10 Reasons to Include Community Input in Medical Staff Planning

Hospitals and healthcare systems engage in a variety of research studies and analyses to support their planning efforts. However, the value of these studies is often not fully realized because the information is maintained by different groups and departments. Hospitals can be data rich, but the information is frequently used to support specific objectives and not necessarily available to decision-makers involved with other projects.  

Two common examples of information "silos" in healthcare are consumer studies and medical staff planning. Medical staff planning is generally done to ensure adequate physician depth and breadth is achieved and maintained. On the other hand, consumer studies are frequently conducted to support business development and market planning projects.

For those organizations that regularly conduct both types of studies, there may be an opportunity to incorporate consumer input into the medical staff planning process. Let's look more closely at why organizations may want to consider this combined approach.

1. Social and behavioral risks
Hospitals have been engaged in community health studies for years; however, these efforts have become more focused with the new federal requirement that all non-profit hospitals prepare a Community Health Needs Assessment to maintain their tax-exempt status and avoid penalties. A key component of a CHNA is an assessment of the socio-economic and behavioral risk factors affecting community health (e.g., obesity, poor nutrition, substance abuse, etc). When findings from these studies are incorporated into the medical staff development plan, they can help identify the most critical recruitment needs to effectively address these community issues.

2. Unmet community need
Traditional consumer studies as well as CHNA surveys often seek to identify healthcare services not readily available in the community. Surveys generally address primary care availability including pediatrics, women's and senior care as well as specialty care and ancillary services such as imaging and screenings. There is also the opportunity to probe into other community needs such as mental health services, children with special needs, healthcare for low income individuals and substance abuse treatment. Medical staff and physician recruitment planning can benefit greatly from identifying those healthcare services not readily available to the community.

3. Disease management
Many consumer studies address healthcare issues affecting members of the community including diseases or disabilities requiring ongoing care. While not necessarily valid in the purest statistical sense, this information can help identify chronic medical problems requiring significant resources to effectively manage over time (e.g. asthma, diabetes, hypertension, etc). When incorporated into the medical staff planning process, organizations can plan accordingly to ensure an adequate supply and mix of primary care and specialty physicians to manage prevalent medical conditions and diseases in the community.

4. Access barriers
While healthcare may be available in the community, many residents may have difficulty accessing services for a variety of reasons including practices not accepting new patients or lengthy wait times for an appointment. Or, practices may not accept patients with specific insurance coverage such as Medicare, Medicaid or state plans. Beyond these practice constraints, other access barriers can include drive times, office hours and the lack of transportation. Studies that identify these challenges from the consumer perspective can be significant contributors to the medical staff plans.  

5. Primary care coverage
Healthcare planners have understood for quite some time the importance of the primary care physician in meeting the basic healthcare needs of the community. Consumer studies will often explore the patient-primary care physician relationship including if individuals have a personal or family physician, length of the relationship, frequency of use and satisfaction with their current provider. Other factors that can impact access to primary care include lack of insurance coverage and the cost of care. While traditional medical staff planning studies may find no community need for additional primary care, consumer input may challenge this finding based on many of these factors. Successful network development strategies require not only an adequate supply of primary care physicians to meet the basic healthcare needs of the community but also to serve as a feeder system for specialists on the medical staff.

6. Consumer preferences
Healthcare marketers frequently conduct a variety of consumer studies to support development of successful marketing strategies. These studies seek to better understand consumer awareness, perceptions and preferences for different healthcare providers in the local market. Other items may include past healthcare usage patterns, patient satisfaction and reasons for seeking care at other hospitals or providers. Program strengths as well as weaknesses relative to competitors in the marketplace can clearly impact recruitment strategies even if traditional medical staff planning studies show no community need.

7. Care preferences
As healthcare continues to evolve, new delivery mechanisms have started to surface including the use of mid-levels providers such as nurse practitioners and physician assistants to provide basic care in many communities. Items that can affect physician need in the local community include consumer receptivity to these alternative providers as well as preferences for particular types of physicians (e.g. pediatrician vs. family physician, OB/GYN vs. family physician). This information can help ensure an appropriate complement of providers is available in the community to meet consumer preference patterns.

8. Outmigration for specialty care
A key objective of many consumer studies is to identify specialty services available in other markets that consumers would like to see in the local community. A common approach is to explore the specialty services and reasons why residents have migrated out of the community in the past for care and treatment. Reasons often include lack of specialists in the immediate area, referral patterns of local physicians, reputation of specialists and perceptions that better care is available in other communities. This consumer information can be used to evaluate which specialty services are the best candidates for expansion into the local community as well as the number and types of specialists needed to support the growth initiatives.

9. Strategic medical staff planning
Arguably the most critical component in the delivery of patient care, the medical staff is one of the organization's most important strategic assets. In addition to being the key supplier of patients, physicians are an important resource in the development of new programs and services. An effective medical staff plan needs to be strategically focused while concentrating on hospital-physician relationships, the organization's growth initiatives as well as community need. Input from consumer studies can be a valuable strategic addition when assessing growth and market expansion opportunities and the implications for medical staff planning.

10. Full use of all information

In a recent case study, one organization conducted a consumer survey study and a medical staff planning project to assess physician need in the market. In many cases the consumer findings were consistent with the medical staff planning results. However, additional insight was gained by incorporating consumer input into the medical staff planning analysis and interpretation. For example, while no need was found for additional mental health providers in the community, consumer input indicated the current location of providers was inconvenient and created access issues. As a result, the organization is now considering physician placement strategies rather than adding mental health providers in the community.

David Zirkle has worked as a healthcare market strategist for over 20 years. He helps organizations transform data and information into knowledge that is then distributed to the right people, at the right time, in the right format. Past experience includes the full array of marketing disciplines: strategic planning, market research, brand development, service line planning, competitive analysis, CRM and sales management. Much of this is "hands-on" experience with one of the largest healthcare systems in the country. He is a past president of the Indiana Healthcare Marketing and Public Relations Society and has a PhD in Statistics from Oregon State University.


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