Presented by INTEGRATED Healthcare Strategies, as authored by
Chad Stutelberg, Executive Vice President and Practice Leader
It has been well documented that there is a severe shortage of Primary Care Physicians (PCPs) in the United States. Even before the Affordable Care Act (ACA) of 2010, the Association of American Medical Colleges projected a shortage of 46,000 PCPs by 2025. However, with the adoption of the ACA in 2010, and its related impact on coordination of care, disease management, and more, most believe that the shortage will be even greater.
An 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 the projections for the shortages of PCPs have varied depending upon the source, most experts agree that we are looking at a severe shortage of PCPs in the future.
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. This article will review the strategies that have proven to be successful in the recruitment and retention of physicians who provide primary care services.
Of course, no one strategy works for every organization. The strategies discussed have worked in part because the management and leadership (both physicians and non-physicians) had the foresight to understand what would work for their institution. 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.
Following are the top five strategies INTEGRATED Healthcare Strategies has encountered for recruiting and retaining primary care physicians.
Strategy #1: Get PCPs Out of Taking Call. Organizations that use hospitalists to take the call for the primary care physicians are much more successful at recruiting and retaining these physicians. 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.
Strategy #2: Encourage PCPs to use Advanced Practice Clinicians. Beyond the benefit of increasing the number of providers and expanding the scope and reach of the PCP practice, 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. That is why compensation models need to be adjusted to account for the use of these providers in the practice setting.
Strategy #3: Implement/Accelerate the use of Electronic Medical Records. Today, most PCPs have a component of their compensation (5% to 15% of their income) based on their performance in clinical outcomes. Therefore, it is critical that these providers have access to reliable quality data that can only be found in well developed EMR systems. This will ensure that your 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.
Strategy #4: Development of a PCP “Culture” Through Committee and Governance Structures. In the past, organizations have focused on specialty care, sometimes at the expense of their primary care physicians. However, organizations that adopt a culture of leadership and that focus on primary care (which can be done in conjunction and not at the expense of specialty care) - typically through the use of physician leaders and pro-active committee/governance structures - have been 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.
Strategy #5: Minimize Administrative Burden – Have a Good Practice Management System. Physicians today are inundated with data and increased burdens around patient quality and safety, billing and collection, payor contracting and practice operations. It is critical that organizations minimize the administrative burden for the physicians, either through the implementation of a good practice management system and/or ensuring appropriate levels of clinical and practice support. This allows the PCPs to focus on providing clinical care, rather than on practice issues. Providing sufficient support increases PCP satisfaction and allows them to maximize their income under productivity models that are present today.
About the Author
Chad Stutelberg is an Executive Vice President and Practice Leader in the Physician Services practice of INTEGRATED Healthcare Strategies. Mr. Stutelberg may be contacted by calling 612-339-0919 or emailing email@example.com.
About INTEGRATED Healthcare Strategies
For more than 30 years, INTEGRATED Healthcare Strategies has provided consultative human-capital services to clients across the healthcare spectrum, including community and children’s hospitals, academic medical centers, health networks, clinics, and other healthcare-related organizations. Our expert consultants and nationally recognized thought-leaders help organizations achieve their business goals by ensuring top talent is attracted, retained, and engaged while measuring and maximizing human and organizational performance. With tailored solutions that extend well beyond single services, INTEGRATED offers the knowledge, guidance, insights, and alignment that organizations need to not only survive the rapidly changing healthcare environment, but to succeed in it. Exclusive to Healthcare, Dedicated to People.(sm)
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