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The good and bad news from the staffing world

September 2009

Last week, I attended the Staffing Industry Analysts Healthcare Summit. This was a gathering of permanent placement and locum tenens companies specifically focused on health care staffing that meet annually to review the current state of the union.

The meeting was held in Washington–appropriately enough, because the major topic of conversation, both formally and informally, was health care reform.

Data presented at the conference revealed pessimistic projections for the traditionally strong locum tenens specialties such as general surgery, anesthesia and orthopedics. This likely reflects the economic downturn and the decrease in elective surgeries that our hospital partners are seeing.

There were however, strong signs that primary care in general and hospital medicine specifically would lead the way in locum tenens staffing needs over the next year or two. That’s good news–for my company and for your job security. Yes, the medical employment market is feeling the impact of our economic mess but, at least for the foreseeable future, hospitalists remain in demand.

Now, the bad news, which points directly to our hospital medicine workforce shortage as a major issue.

Former Sen. Tom Daschle addressed the group as the keynote speaker and offered some familiar rhetoric that any reform plan must contain the key elements of increased access, lower cost and improved quality. Most would agree.

But I remain disappointed in the attention that the primary care and hospital medicine workforce shortage issue attracts in this debate. Increasing access to care will need expanded capacity in a primary care system that is already overburdened and will directly result in increased capacity demands in hospital medicine.

Sen. Baucus’ recently released reform plan provides funding (a portion of a $54 billion carve-out in recouped funds from Medicare fraud/abuse prevention efforts) for items such as incentives to physicians choosing primary care. But it is vague as to those details and seems to focus on areas currently underserved. I think the scope of this program needs to be expanded to primary care specialties, including hospital medicine.

Organized medicine (an oxymoron according to some) actually has some thoughtful proposals on this front. ACP, AAFP and the AMA among others are putting forth some fairly detailed recommendations that range from debt forgiveness to all-important Medicare reimbursement reform, which will ultimately make primary care careers more lucrative and attractive.

It will obviously take a long time for any reforms to reshape the current workforce. That represents ongoing opportunity for the staffing industry and employment choice for hospitalists. But in the meantime, where are all the doctors going to come from to care for all these new patients?