Last month, we shared some sobering statistics regarding the current physician shortage. We offered suggestions on how to recruit physicians within this environment and, this month, we want to focus on a specific idea - give it up.
Not entirely, of course. And not immediately. But it’s important to understand the current landscape and be realistic about your competitive standpoint (or lack thereof). If physician recruiting has been challenging for your organization, it might be time to branch out and, today, we’re going to address: 1) common reasons practices switch to a mixed provider model, 2) typical concerns in making this decision, 3) simple solutions to a smooth transition, and 4) long-term benefits.
Deciding to move from a physician to a physician-and-mid-level model is easy enough on paper - if you’re not hiring physicians fast enough, start hiring mid-levels. But, like most things, this is easier said than done. You’ll first want to explore your recruiting function and make sure your lack of success isn’t due to deficiencies in your recruitment process. If that’s in order and your job offering is as good as it can be, then it’s time to move on. Some of the most common factors that force a practice’s hand are being in a geographically remote/undesirable location, a less-than-competitive compensation package (but the best it can be for your situation), and being in a unpopular specialty. If any of these factors apply to you, utilizing mid-level providers is a likely solution and the sooner you adjust your recruiting, the faster your practice will succeed.
The #1 concern we hear is a fear that patients won’t accept a Nurse Practitioner or Physician Assistant. While there might be some initial trepidation, it’s important to keep in mind that this type of provider mix is quickly becoming the norm and patients are becoming used to it. Don’t believe us? Ask your inner circle, as we did before writing this article. You’ll be surprised how many are already seeing an NP or PA for their general healthcare needs and how many actually prefer it! Practices also worry about reduced reimbursement rates, but this is an easy one to mitigate - the lower salaries you’ll pay mid-level providers quickly make their reimbursement rates come out in the wash. And by having enough providers to see patients, you keep your revenue (and patient satisfaction scores) out of the red.
When it comes to patient emotions, your current physicians can help ease fears by verbally supporting the new mid-level providers to patients who are going to be transitioned and reassuring them that a physician is still available within the practice and working collaboratively with the mid-level. It’s also important to remember that you’re not going to be converting from a 100% physician model to a 100% mid-level model overnight. If you have the option, it’s best to slowly bring in mid-level providers. This will ease both your practice operations and your patient base into the new model.
While it may be challenging to employ your first mid-level provider, moving in this direction is critical to the success of medical practices. By diversifying now, you’re making your organization more nimble to respond to future changes and ensuring you have the infrastructure in place to employ mid-level providers as you grow in volume and lose physician staff members in the midst of this competitive environment. If you’ve been working within a staff shortage for some time, a mid-level provider is likely to be found much more quickly, allowing you to stop the hemorrhaging of patients and revenue and ensure the future of your business.
As noted above, we realize this decision is fraught with emotional difficulties and much easier on paper than in practice (no pun intended). But the numbers speak for themselves and by accepting this now, looking realistically at your current recruitment practices and position in the marketplace, and switching to a mixed provider model, you can begin to ensure the long-term success and stability of your healthcare organization.