Increase in Hospital Employment Positions

The New York Times and The New England Journal of Medicine have both recently published articles on the increasing trend of physicians seeking employed opportunities. The articles both reference physicians being motivated by a higher quality of life offered by employed positions, presumably as compared to private practice.

The New England Journal of Medicine documents the increase in hospital employed positions, rising from just over 20% in 2002 to over 50% in 2008, the last year for which the study had data.

The New York Times article highlights the dramatic changes in physician employment as being driven by doctors' evolving professional and personal goals. The Times article chronicles the lives of three generations of Pennsylvania doctors: starting with the grandfather, a family physician in the 1940s who worked 80+ hours per week, and ending with a granddaughter, a hospital-based ER doctor named Kate Dewar, who works 36 hours per week so she can be home with her new twins.

In the 1990s, hospitals pushed to hire doctors to fill out their referral networks, as managed care took over. Now, the trend is "more physician-driven" as doctors choose to forego the "hassles of private practice" such as insurance and government billing requirements and the administration of a large office.

However we feel there will also be a place for private practices, both to offer options to patients and maintain quality of care. Physician offices also provide good jobs in local economies, and physicians can still enjoy a good quality of life with shared call, business and billing consultants, and can control how they would like to run their practice.

Read the article in the New York Times by clicking here: http://www.nytimes.com/2011/04/02/health/02resident.html?pagewanted=1&_r=3&ref=homepage&src=me

Read the article in the New England Journal of Medicine by clicking here: http://healthpolicyandreform.nejm.org/?p=14045&query=TOC

Hospitals' New Physician Leaders: Doctors Wear Multiple Medical Hats

A new trend in hospitals is employing physicians in both administrative and clinical roles. A new generation of physicians are combining clinical care and executive leadership concurrently. There are more of these positions as hospitals and large health systems prepare for the implementation of health reform and recognize the need for greater alignment with physicians. Physician leaders are viewed as more important than ever to closing the divide between clinicians and the administration as they try to create accountable care organizations, reduce readmissions, improve care, and implement electronic medical records. Physicians playing an executive role feel they have more control of patient care and hospital regulations. They are working to improve quality in their every day clinical atmospheres; they feel they can trust initiatives more and have representation on the board. Also the trend has created new titles available to accommodate new administrative needs. The chief medical officer remains a common leadership position, but hospitals are creating positions such as chiefs of physician relations, integration, and medical informatics. These new positions incorporate some duties that until now physicians traditionally would have carried out as volunteers as part of the medical staff or various committees. Read the full article in American Medical News, or click here: http://www.ama-assn.org/amednews/2011/04/04/bisa0404.htm

Office-based Doctors Support 4 Million Jobs

As other industries are slowing down and unemployment is continuing at record highs, office based physicians are bringing jobs to their communities. Medical Group Management Association researchers have devised national and state-specific multipliers to determine the value of a physician's contribution to local economies, including jobs created, spending at nearby businesses, and taxes generated. According to these figures office based physician practices contributed to over 4 million jobs in 2009. With unemployment still rising, the number of jobs at physician offices has continued to increase. These jobs pay well and offer strong benefit plans; also they offer a stable environment and more job security than many other industries. These figures confirm that physician offices are a large contributor to the economy; having physician offices in a community is economically healthy for the local area. Numbers vary by physician practice and specialty, however on an individual level, physicians support an average of 6.2 jobs each, including their own. One physician leads to about $100,000 in state and local tax revenue and $2.2 million in overall financial activity. Read the full article in American Medical News, or click here: http://www.ama-assn.org/amednews/2011/04/04/bil20404.htm

10 Current Healthcare Employment and Compensation Trends

Becker's Hospital Review has reported 10 trends physicians and hospitals noted last year in employment and compensation. The trends provide good insight in to what to expect this year and also in to the future regarding hospital employment and compensation.

Here are the trends reported:

1. Nursing enrollment is rising

2. Female physicians earn less

3. More medical students choose primary care

4. Physician compensation in academic settings increased in 2010

5. Staffing levels affect mortality rates

6. On-call pay has increased in half of hospitals

7. Critical care employees report lowest job satisfaction

8. Employed physician salaries are expected to increase

9. Nurse provider shortage decreases

10. Feb. 2011 saw higher employment than Jan. 2011 and Feb. 2010

Read the full article on Becker's Hospital Review, or click here:

http://www.beckershospitalreview.com/hospital-financial-and-business-news/10-current-healthcare-employment-and-compensation-trends.html

