Becker's Hospital Review

30 Clinical Integration & ACOs The current physician workforce will be impacted, too. With the growing emphasis on value-based care combined with the financial and practical challenges of meeting quality standards and complying with the many regu- lations of the PPACA, physicians are finding it more and more difficult to maintain private practices. According to Dr. Gottlieb's March 2013 op-ed, "The doctor won't see you now. He's clocked out," published in the Wall Street Journal, the PPACA favors the delivery of care through hospital-owned networks, and this will drastical- ly reduce the amount of local physician-owned practices. For regions without enough physicians, an increase in hospital and health system employment could exacerbate the problem. "Hospitals are making a mistake by buying physician practices," Dr. Gottlieb said. "They are trying to seek temporary advantage at the expense of long- term management challenges, but physicians practicing as part of a hospital- owned health system hasn't worked in the past." According to his article, when physicians become salaried hospital employees, their productivity falls, ultimately making the delivery of care more expensive. Because physicians can "clock out" when their shifts are over, they will see fewer patients, be less inclined to see patients in the emergency department or take phone calls. In the end, continuity of care will suffer, Dr. Gottlieb explained. The real issue, and real solutions According to Randy Gott, senior vice president of consulting and manage- ment services at The Advisory Board Company, access to care is largely predi- cated on location. The problem isn't so much a national physician shortage. Rather, inadequate supply of physicians exists on a market-by-market basis. "In many nonmetropolitan markets, I see a workforce of physicians that is aging, increasingly restricting their practices and hospitals and health systems that are struggling to meet the demands of the market they're in." The physician shortage isn't a national issue, but a local one. According to Mr. Gott, each health system and market should analyze its own resources and decide the best strategy to ensure patients have sufficient access in the future. "When an organization does its own forecasting, it must go through its cir- cumstances given the market they're in and use both quantitative and quali- tative analysis to provide direction to best meet [its] needs," Mr. Gott said. The Medical College of Wisconsin is an example of an organization doing just that. A private, freestanding medical school in Milwaukee, MCW is opening new regional medical school campuses in Green Bay in 2015 and central Wisconsin in 2016 that will offer a three-year curriculum and im- mersive education programs. Participating students will complete all aspects of their education in surrounding regions, most of which need to grow their physician workforce. Joseph E. Kerschner, MD, executive vice president of MCW and dean of the medical school, said that although the issue of physician shortage might be debated, physician "mal-distribution" in the U.S. is clearly a problem already today and likely into the foreseeable future. "This is the reason we have devel- oped this brand new model of education for students," he said. The three-year program selects students with backgrounds that suggest they have a genuine interest in living and working in underserved areas, and pre- pares them by immersing them in these communities. "In a three-year model, students will pay less in tuition and have a chance to acquire less debt. Some students may choose specialties based on how much they will earn and how much debt they have from school, but [after complet- ing this program], students will be out in the workforce a year earlier," Dr. Kerschner said. n S ixty-three percent of residents have been approached with job opportunities by hos- pitals, medical groups and recruiting firms 51 times or more during the course of their training. Furthermore, 46 percent of residents said they've been approached by recruiters 100 times or more during their training. This includes all recruiting letters, phone calls, personal conversations, emails or any other form of communication about a job to practice medicine. The results are based on Merritt Hawkins' 2015 Final-Year Medical Residents Survey, which in- cludes responses from more than 1,200 residents about to complete their training and enter the job market. Survey respondents participated from May to June 2014. "Unlike virtually any other type of professional in today's economy, newly trained doctors are being recruited like blue chip athletes," said Mark Smith, president of Merritt Hawkins. "There are simply not enough physicians coming out of training to fill all the available openings." Heavy recruiting has been on the upswing in the past two editions of the survey (this latest edition and that from 2011) after a decline in 2008. For instance, in 2008, only 6 percent of residents re- ported they were contacted more than 100 times by recruiters. That figure grew to 47 percent in 2011. Most physicians (67 percent) find personal net- working most useful for learning about job op- portunities, followed by their residency program and online job boards. Medical journals and phy- sician recruiters were cited as some of the least useful sources of information about jobs. Despite their favorable employment outlook, some new physicians regret their choice of profession. When asked if they would study medicine if they had their education to do over again, 25 percent of residents said they would select another field. n New Physicians Overwhelmed by Job Opportunities By Molly Gamble SAVE THE DATE! Becker's Hospital Review 6th Annual Meeting May 7-9, 2015 • Swissôtel - Chicago, Illinois 153 Great Health System Executives Speaking 119 Sessions • 212 Speakers To learn more visit www.BeckersHospitalReview.com To register, visit www.regonline.com/hospitalreview6thannualmeeting

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