“To study the abnormal is the best way of understanding the normal.” — William James
Determining demand/supply is still relevant in today’s medical staff development plans. But, this is only one set of analytics used to determine the organization’s recruitment needs. The medical staff development planning process can include additional components, beyond the community need analysis, to bring greater precision to the final recruitment recommendations. Among these can be:
- Physician Alignment: Determining the proportion of practices “owned” by one entity over another within a market region can help to assess the organization’s ability to drive referrals and market share. This can be particularly important in highly competitive markets within in the primary care specialties.
- Outmigration or “Leakage”: While there may be an adequate supply of physicians, the organization may still not capturing the desired Outmigration data, available via state, payer or private suppliers, can identify those physicians who are driving the majority of volume and to which health system it is being directed.
- Physician Input: Asking physicians for their feedback about the availability and accessibility of various specialties can identify potential growth barriers. This feedback can be captured in web-based surveys or one-on-one interviews with primary care, hospital medicine and emergency medicine physicians, often providing the most compelling insights.
- RVU Comparisons: While RVUs are most often used to determine the individual incentive compensation of a physician, this metric can also be used to compare productivity of physicians in each specialty or comparable peer groups. If any of the organization’s physicians is at or above comparable RVU benchmarks, additional capacity will be needed to achieve growth.
- Clinic Utilization: An alternative way to assess physician capacity is by evaluating the actual clinical practice and time availability.
- First, are the physicians actually practicing the assumed clinical area? For example, are the general surgeons practicing bariatrics, breast, vascular or another subspecialty rather than general surgery?
- How much time is actually available for patient care – versus administrative, teaching and other obligations?
- What percent of the clinical time is being used? If ‘kept appointments’ are at 90 to 100% of capacity, then additional clinical hours need to be created to achieve growth.
- If there is clinical capacity, are there other restrictions on physician availability.
- Is the physician open to new patients?
- Is availability defined as any clinician in that specialty, or specifically a named physician? Are there slots available for walk-in/the unscheduled?
- What about patients who have been referred by another physician who asks that the patient be seen quickly.?
- Are appointments available when folks prefer to be seen?
Often, this is an area that can easily be distorted by anecdotal experience or scenario complexity, using these assessment resources can help to glean additional insights.
- Mystery Shopping – Armed with socio-economic and specialty-specific scenarios, including age, gender, presenting complaint, and/or insurance coverage, the “shoppers” gather data that indicates just how available (i.e. through lead time) appointments may actually be, for the new or returning patient.
- Call centers or centralized appointment centers, embedded within the health system, can supply data on ease of scheduling appointments. Reports from these centers can be supplied to those doing the medical staff development planning analysis as another input to the assessment.
Going beyond the demand/supply assessment as part of the medical staff development planning process can offer a more in-depth understanding of the need to recruit additional physicians and/or implement a different physician growth strategy to achieve desired results.