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PROJECTIONS: Physician supply and demand in 2025

Physician manpower projections by specialty for the year 2025 have been prepared by the Health Resources and Services Administration (HRSA) using 2013 as a baseline year.  Here are the projections for 2025 giving the difference between supply and demand.  Note that a negative number means a projected shortage of physicians in that specialty.  Also note that these are FTEs – full time equivalents.  The largest shortages are projected in Family practice and General internal medicine, two key primary care specialties.

PHYSICIAN FTEs in 2025 (DIFFERENCE between supply and demand)

  • (-)   480  Allergy and immunology
  • (-)7,080  Cardiology
  • (-)1,810  Cardiothoracic surgery
  •         130  Colon/rectal surgery
  •      1,480  Critical care
  • (-)   430  Dermatology
  •         280  Endocrinology
  • (-)13,100 General and Family medicine
  • (-)12,960 General internal medicine
  • (-)2,970  General surgery
  • (-)1,630  Gastroenterology
  •         890  Geriatrics
  • (-)1,400  Hematology/Oncology
  •         210  Infectious disease
  •         140  Neonatal/Perinatal medicine
  •         130  Nephrology
  • (-)1,200  Neurological surgery
  • (-)4,930  Obstetrics
  • (-)6,180  Ophthalmology
  • (-)5,050  Orthopedic surgery
  • (-)1,620  Otolaryngology
  •      1,530  Pediatrics, general
  • (-)1,490  Plastic surgery
  • (-)6,080  Psychiatry, or (-)15,400 – two scenarios are given
  • (-)1,400  Pulmonology
  • (-)   280  Rheumatology
  • (-)3,630  Urology
  • (-)    520  Vascular surgery

Source: U.S. Department of Health and Human Services, Health Resources and Services Administration. (2017). Health workforce projections. Click here for access to free full text: https://bhw.hrsa.gov/health-workforce-analysis/research/projections  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

 

PHYSICIAN VISITS: Same day appointments with specialists

It is more common for health care providers to offer same-day visits to primary care physicians, but at least one health system is also offering same-day visits to specialists on a large-scale basis.  Allegheny Health Network (Pittsburgh, PA), an 8-hospital system with 250 outpatient clinics, started to offer this option in January 2017.  In the first few months, there have been 36,000 patients who scheduled a same-day appointment, with about one-third seeing specialists.  Patient satisfaction with this option is reported as being very high.

Sources:

Castellucci, M. (2017, April 3). Offering same-day doc visits. Modern Healthcare, 47(14), 32.  Click here for link to publisher: http://www.modernhealthcare.com/article/20170401/MAGAZINE/304019981

The Advisory Board. (2017, February 28). The 5 lessons Allegheny Health Network learned from offering same-day specialist appointments. The Daily Briefing. Click here: https://www.advisory.com/daily-briefing/2017/02/28/allegheny-specialist-same-day

Venteicher, W. (2017, January 19). Allegheny Health Network to schedule same-day doctors’ appointments. Trib Live.  Click here: http://triblive.com/news/healthnow/11804612-74/appointments-health-patients

Allegheny Health Network website has some FAQs about this service here: https://www.ahn.org/same-day

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

MAGNET HOSPITALS: How did the idea come about?

During the nursing shortage of the early 1980s, there were an estimated 100,000 vacancies nationwide and inadequate staffing in over three-quarters of U.S. hospitals.  In an effort to alleviate the shortage, the American Academy of Nursing engaged four AAN fellows to choose a topic and conduct research on nurses employed at hospitals.  The author of this brief article – Muriel Poulin – and her colleagues Margaret McClure, Margaret Sovie and Mabel Wandelt, decided to study the characteristics of hospitals that were doing a good job of retaining nursing staff.  They surveyed 41 hospitals and prepared a report that served as the basis of the later Magnet Recognition Program.

When I stop to consider how much the program has progressed, I cannot get over it.  It has been a remarkable evolution that now includes hundreds of healthcare organizations around the world…” (Dr. Poulin, page 73).

Sources:

Poulin, M. (2017, February). A remarkable journey: Why the Magnet Recognition Program continues to resonate today. JONA. The Journal of Nursing Administration, 47(2), 72-73. Click here for publisher’s website: http://journals.lww.com/jonajournal/Abstract/2017/02000/A_Remarkable_Journey__Why_the_Magnet_Recognition.2.aspx

American Nurses Credentialing Center. (2017). ANCC Magnet Recognition Program. Click here: http://www.nursecredentialing.org/Magnet  Posted by AHA Resource Center (312) 422-2003 rc@aha.org

PHYSICIAN BURNOUT: May exceed 50 percent in U.S.

