Healthcare Job Losses Spell Trouble for Physicians

The healthcare industry made history this December — but not in a good way.

Last month, the healthcare industry lost jobs, according to data from the Bureau of Labor Statistics. It was the first time in 10 years the industry posted a monthly jobs loss, and just the second time it's happened in 23 years, according to Jim Stone, president of The Medicus Firm.

Further, job gains in the industry throughout 2013 were well below the norm: Healthcare job gains averaged 17,000 a month last year, while in 2012 the monthly average gain was 27,000.

The slowed growth can be connected to the delay of the employer mandate and the changing terms of the individual mandate, as well as the slow start to enrollment on healthcare.gov and state exchanges, according to Mr. Stone. Because coverage dates keep getting delayed, employers may shed jobs or slow hiring efforts until they feel the need to ramp up for the newly insured.

He points to an old saying: Anticipation of death is worse than death itself.

"This may just be a move on the part of healthcare providers that they're going to hunker down until they get more clear direction," he says. "It's the anticipation that's killing everyone."

Hospitals specifically have contributed to the slowed jobs growth in healthcare, as several hospitals across the country have decelerated their hiring or made major cuts to their workforce. Jobs in home health and outpatient care centers, on the other hand, generally grew month to month last year.

However, while healthcare organizations cut jobs to meet their budgets and wait for a clearer direction, slowed job growth and layoffs in the industry are having an affect on physicians. The timing of these changes, with aging baby boomers and an expanding insured population, has some repercussions for the supply/demand balance of healthcare services.

Straining physicians

Because of healthcare reform, the industry is waiting to take on millions of newly insured patients, further putting a strain on an already short supply of physicians — leading to the rise of team-based care, Mr. Stone says. Providers like social workers, dieticians, diabetes educators, case managers and others can support patient care in a team setting. This takes pressure off physicians and allows them to work at the top of their license, performing services and tasks that only physicians are qualified to do.

However, recent job cuts tend to be "non-physician, non-revenue driving members of the team," Mr. Stone says, so physicians, nurse practitioners and physician assistants tend to not be affected. "So we lose the staff that's supposed to be providing the team-based care."

This means physicians, along with NPs and PAs, will be responsible for caring for a growing population of patients without as much help as previously expected. "There's no relief in the immediate future in terms of the workload we're going to be asking of physicians," he says. "We're going to be asking our physicians to do more for more people."

Future outlook

Despite the slow growth throughout 2013 and the job losses in December last year, Mr. Stone believes the job market will turn around. "I think it has to," he says, citing the aging population as well as the influx of newly insured patients as the reason. "Someone is going to have to provide that care."

How long it takes to bounce back, and the long-term effects of December's historic job losses and the slow 2013 growth, however, remains to be seen.

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