Impending Physician Shortage: New Medical Schools are Opening, Shortage Still Concerning

The Association of American Medical Colleges predicts a shortage of at least 125,000 physicians by the year 2025. The number of residents and fellows increased 8% from 1987 to 2007, according to an AAMC report, but that growth rate will not be enough to match the loss of baby boomer physicians set to retire soon; one in three active physicians currently practicing is 55 or older.

However some experts on work-force issues say new schools are not enough to significantly alleviate the upcoming physician shortage. We have also heard from many of our candidates that with the uncertain future for the medical community because of health care reform many potential applicants are not applying for medical school or changing from pre-med to other disciplines.

Without more federal funding for residency slots or changes in the doctor payment system, the schools are unlikely to avert an overall work-force shortage or address the undersupply of primary care physicians and general surgeons.

Since 2007, more than a dozen allopathic schools have started the Liaison Committee on Medical Education accreditation process. Another 10 are under discussion, and five osteopathic medical colleges have opened.

There are 13 allopathic schools in the accreditation process, with at least 10 more in the planning stages. In addition, five new osteopathic schools have opened across the country. Educators and physician leaders hope that the graduates of the new schools will help ease a predicted physician shortage, but they add that more funding and residency positions will be needed to avert future holes in the overall work force.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/03/29/prl20329.htm

Hospital Employed Positions for Physicians Increasing

Hospitals & Health Networks has published an interesting article on the increasing trend of physician employment. Many of the hospitals we recruit for are changing models from income guarantees to full hospital employment, and many of the physician candidates we work with request hospital employment positions.

H&HN agrees, physician employment by hospitals is increasing. According to their article, the American Medical Association reports that the total number of physicians employed in community hospitals increased 24% between 2003 and 2007, while the number of physicians nationally increased only 8%.

In addition, a recent survey by the Society for Healthcare Strategy and Market Development indicated that health care leaders across the nation believe the percentage of physicians on hospitals' active staffs who are employed will increase from 10% today to 25% by 2013.

Read the full article in Hospitals and Health Networks, or click here:

http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/09SEP2009/090922HHN_Online_DeBoer&domain=HHNMAG

More Doctors Giving Up Private Practices

Traditionally, American medicine has been largely a cottage industry. Most doctors cared for patients in small, privately owned clinics - sometimes in rooms adjoining their homes. However an increasing share of young physicians, burdened by medical school debts and seeking regular hours, are deciding against opening private practices. Instead, they are accepting salaries at hospitals and health systems. And a growing number of older doctors - facing rising costs and fearing they will not be able to recruit junior partners - are selling their practices and moving into salaried jobs.

As recently as 2005, more than two-thirds of medical practices were physician-owned - a share that had been relatively constant for many years, the Medical Group Management Association says. But within three years, that share dropped below 50%, and analysts say the slide has continued. The process feeds on itself because doctors who remain in private practice worry that as their peers sell out, their own options become more limited and the prices for their own practices fall.

The trend away from small private practices is driven by growing concerns over medical errors and changes in government payments to doctors. But an even bigger push may be coming from electronic health records. The computerized systems are expensive and time-consuming for doctors, and their substantial benefits to patient safety, quality of care and system efficiency accrue almost entirely to large organizations, not small ones.

Read the full article in The New York Times, or click here:

http://www.nytimes.com/2010/03/26/health/policy/26docs.html?ref=health

Twitter Becoming Essential Tool Amongst Physicians

Healthcare IT News tracks more physicians utilizing Twitter, so much in fact it is becoming an essential communication tool.

Doctors don't generally use Twitter to give medical advice but to guide the public and other physicians and colleagues to reputable sources of information or share breaking medical news.

Twitter will soon be an essential tool for medical practices according to a poll conducted by Case Western University, an independent research university in Cleveland.

Fifty-nine percent of those who participated in the poll voted "yes" that Twitter would become an integral part of the way doctors communicate with patients and other medical professionals.

Read the full article in Healthcare IT News, or click here:

http://www.healthcareitnews.com/news/twitter-becoming-essential-tool-docs

Follow Harlequin Recruiting on Twitter!

http://twitter.com/DOMDRecruiter

Physicians: Selling Your Practice

Whether you are planning to start a new employed position or retiring, selling your current practice is a very important consideration.

Medical practice sales experts recommend that doctors follow a series of steps, ideally beginning the process two or three years before the desired time of sale. These measures include getting financial records in order, making the practice visually appealing, setting realistic price expectations, communicating the interest to sell and planning the transition.

Read the full article in American Medical News, or click here:

http://www.ama-assn.org/amednews/2010/03/15/bisa0315.htm

Physician Recruitment Income Guarantees Ease Hiring Of New Docs

Many of the larger facilities we work with offer new physician employees income guarantees as part of their employment package. Recently, physician income guarantee agreements are enjoying a resurgence.

