Provider shortages are widespread, longstanding and not abating anytime soon. To slow the exodus of highly qualified clinicians and cope with growing demands for care, many health systems need to reassess their care models, culture, compensation schemes and use of technology.
During an April Becker’s Hospital Review webinar sponsored by Medicus Healthcare, Shannon Peterson, senior vice president and head of delivery at Medicus Healthcare, moderated a discussion about strategies organizations can use to mitigate provider shortages.
Panelists were:
- Robert Roose, MD, President, Community Hospitals, Trinity Health of New England (Hartford, Conn.)
- Chad Tuttle, Chief Operating Officer, Corewell Health (Grand Rapids, Mich.)
Three key insights were:
- Health systems face ongoing, significant clinician-staffing challenges — requiring swift, smart action. From rural clinics to urban hospitals to large academic medical centers, healthcare organizations of all sizes, in all geographies, are facing provider shortages.
The primary driver of these shortages is supply and demand misalignments in specialties such as radiology, anesthesiology, psychiatry and geriatrics, where the growing need for services is not matched by the number of available or graduating physicians.
Other factors include physicians’ retirements and lifestyle choices, such as scaling back work hours or shifting to telematic care delivery. “Finding psychiatrists in inpatient settings could be particularly challenging as the demand for behavioral healthcare expands dramatically and there’s more access in outpatient settings and through telehealth means,” Dr. Roose said.
For patients, the most detrimental impacts of physician shortages are reduced access to care and extended wait times. If clinician shortages can’t be addressed, some hospitals may have to discontinue critical services, such as birthing units or neonatal care centers. Operationally, shortages can increase hospitals’ length-of-stay metrics, while financially, shortages can dampen revenue and growth opportunities. - Corewell and Trinity have implemented a mix of strategies to address provider shortages and their downstream impacts. Corewell rebalanced its employed versus contracted staffing models to improve coverage in rural settings, which are often seen as less desirable places to work than urban settings.
“We used to recruit for the option of, ‘Which setting are you looking for?’ We recently switched to, ‘If you’re going to join a practice group, we’d like you to be able to do a little bit of both settings,'” Mr. Tuttle said. Corewell complemented its elevated requirements with modernizing physicians’ compensation schemes and leveraging more technology and AI tools.
Trinity also started using a rotational urban/rural model for its physicians. In addition, it promoted the roles of advanced practice providers (APPs) and advanced practice registered nurses (APRNs) and cross-trained them to cover multiple service lines. “In some cases, that means having more APPs than physicians, depending on the specialty and the setting,” Dr. Roose said. He expects the APP trend to accelerate in the next few years as physician shortages continue to worsen.
In line with that trend, Corewell recently piloted a program that had APPs manage physicians’ inboxes (inbox management is a common source of physician frustration). This pilot received “rave reviews.” Although scaling up AAP management of physicians’ inboxes represents a significant investment by Corewell, it is well worth it. This program allows physicians to see more patients while increasing their well-being and engagement — key drivers of physician retainment. - Culture is as essential as compensation for mitigating provider shortages. In addition to redesigning care models, updating compensation and leveraging more technology and AI tools, healthcare organizations are taking a deeper look at their culture. Although culture is difficult to measure, “getting it right” is fundamental for physician retainment.”Overall, culture is slightly more important than compensation,” Dr. Roose observed. “It’s about feeling valued — and money is not the only way that makes people feel valued.”
A work environment shaped around what makes physicians feel valued and what they value — including autonomy to influence their day-to-day and input into corporate decision-making — is now more necessary than ever. “You want to be giving your providers the opportunity to give feedback and then responding to that feedback,” Mr. Tuttle said.
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