Healthcare Issues & Trends

Advice & Insights for healthcare's Leaders & HR Professionals

5 Strategies to Maximize Recruitment and Retention of Primary Care Physicians

Posted on February 27, 2013 by Gallagher Integrated

Originally authored by Chad Stutelberg, Executive Vice President and Practice Leader of INTEGRATED Healthcare Strategies
There is a severe shortage of Primary Care Physicians (PCPs) in the United States.  Even before the Accountable Care Act (ACA) of 2010, the Association of American Medical Colleges projected a shortage of 46,000 PCPs by 2025.  A recent article in the Annals of Family Medicine showed that with the implementation of the ACA, the United States will have a shortage of 52,000 PCPs by 2025; 8,000 of which are needed just to address the additional estimated 30 million more Americans that will be covered under the ACA.  
While there certainly have been many different strategies put forth in the industry to address this shortage - including using advanced practice clinicians (e.g. Nurse Practitioners, Physician Assistants, etc.), encouraging more residents to stay in primary care, and a focus on increased reimbursement for primary care services from the payors - healthcare organizations have put a focus on primary care. 
Top 5 strategies for recruiting and retaining primary care physicians  

  1. Get PCPs Out of Taking Call.  The key in implementing a hospitalist program is understanding the impact it can have on the PCP compensation model.  Typically, compensation per wRVU rates are slightly less for those PCPs that don’t take call coverage.
  2. Encourage PCPs to use Advanced Practice Clinicians.  These providers can be used to make the PCPs more effective and productive.  The key in implementing advanced practice clinicians into a practice is identifying the right “fit” between the providers and ensuring that the physician is not harmed economically through the use of these providers - compensation models need to be adjusted to account for the use of these providers in the practice setting.
  3. Implement/Accelerate the use of Electronic Medical Records.  Most PCPs have 5% to 15% of their income based on performance.  It's critical that providers have access to reliable quality data in well-developed EMR systems.  This will ensure that physicians get the information they need to make solid clinical decisions, and that they are reasonably satisfied with the compensation that is paid to them for these services.
  4. Development of a PCP “Culture” Through Committee and Governance Structures.  Adopt a culture of leadership and focus on primary care (which can be done in conjunction and not at the expense of specialty care). Organizations that use physician leaders and that have pro-active committee/governance structures are more successful in recruiting and retaining PCPs.  One of the key factors in supporting this new “culture” is compensating physicians for their time in these positions and understanding how this commitment impacts their clinical income/practice.
  5. Minimize Administrative Burden – Have a Good Practice Management System.  It is critical that organizations minimize administrative burdens for physicians, either through the implementation of a good practice management system and/or ensuring appropriate levels of clinical and practice support.  Providing sufficient support increases PCP satisfaction and allows them to maximize their income under productivity models that are present today.

It is fair to say that any organization engaged in “best practices” would tell you that they are constantly re-evaluating their strategy for PCPs (and their entire physician network, for that matter) and they commit to doing everything possible to maximize their short and long-term success.

See the full article

National Healthcare Compensation Surveys

Posted on February 17, 2013 by Gallagher Integrated

The INTEGRATED National Healthcare Leadership Compensation Survey just opened last week - but our Nursing and Staff Compensation Surveys have been open for nearly a month now, too!  We don't want any healthcare organizations to miss their chance to participate and receive special discount pricing.  And, purchasing certain surveys in bundle gets you even more savings! 

At INTEGRATED, we have over 20 years of expertise & knowledge in healthcare compensation surveys, and we're proud to provide high-quality resources that help healthcare organizations make critical compensation decisions. Check out the list below for the compensation surveys we offer, and important information like participation dates and when survey reports will publish.
Data on more than 200 positions at executive, director and manager levels.
Participation deadline:  May 10, 2013
Publication:  August 30, 2013
Co-sponsored by ASHHRA


Published for over 20 years and includes more than 250 benchmark positions.
Participation deadline:  April 5, 2013
Publication:  June 28, 2013
Co-sponsored by ASHHRA 

Bundle and save!  The National Healthcare Leadership and Staff Compensation Surveys may be purchased together at discounted rates - participate and save even more!
Includes more than 100 positions, special pay practices, and data reported nationally and by region.
Participation deadline:  March 29, 2013
Publication:  May 10, 2013

Covers more than 90 position titles and includes data from more than 150 organizations.
Participation opens:  April 1, 2013
Participation deadline:  June 7, 2013
Publication:  August 30, 2013

More than 70 benchmarks for nurse practitioners, physician assistants, and nurse midwives.
Participation opens:  July 11, 2013
Participation deadline:  September 27, 2013
Publication:  December 27, 2013

Infinite possibilities from custom cuts of data and Custom Surveys offered by INTEGRATED.