What is an income guarantee? The facility guarantees that the new physician will earn a set amount of total income in the first 12-24 months of employment. If the cases completed do not reimburse the physician according to the guarantee level, the facility pays the additional income to the physician, thus 'guaranteeing' a certain amount of income. Technically, this is a “loan” to the doctor, but the “loan” is forgiven if the physician remains in practice in the hospital’s service area for 2-4 years after the guarantee period.

Income guarantees are becoming more common in new physician employment offers. The income guarantee serves to alleviate the concerns of the group or facility that if it hires the new physician, the senior doctors will be forced to take a pay cut to fund the new doctor’s salary, as that doctor ramps up his or her practice.

Income guarantee agreements are complex, and there are generally many strings attached, i.e. potentially no non-compete for group, taxes issues, and liability issues.

Daniel M. Bernick is an Attorney and Principal of Health Care Law Associates and has provided an article explaining income guarantees and also 7 core legal and business pointers about the guarantee agreements.

Read the full article in Physicians News Digest, or click here:

http://www.physiciansnews.com/2010/01/14/physician-recruitment-income-guarantees-ease-hiring-of-new-docs/

NEJM Physician Survey: Health Reform May Lead to Significant Reduction in Physician Workforce

The New England Journal of Medicine has published a physician survey determining the impact of health reform on physicians and ultimately on medicine as we know it today.

The BLS (Bureau of Labor and Statistics) predicts a more than a 22% increase in physician jobs during the ten-year period ending in 2018. This places physician careers in the top 20 fastest-growing occupations from 2008 to 2018. Meanwhile, nearly one-third of physicians responding to this survey indicated that they will want to leave medical practice after health reform is implemented.

The Medicus Firm, a national physician search firm based in Dallas and Atlanta, conducted a survey of over 1,000 physicians to determine their expectations as to the impact of health reform on their practices, income, job satisfaction, and future career plans.

Although it's probably unrealistic that nearly half of the current practicing physicians will exit the medical practice industry after a version of health reform were implemented, even if a much smaller percentage such as 10, 15, or 20% are pushed out of practice over several years at a time when the field needs to expand by over 20%, this would be severely detrimental to the quality of the health care system.

The survey indicates that doctors do want change in our current healthcare system. Only approximately 4% of physicians surveyed feel that no reform is needed. However, only 28.7% of physicians responded in favor of a public option as part of health reform.

What does this mean for physician recruiting? It’s difficult to predict with absolute certainty, but one consequence is inevitable. After health reform is passed and implemented, physicians will be more in demand than ever before. Shortages could be exacerbated further beyond the predictions of industry analysts.

Read the full article in the New England Journal of Medicine, or click here:

http://www.nejmjobs.org/rpt/health-reform-may-reduce-physician-workforce.aspx

Percentage of Physicians Practicing in the State Where They Completed Training

The New England Journal of Medicine has published an article tracking the percentage of residents and fellows that ended up accepting positions in the states where they completed training.

According to the NEJM, after completing training in an ACGME-accredited program, 47.6% of physician graduates either stayed or returned to the state where they completed GME. Retention rates were highest for physicians who completed both UME and GME in the same state. Two thirds of the physicians who completed UME and GME in the same state accepted positions in the same state.

Six of the top ten states with the highest GME retention rates were in the West. In terms of overall retention, 8 of the top 10 states were n the South and West.

The New England Journal of Medicine has created a map tracking GME retention. Read the map on their website, or click here:

http://www.nejmjobs.org/rpt/acgme-retention-rates.aspx

Healthcare Sector Job Growth: Continued Increases Expected

The Healthcare Sector has created additional jobs in January reports, slightly impacting the economy as a whole. The Bureau of Labor Statistics reported on the national employment situation on February 5th an increase in healthcare jobs, and the organization along with other reports suggest the trend in an increase of healthcare jobs will continue.

According to the Bureau of Labor Statistics, January reported an increase of healthcare jobs of 15,300 new jobs in ambulatory medical centers, including 5,600 in physician offices. Another 5,000 were added to hospital payrolls. More jobs were created this past January in the health care industry than at this time last year.

Experts say this is being driven by the fact that, although some areas of the country are experiencing shortages of medical professionals, there are more physicians entering the marketplace, and very few, if any, end up working alone. According to MGMA data, a physician needs an average of 4.5 support staff, although this can vary by specialty.

Other surveys supported the idea that health care is driving job creation and will continue to do so. A report by the Conference Board issued February 1st found that the number of jobs advertised online increased 382,000 and topped 4 million for the first time since November 2008. Listings for health care professionals increased by 24,500, bringing the total for this category to 567,800. About 6,500 additional ads were placed for medical support staff for a total of 119,000.

Read the full article in American Medical News, or click here:

http://www.ama-assn.org/amednews/2010/02/22/bisc0223.htm