can say for sure what lies ahead in terms of physician hiring and compensation, it’s safe to say that physicians have the upper hand in job negotiations.

If you are actively recruiting and finding candidate acquisition more challenging than in the past, reach out to Jackson Physician Search today.

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[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.

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2021-JPS-physician-practice-trends-FINAL-compressed

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?
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Jackson-Physician-Search-COVID-19-Changed-the-Physician-Job-Market-7132021

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 

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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.

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2021-JPS-five-benefits-hiring-advanced-practice-providers_

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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