As many as half of practicing physicians may experience at least some degree of burnout – making consideration of underlying factors a key concern for health care managers and the nation as a whole.  This short commentary just posted in JAMA was written by Dr. Tait Shanafelt and colleagues at the Mayo Clinic – who are among the foremost experts in the field of clinician well-being.

The authors make specific suggestions – at the national, state, institutional, and personal  (self-improvement) levels about how to improve conditions for physicians, including among others:

  • Reduction and streamlining of required documentation
  • Integration of maintenance of certification and continuing medical education requirements
  • Implementing participatory management
  • Physician self-care

Source: Shanafelt, T.D., Dyrbye, L.N. (2017, Feb. 9). Addressing physician burnout: The way forward. JAMA. Click here for free full text: http://jamanetwork.com/journals/jama/fullarticle/2603408   Posted by AHA Resource Center (312) 422.2050 rc@aha.org

CUSTOMER SERVICE: Hire more of “the controller” type

Customer service is getting more difficult because technology siphons off the easy customer contacts.  Customer complaints that are escalated to a human being are, by definition, harder to handle.  Yet, at the same time, customer service staff tend to lack appropriate training, so attrition rates are on the rise.

The authors studied customer service reps in different countries and in different industries.  They found that there are seven categories of personality types that reps fall into – the controller, the rock, the accomodator, the empathizer, the hard worker, the innovator, and the competitor.  The personality type judged the most successful was “the controller”, yet managers were found to be more likely to hire empathizers.

This article advises on how to hire “controllers” and how an organization can take advantage of “controller” skills and mindset.

Interesting customer service metric: Cost per live service contact averaged about $7 in 2009 and nearly $10 in 2014 – a 38 percent increase.  (This is a general statistic – not health care specific.)

Source: Dixon, M., and others. (2016, January-February). Kick-ass customer service: Consumers want results – not sympathy. Harvard Business Review, 95(1), 110-117. Click here for publisher’s website: https://hbr.org/2017/01/kick-ass-customer-service  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

COMPENSATION: Nurse leader salary survey with 2015 data

Data from the second compensation survey conducted by the American Organization of Nurse Executives (AONE) – based on 2015 data – are summarized in this article.  The data are reported as the percentage that fall within ranges for different positions.  For example, the most frequently reported range for chief nursing officers in nonsystem hospitals is $250,000 or more (17 percent reported this).  CNOs in system hospitals were much more likely to be in this top salary band – 52 percent reported earning $250,000+.  Not surprisingly, nurse executives working for health systems in the corporate office, those in academic medical centers, and those in consulting firms were more likely to draw higher compensation.

Source: Kittner, A., and Thrall, T.H. (2016, October). AONE 2016 salary survey: Wide ranging compensation, strong satisfaction. Nurse Leader, 14(5), 311-316.  Click here for full text: http://www.nurseleader.com/article/S1541-4612(16)30112-4/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Physician Practice Acquisition and Employment Trends

A new report by the Physicians Advocacy Institute (PAI) in collaboration with Avalere Health analyzes recent trends in physician employment and the acquisition of physician practices by hospitals and health systems. Physicians may become employees through a group practice acquisition, or individual physicians may enter into employment arrangements directly with hospitals/systems. Here are some highlights from the analysis:

  • Between July 2012 and July 2015, the percentage of hospital-employed physicians increased nearly 50%
  • By 2015, 38% of physicians were employed by hospitals
  • Hospital or system ownership of physician practices grew by 86% from 2012 to 2015
  • By July 2015, there were 67,000 hospital-owned physician practices
  • One in four physician practices was hospital-owned by 2015

Regionally, nearly half of all physicians in the Midwest were employed by hospitals in 2015. Physician employment rates were lowest in the South and in Alaska and Hawaii where a third of physicians were hospital-employed. The pros and cons of these employment trends are briefly listed.

PAI and Avalere are planning additional analysis of this trend and its implications for early 2017.

 

Source: Avalere Health. Physician practice acquisition study: national and regional employment changes. Physicians Advocacy Institute, Sept. 2016. http://www.physiciansadvocacyinstitute.org/Portals/0/PAI-Physician-Employment-Study.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org