Issue link: https://beckershealthcare.uberflip.com/i/568709
41 CARE DELIVERY Healthcare's Silent Shortage By Emily Rappleye T he demand for psychiatrists hit a record high in the past year, according to physi- cian search firm Merritt Hawkins, a division of AMN Healthcare. Psychiatrists were the third most-requested type of physician to recruit, behind family medicine physicians and internists. Much of this demand stems from a larger need for behavioral health pro- fessionals, as the nation's 30,088 psychiatrists in practice must collectively care for the nearly 13.6 million adults living with a serious mental illness. But it's not just that. What makes this shortage especially pronounced is that psychiatrists are not evenly distributed around the country. In Texas, for example, there are 185 counties with no psychiatrist, according to Merritt Hawkins. As of April 2014, there were 3,968 mental health profes- sional shortage areas nationwide, meaning there were nearly 4,000 areas with less than one mental health professional to every 30,000 residents, according to the Kaiser Family Foundation. To eradicate those mental health HPSAs, the U.S. would need 2,707 more prac- titioners. We spoke with Travis Single- ton, senior vice president of Mer- ritt Hawkins, to get the scoop on the demand for psychiatrists. Here Mr. Singleton goes into depth on the firm's recent physician recruit- ment study, why mental health is suffering a "silent shortage," and what hospitals and health systems can do about it. Question: The demand for psychiatrists skyrocketed this year, and it was more in demand in the last 12 months than in the last 27 years of the report. What caused this sudden spike? Travis Singleton: e demand for psychiatrists has been a steady, huge spike for last three to four years. It's not new — unfortunately it didn't sneak up on us — we just didn't address it before. It's very difficult to get young physicians to go into psychiatry. We are seeing that in all fields of mental health. Not only do we have maldistribu- tion problems in rural areas, but psychiatrists are also in the wrong setting. ey are typically looking for urban, outpatient settings, but the greatest need is in inpatient psychiatry. In the report, demand was calculated in two different ways. Mental health specifically is one of the largest specialties out there, so demand based on the number of search assignments in this field will also be among the greatest. We also reported absolute demand, or the demand in relation to its own specialty size. Even with the recalculation, family medicine and psychiatry were most in demand. ough the specialty is big, the demand is still enormous. I don't see that going away in the next two to three years. Q: Psychiatrists were second to family medicine physi- cians and internal medicine physicians in terms of search requests. Given the demand for those specialties, why do you feel it is important to highlight the demand for psychiatrists? TS: With primary care, there has been a dulling of the headlines. e restructuring of our health- care system in terms of reimburse- ment, team-based care and popu- lation health means we are at least talking about the need for primary care physicians. Our fear about mental health — this not the case. [Mental health] can be one of the most misdiagnosed and un- der-diagnosed fields in medicine. If you twist your knee and need to get it fixed, our healthcare system funnels you where you need to go. Mental health isn't quite so clear. Patients who are misdiagnosed or not diagnosed at all and sent back out into the general population could spark other issues. It's still flying under the radar, and that's what scares us most. Q: The study shows psychi- atrists are also among the top specialties with the most practitioners over age 55. Why aren't young physicians choosing this specialty? TS: We know some reasons and we can guess on others. Even though compensation is not the worst, it's not going to compare