More Physicians Needed to Counter Physician Shortage

We've all been hearing about the physician shortage, particularly the shortage of primary care physicians and also the increase in all physician shortages with impending healthcare reform. The AMA House of Delegates has adopted policies aimed at increasing the physician work force and staving off shortages.

Demand for doctors is expected to outpace supply by as many as 159,000 physicians by 2025. Currently, at least 22 states and 15 medical specialties have reported physician shortages.

The policies AMA has targeted call for promoting physician practice in underserved areas, expanding residency training, encouraging more people to become primary care physicians, and addressing a severe shortage of child and adolescent psychiatrists.

An AMA report adopted by delegates urges vigilance in seeking funding from a variety of sources for more residency slots.

The Department of Health and Human Services announced $250 million to strengthen primary care, including $168 million to create more primary care residency slots. The money is expected to help train more than 500 primary care physicians by 2015.

Read the full article in American Medical News or click here:
http://www.ama-assn.org/amednews/2010/06/28/prsk0628.htm

Physician Owned Hospitals: Will Healthcare Reform Make it Harder for them to Operate?

Physician-owned hospitals have long since been a profitable and well-run industry if operating correctly. However this may soon change with healthcare reform. A provision in the health reform law enacted in March placed major limits on physician ownership of hospitals.

Under healthcare reform, new doctor-owned facilities that are not certified as Medicare participants no longer will be allowed into the program. E xisting physician-owned facilities face immediate restrictions on expansion. Physician investors say those rules are so strict that virtually none of their hospitals will be able to grow.

Other new regulations include capping physician ownership, ending some exceptions to Stark self-referral bans and mandating more disclosure of physician owners' potential conflicts of interest when they send patients to their own facilities.

Physician-owned hospitals include specialty hospitals, surgery centers, acute care facilities, multi-specialty hospitals and even struggling community hospitals that have been propped up financially by physicians.

Until litigation, legislation or regulation direct otherwise, plans for new or expanded physician-owned hospitals will be in a holding pattern. Facilities also will need to make sure they don't run afoul of the law in their continuing operations.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/06/28/gvsa0628.htm

More Hospital Deals with Healthcare Reform

One positive spin for hospitals with the impending healthcare reform is it is predicted there will be even more hospital buy-outs from larger firms or healthcare conglomerates in the future. Recently there has been a lot of press of larger organizations acquiring hospitals throughout the country.

With the changes in the healthcare sector because of healthcare reform, there are apt to be even more hospital buy-outs as well as aggregation of existing hospital companies, diversification into outpatient sectors, and more jostling among companies to pick up larger positions in local markets.

There has been news of many hospital buy-outs lately, namely Cerberus Capital Management has agreed to buy Caritas Christi Health Care in the Boston area and the Blackstone Group-backed Vanguard Health Systems is buying the Detroit Medical Center.

Read the full article in The Wall Street Journal, or click here:
http://blogs.wsj.com/privateequity/2010/06/23/one-impact-of-health-care-reform-expect-more-hospital-deals/?mod=rss_WSJBlog

Increase in Compensation and Roles of Physician Leaders

There has been a trend of physicians who have leadership roles within hospitals experiencing an increase in responsibilities and also in compensation for the additional roles and duties. Some of this is due to an increase in affiliations with academic facilities and hospitals.

Leadership positions in hospitals are becoming more fully developed and time-consuming than in the past, incorporating the financial aspects of the department, physician recruitment, coordination with academic medical centers, quality, and even marketing roles.

Compensation for different leadership roles varies by specialty and institution. However based on the findings of this article in Becker's Hospital Review, the increased roles and responsibilities of physicians in leadership positions will be compensated at a higher level. Also, healthcare reform is likely to accelerate this trend as more organizations adopt more fully integrated models such as accountable care organizations and also lead to more value-based compensation.

The complexity of leadership roles in hospitals typically requires the physicians to have a much more business-oriented skill set. Hospitals are responding by investing more in improving their physicians' leadership, business, and communication skills.

Read the full article in Becker's Hospital Review, or click here:
http://www.beckershospitalreview.com/physician-hospital-relationships-employment-jvs/physician-hospital-relationships-employment-jvs/roles-and-compensation-of-physician-leaders-in-hospitals-growing.html

Practice Management Firms Buying More Hospital-Based Physician Groups

There has been a recent increase in the trend of hospitals purchasing existing private practices. However practice management firms are also buying practices. This is beneficial to practices interested in being purchased because they can have competitive offers and additional options than just being bought out by a hospital.

Inpatient Specialists are the most likely types of private or hospital based practices to be purchased by practice management firms. There are also practices being purchased by private firms although these deals are not made public.

The practice management firms are focusing on hospital-based practices and are buying within certain specialties. Typically the purchased practices are already financially healthy and have long-term relationships with hospitals, but need a larger entity to grow, acquire technology or negotiate with third-party payers.

Unlike with a sale to a hospital, practice management companies don't always employ the physicians after buying the practice. Practice management companies handle administration, own the practice's contracts and take in the payments, a portion of which is then distributed to the practice. Physicians can be employees or independent contractors of the management company directly, or of the practice. How this is handled is usually dictated by local laws and styles of practice.