See more about our Compensation Surveys on our website.

To participate or order any of our surveys, please email

The New Health Care Workplace: Health Care Reform and Younger Generations

Posted on February 8, 2013 by Kevin Haeberle

As published in HR Pulse Magazine, Spring 2013 issue. 

I was honored to recently author an article for HR Pulse Magazine, published by the American Society of Healthcare Human Resource Administration (ASHHRA).  Following is a short excerpt from the article.  Click the link at the bottom to download a full copy of the article.

The forward movement of time does funny things to our perspective of work and the people around us. A few years ago, those of us who looked at the future of health care organizations began discussing the impending changes that would be caused by the X and Y generation of employees entering the workplace. These younger employees bring different ideas about work and relationships than the current babyboomer created culture holds. In the early 2000s, the idea that fundamental shifts in management style and approach would be needed was greeted by denial and skepticism. The baby-boomer dominated leadership thought that the new generation of employees would surely mold into the culture of the workplace as it existed at that time. The idea of changing fundamental management systems and programs that had been in place and successful for years was simply too difficult for those leaders to grasp.

Around the same time, some health care organizations started noticing that their current workplace approach was starting to impact the recruitment of younger employees. Senior leaders started thinking that maybe they did have a potential issue and needed to make changes. As this awareness level started to gain traction, the recession hit and the focus on recruitment needs was replaced by wage freezes, layoffs, and high unemployment. The concerns about generational changes and related workplace changes were relegated to a low priority level. The perception was that the problem had gone away since employees of all ages could be heard saying, “I am just happy to have a job.” Unfortunately, the need to change the workplace did not go away. In fact, time marched on and the workplace generational change was moving forward at an accelerated pace, with little reaction from leaders. Like a weak dam holding back a flooded river, the pressure continued to build, and an impending flood was inevitable.

Read full article

Impact Of Healthcare CEO Turnover and External Recruiting on Executive Pay

Posted on February 4, 2013 by David Bjork

The American College of Healthcare Executives (ACHE) has followed healthcare CEO turnover since 1981.  According to ACHE, the nationwide healthcare CEO turnover rate has never fallen below 13%.  In 2011, the turnover rate rose to 16%.  With many executives of the Baby Boomer generation approaching retirement age, the turnover rate could increase even more over the next few years.
Following is an excerpt from my recently published book titled, Healthcare Executive Compensation: A Guide for Leaders and Trustees, regarding the effect turnover has on executive pay within healthcare organizations.
From the chapter: “Impact Of Turnover and External Recruiting On Executive Pay”

Considering more than 5,000 hospitals are operating in the United States, executives have ample opportunity for career advancement.  Some change jobs every few years. This turnover provides plenty of occasions for employers to decide how much to pay the next incumbent or find out what it costs to hire the right person for the job.
More often than not, employers pay the next incumbent as much as or more than the last incumbent.  If they recruit externally, they find out what other organizations are paying experienced executives.  If they choose an external candidate, they often find they have to pay significantly more than they paid the last incumbent.
If they promote an internal candidate, they may start them at a lower salary than the last incumbent was paid, but they rarely decrease the salary range and generally bring them up to the middle of the range within a few years.
When a good executive receives an offer from another hospital and the employer wants to retain the executive, the employer often offers a higher salary. When CEOs and trustees know an executive is getting calls from recruiters, they may increase the executive’s pay or institute a retention incentive to keep the executive from leaving.
The dynamics of the labor market also drive pay upward. Executives learn that they can increase their pay by moving to another organization.  CEOs and trustees learn that they need to keep pay competitive to retain talented executives.  They also learn that it can cost more to hire a replacement than to hold onto the current incumbent.

With higher CEO turnover rates predicted on the horizon, it is more important than ever for healthcare organizations to have strategies in place to retain existing executives, recruit new talent, and implement successful CEO transition and succession plans.

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