Announcements of practices being opened, as well as promises to provide top-tier care to a new patient pool — that’s all the work to build physician groups that you see.
Englewood Health physician group leader Stephen Brunnquell spends most of his day on a different, less visible side of that work: actually finding the personnel to staff those offices.
“That’s our biggest single challenge right now,” he said, “finding not just a nurse, but the right ER nurse you need. … It hasn’t prevented us from opening new offices, but it does make life harder.”
Nurses, radiologic and MRI technologists, specialized physicians, medical assistants and even (if not actually) ancillary staff, such as information technology professionals or front-desk workers — they’re all highly in demand right now.
While the country’s physician practices are experiencing upticks in revenues over the pandemic and even pre-pandemic times, according to insight and data group Kaufman Hall, those practices and the health care systems they’re sometimes paired up with are challenged by the availability of labor across their geographies.
“People are leaving the workforce in general across different industries, and it has disproportionately come to bear on health care because the pandemic has disproportionately affected the industry,” said Steven Sheris, president of Atlantic Medical Group.
Sheris, who leads the physician-led organization affiliated with Atlantic Health System, said that has meant they have to “grow purposefully and thoughtfully,” with an added emphasis on workforce retention, as they look to fill health care gaps across the state.
As one of New Jersey’s large physician groups following the population health trend in hopes of reducing costs and improving health outcomes using data analytics, Sheris conveyed that the goal for Atlantic Medical Group is to bring care closer to home for Jerseyans.
James Clarke, president of the Physician Enterprise Division for Hackensack Meridian Health, leads another growing physician group in New Jersey. That growth is part of what allowed local medical providers to step in when the region’s first spike of COVID filled New York hospitals.
Clarke said it was difficult to prepare staffing-wise for any of that, due to the fact that so many health care professionals contracted the highly transmissible disease they were treating.
On the other side of a peak of new COVID cases in New Jersey, the industry is now reckoning with a more permanent departure of workers.
James Clarke of Hackensack Meridian Health paints an entrepreneurial portrait of newly minted doctors, like himself, entering into the medical profession in the ’80s. Given that, private practice was a natural fit for himself and many peers.
Doctors entering the medical profession now don’t fit that picture. He doesn’t blame them.
When looking at the industry’s economic changes and the mountains of student debt a doctor-in-training is asked to take on, Clarke said, it’s no wonder they’re not as entrepreneurial.
“And when you factor in the costs today of IT infrastructure, staff and all the costs related to COVID, many have realized that employment (at a hospital or physician group owned by a health system) made more sense to them,” he said.
In an American Medical Association study done several months into the pandemic, the amount of physicians working inside of physician-owned medical practices had already for the first time in many years fallen to a minority. The number of doctors working outside of private practices could be even higher two years later, as it has steadily trended in that direction for about a decade.
“There’s been a dramatic change in how new graduates think about the question of, ‘Can I go out and do it on my own?’” Clarke said. “When you look at everything, most feel they can’t afford to.”
“Senior physicians, in particular, were working hard to supply the high level of care communities needed during the spread of COVID, but we’ve seen more and more retirements,” he said.
Brunnquell, president of the Englewood Health Physician Network, agrees that the past two years of an intense battle with rising cases of COVID in the health care sector factored into a wave of retirements.
At the same time that veteran experience was being lost, the industry’s training schools — such as those for medical assistants — were either shut down or saw enrollment slowdowns.
“That means we lost a whole class of medical assistants,” Brunnquell said, adding that the organization has weighed options for “having our own training programs and maybe developing our own pipeline.”
The conversations are still early, Brunnquell said, but there have been talks at an organization such as Englewood about establishing credentialed training programs, or forming joint ventures with educational institutions.
“These are things that have been kicked around,” he said. “The idea would be to get more involved than we are in training the best people and trying to keep them here.”
As far as how successful health care organizations have been at retaining employees, Brunnquell said the sector is experiencing the same pandemic-, quarantine- and remote learning-influenced decisions to step back from careers as any other industry.
“Child care schedules in particular are a factor here,” he said. “I think we as a country, and perhaps as an organization, need to do more to defray the cost of child care to get people back to in-person work.”
Until the labor woes subside, which no health care leaders seem sure is just around the corner, organizations are reexamining competitive wages and fringe benefits so as to not lose out in the talent war with other physician networks.
Where the labor challenges are severe enough, health care organizations are turning to staffing agencies to fill roles.
Brunnquell said everyone in the industry is scrambling.
“It’s a seller’s market,” he said. “We, as the buyer, need to be a little bit more nimble.”