Before selling, physicians should assess a company's viability as well as determine if the company is one they want to work with over the long term.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2010/06/21/bisb0621.htm

Reimbursement to Blame for Primary Care Shortage

This is an interesting article from The Baltimore Sun stating low reimbursement for primary care physicians is the result of the shortage and medical schools are not to blame.

When physicians enter into medical school and residency training, additional fellowship training to become a specialist is tempting because of the dramatic increase in remuneration. Also taking in to consideration how much debt many students are in after completing their training makes a higher paid position seem worth the extra few years of training.

Some medical schools are trying to attract primary care physicians to their programs to contribute to the shortage of primary care physicians. According to the article Johns Hopkins offers many different financial aid packages to primary care students.

Whatever the cause of the physician shortage, the scarcity is a huge concern currently as well as the dramatic change the medical industry may experience with healthcare reform.

Read the full article in The Baltimore Sun, or click here:
http://weblogs.baltimoresun.com/business/hancock/blog/2010/06/blame_reimbursement_not_school.html

Healthcare Employment Increase

Despite the recession and the increase in unemployment and decrease in jobs in many arenas, healthcare jobs have increased over the last month and have been increasing or steady all year.

Employment in the U.S. healthcare sector increased by approximately 8,000 jobs in May, and healthcare has added 20,000 new positions per month over the last year.

According to the latest jobs report from the federal Bureau of Labor Statistics, the biggest healthcare job gains were in ambulatory care, where 8,700 jobs were added in May. Of the new ambulatory care jobs, 2,500 were in physician offices and 1,600 were in home healthcare services.

Read the full article in Healthcare Finance News, or click here:
http://www.healthcarefinancenews.com/news/healthcare-industry-hiring-steady-clip

15%+ of Physicians Change Jobs Annually

SK&A has completed a study on the percentage of physicians relocating annually for a new job. According to their study titled Physicians on the Move, the 3 year average of physicians that moved to a new location or practice is 15.2%. This figure also includes those physicians that retired or passed away.

Summer is an interesting time in physician recruiting; most of the residency and fellowship graduates have identified positions but there are still a lot of experienced candidates interested in making a move, and 2011 candidates are ready to begin interviewing. This article is interesting because it reveals the rate of change of office-based physicians by practice specialty, and is targeting established and experienced physicians.

We have found a high percentage of physicians changing their first job out of residency in the first 2 years of practice. Often times new graduates are attracted by high reimbursements or a large salary, and once they have signed with a facility either the promises made are not kept or physicians change their motivating factors, such as location, case load, trauma call, and community amenities. However this article states physician stability and job change has decreased over the last 3 years.

According to the article from SK&A, data from their study suggests that the move rate of physicians has declined steadily in the past 3 years, indicating recent stability among the specialties surveyed. The rate has gone from 18.2% in the 2008 reporting period to 15% in 2009 to 12.4% in the 2010 period.


Read the full article in Healthcare Finance News, or click here:
http://www.healthcarefinancenews.com/news/study-more-15-percent-physicians-move-annually

Hospital Owned Practices Attracted 65% of Physicians in 2009: MGMA

According to the Medical Group Management Association (MGMA), hospital-owned practices were the most successful in attracting physicians in 2009.

Candidates fresh out of training as well as experienced candidates seek hospital based and/ or hospital employed opportunities because they often times choose jobs based on quality of life and security. Where as at our physician recruiting firm our private practice opportunities can provide significant income and potential, some candidates believe hospital owned practices offer more stability, guaranteed income, and less and shared call.

Some candidates also believe hospital owned practices may provide more security with the uncertain future of healthcare reform.

According to the MGMA’s Physician Placement Starting Salary Survey: 2010 Report Based on 2009 Data, 65% of experienced/ established physicians changing jobs in 2009 selected hospital owned practices, and 49% of residency and fellowship graduates chose a hospital owned practice.

The survey also shows that first-year guaranteed compensation has decreased by 2.1% since 2006 for specialists in single specialty practices, whereas primary care first-year guaranteed compensation has increased by 17.4%.

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

http://www.healthcarefinancenews.com/news/mgma-65-percent-established-doctors-are-hospital-owned-practices

Recruit and Retain Physicians

Now that summer is here and most of the 2010 residency and fellowship graduates have identified positions, we thought it would be appropriate to post an article from The New England Journal of Medicine on how to recruit and retain physicians.

In these economic times, hospitals and private practices have to be creative on how to attract the best physician candidates for their physician job openings. However, once the physician has signed the contract it is still important to actively work at retaining the physician.

How to retain a physician comes down to simple concepts: communication, follow-up, even asking if the physician is happy and how the circumstances of his or her position can be improved.

According to the NEJM, health care organizations that keep an eye toward the future and explore innovative ways to position their organizations to meet the needs of physicians throughout their career cycles will develop competitive advantages for recruitment and retention.

Read the full article by clicking here:
http://www.nejmjobs.org/rpt/recruit-and-retain-physicians.aspx