Most rural physician vacancies are identified late and never formally priced, according to a survey of rural healthcare administrators and clinicians from Jackson Physician Search, LocumTenens.com and MGMA.
Three-quarters of administrators surveyed reported a consequential physician vacancy in the past three years. For their single most consequential vacancy:
- Still open: 65% were still active searches.
- Duration: 42% had been open seven months or longer.
- Seen coming: only 12% were anticipated more than a year ahead. Fifty-seven percent were anticipated less than six months ahead or not at all.
- Planned interim coverage: 19% of administrators said the interim arrangement was part of an existing contingency plan. Sixteen percent said no interim approach was used.
- Interim models: the most common were physician-plus-APP models, 21, internal physician cross-coverage, 18%, and APP-led access with physician oversight, 15%. No administrator named telehealth.
- Cost estimates: only 25% formally estimated the vacancy’s financial effect. Forty-three percent made no estimate or evaluation at all.
The report cites American College of Surgeons figures that a rural surgeon can contribute an estimated $1.05 million to $2.7 million a year to a small hospital.
More departures are coming. Sixty-four percent of administrators expect at least one physician to retire or substantially reduce hours within five years. Of those, 26% have a formal plan for all or most of those departures, and one-third have only informal plans.
Administrators said a major vacancy led to longer patient waits, 57%, more physician workload or call, 51%, and patients leaving the local system, 43%. Twenty-three percent said the vacancy made it harder to recruit other physicians or clinicians.