NEJM: Physician Shortages in the Specialties Taking a Toll

The physician shortage has not been lacking in recent press, particularly with the impending changes healthcare reform promises to contribute to the current shortage. Although most of the press has targeted the primary care shortage, there is a shortage in specialists and surgeons as well. The aging population and retirement of the baby boomers is one factor that will contribute to the increase in specialists, particularly those that specialize in older adult care. Some of the obvious specialties that care for older adults are Cardiology, Critical Care, Diagnostic Radiology, Oncology, and Orthopedic Surgery. Shortages in Dermatology, General Surgery, Neurology, Psychiatry, Urology, and Vascular Surgery are also predicted to increase in demand and therefore shortage. There is also a significant shortage amongst pediatric physicians in nearly all specialties. The shortage of specialists has translated to more competitive employment offers, particularly in underserved areas. In its June 2010 report on non-primary care specialty shortages, AAMCs Center for Workforce Studies ventured a dire prediction for the decade ahead: a current deficit of 33% in surgical specialties, and an undersupply of 33,100 surgeons and other specialists by 2015, increasing to 46,100 by 2020. In addition, one third of U.S. practicing physicians are expected to retire over the next decade. Suggestions for how to address the specialty shortage range from training incentives to early medical students to government assistance. Read the full article in the New England Journal of Medicine, or click here: http://www.nejmjobs.org/career-resources/physician-shortages-in-the-specialties-taking-a-toll.aspx

Physician Shortage to Quadruple within Decade

According to an Association of American Medical Colleges (AAMC), the physician shortage we are currently experiencing will be nothing compared to what the future holds.

From the AAMC report, U.S. specialties will reach a shortage of 91,500 doctors by 2020. The AAMC predicts Americans will need an estimated 45,000 primary care physicians and 46,000 surgeons and medical specialists, a higher estimate than other studies have previously reported.

The most affected areas will likely to be rural regions and inner-city areas, according to the report. Factors contributing to the increase in the physician shortage include physicians retiring, the aging population of the American public, and healthcare reform. According to the Census Bureau, the senior population is estimated to grow by 37%.

There are currently 709,700 physicians (in all specialties) for a demand of 723,400 physicians, with an existing shortage of 13,700. By comparison, in 2020, there will be 759,800 physicians (in all specialties) for a demand of 851,300 physicians, essentially a shortage of 91,500 too few doctors.

Read the full article in The New England Journal of Medicine, or click here:
http://www.nejmjobs.org/rpt/physician-shortage-to-quadruple-within-decade.aspx

Increase in Academic Physician Compensation

According to a new report from the Medical Group Management Association there has been an increase in academic physician compensation in 2009 and 2010.

Typically the motivation to be an academic physician is based more on professional fulfillment and self actualization than monetary remuneration. However it's important for academic facilities to stay competitive in the marketplace.

In addition to contributing to the next generation of medicine, academic facilities also offer physicians a stable working environment with set pay and full benefits where they can also continue their training.

Read the full article at FierceHealthcare, or click here:
http://www.fiercepracticemanagement.com/story/mgma-academic-physician-comp-slightly/2011-03-16

Increase in Permanent and Locums Physician Jobs

In a recent survey by Staff Care, there has been a documented increase in the number of physician jobs. Because many of these permanent positions are difficult to fill, there has also been a significant increase in utilizing locums physicians.

There has been a lot of media attention on the physician shortage; however this continued increase in physician jobs can also be attributed to an economic recovery. There is an increase in the lack of physicians to fulfill the number of openings.

The physician shortage is mostly in primary care, however many specialists and surgeons are also in short supply. Utilizing locums has allowed hospitals to continue consistent patient care, behavioral health physicians were the largest specialty utilized for locums with primary care coming in second.

Physicians are favoring locums positions over permanent positions for several reasons including earning extra income, having more flexibility and a better quality of life, or to fill in gaps from other commitments such as military or even employed positions.

Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/03/07/bisc0307.htm

Job Offer Incentives for Physician Candidates

This article in Med Center Today was written primarily for academic physician candidates, however the checklist can also be used by physician candidates seeking hospital employment and even private practice opportunities.

There are many other important factors other than salary to consider when reviewing a contract, many of these negotiable.

Standard incentives offered in most contracts include sign-on, relocation, salary or income guarantee, and support. However other factors some candidates don't think of in the negotiation process are loan repayment assistance (particularly for new graduates), additional support, education for the candidate's children, assistance for spousal employment, and housing assistance in either selling a previous house or in buying a new house.

It's important to consider an offer in it's entirety to see not only how much you will be paid but also what other factors can contribute to both your clinical practice and family/ quality of life. Salary and income aren't the only negotiations to consider in a potential offer.

Read the full article at Med Center Today, or click here:
http://www.medcentertoday.com/checklist.php?id=66

Physician Re-Entry in to a Clinical Practice

Many of the physicians we work with are looking to re-enter in to a clinical practice. Whether the physicians have been in research or teaching exclusively, working in pharmaceuticals, or in executive administration, a lot of hospitals have policies that are unable to consider physicians if they have been out of a clinical practice for more than 2 years.

There is also state re-licensing and board recertification involved in most cases as well. Often times it is difficult to identify opportunities for physicians wishing to re-enter in to a clinical practice.

The American Medical Association, in collaboration with the Federation of State Medical Boards and the American Academy of Pediatrics, issued recommendations on January 25th calling for a comprehensive and transparent regulatory process for physicians to come back to medicine. The organization wants policies ensuring that re-entry programs are of high quality and that physicians who complete them are ready to practice.

This is a good article highlighting what a physician can do in a non-clinical practice to keep up with regulating authorities as well as some licensing requirements per state. Read the full article in American Medical News, or click here:
http://www.ama-assn.org/amednews/2011/02/28/bil20228.htm