Healthcare Workforce Demand Growing Faster than Provider Supply

September 27, 2017 - The demands of the healthcare workforce are significantly outpacing the supply of new doctors available, especially for primary care providers, a recent Merritt Hawkins survey uncovered.

The survey of 935 physicians in their final year of residency training found that 55 percent had been contacted over 100 times by physician recruiters about job opportunities during the course of their training. This is the highest percentage since Merritt Hawkins started conducting the survey in 1991.

Most residents (96 percent) had been contacted at least 10 times, with 86 percent reporting they had received recruiter attention 26 or more times and 76 stating they had communicated with a recruiter over 51 times.

“The search for newly trained physicians is on the verge of becoming a feeding frenzy,” stated Mark Smith, President of Merritt Hawkins. “There are simply not enough physicians coming out of training to go around.”

Physician recruiters particularly targeted primary care providers as well as residents training in family medicine, internal medicine, and pediatrics. In 2017, about three-quarters of these provider types received 51 or more job solicitations during their training versus just 70 percent of all provider types.

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Fifty-six percent of primary care provider residents also received over 100 job solicitations, compared to just one-half of all physicians.

Value-based reimbursement and care drove recruiters to target residents in primary care fields, researchers stated.

“Primary care physicians are in high demand due to their role as leaders of interdisciplinary clinical teams and because they are the indispensable managers of care and resources in emerging quality-driven delivery models such as ACOs [accountable care organizations],” they wrote.

The shift away from fee-for-service may also be the top reason driving most residents to favor a hospital-employed position over an opening in an independent practice.

Only 1 percent of respondents stated that they would be interested in opening a solo practice.

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Conversely, about 41 percent of residents said they were most open to being hospital-employed. Another 34 percent of participants preferred practicing in a medical group.

The results showed that residents are following in the footsteps of most physicians currently in the workforce. A recent American Medical Association (AMA) study found that physician practice owners no longer represented the majority of patient care providers by 2016.

The study marked the first time since the AMA launched its Physician Practice Benchmark Survey that employed providers accounted for the same percentage of those who had an ownership stake in a practice.

“Employment offers a safe harbor from many of the burdens of independent practice ownership as well as the strength in numbers, expertise and organization required to compete and thrive in value-based reimbursement models,” Merritt Hawkins researchers explained.

Employment preferences leaning toward hospitals and medical groups may spell trouble for rural areas, the survey added. Just 1 percent of final-year residents preferred to work in a community of 10,000 people or less and only 3 percent stated they would practice in a community of 25,000 or fewer.

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A community of 100,000 individuals or more was the ideal size for 83 percent of residents. Another 25 percent said they preferred to work in a region with one million or more people.

Residents shied away from rural areas because they were concerned about being on a “clinical island” without specialty support, health IT access, and other resources. They also cited a lack of coverage and the challenge of balancing work and personal life as to reasons for not practicing in a rural setting.

However, rural areas are desperate to fill open positions in their healthcare organizations. Even though 20 percent of the population lives in rural area, only 10 percent of all physicians practice in these regions.

Consequently, the lack of providers in sparsely populated areas represents about 65 percent of the healthcare professional shortage.

Additionally, the survey revealed that final-year medical residents lack healthcare business knowledge. About one-half of residents felt somewhat prepared to manage healthcare business operations, such as employment contracts and compensation arrangements.

Another 38 percent of respondents stated that they were unprepared and just 10 percent felt confident about their healthcare business knowledge.

As the industry shifts to value-based reimbursement models, providers are offered a wider range of compensation arrangements that could include outcome- and productivity-based bonuses on top of traditional fee-for-service structures.

However, approximately 49 percent of residents said that they did not have any formal business training, including compensation arrangement education.

“A great deal of care should be taken by the recruiting party to educate residents regarding the features, benefits, and drawbacks of the growing number of financial arrangements available to physicians in today’s recruiting market,” researchers stated. “Without such guidance, residents are more likely to accept a practice offer coming out of training that may not suit their needs, leading to a high level of turnover.”