Reform's Impact on Physician Recruitment

By: Allison McCarthy, MBA

News about health reform’s impact is abundant with information about accountable care, health exchanges, patient-centered medical homes, clinical integration and more.  Yet, the impact on physician recruitment typically goes unmentioned.

Consider reform’s two major goals:  insure as many people as possible and reduce the cost of care.  To achieve those goals, contracts offered by government, employers and exchanges give responsibility for meeting a designated population’s health needs to a network of providers at a predetermined price.  To succeed, the network must have the right clinical mix in the right setting to deliver lower cost/higher value care.

The need for more primary care will grow but with a different practice model.  Patient-centered medical homes are proliferating so that existing primary care practices can accept more patients and better manage cost by using non-physician providers, such as mid-levels, pharmacists, behavioral health providers and others.  These primary care physicians will be skilled in managing care “teams” and shifting the recruitment team’s obligation to:

  • Be more selective and recruit the right primary care physicians – those that flourish in team environments, can oversee and influence services provided by others and will adapt care approaches to more tightly manage patients that are high system utilizers.
  • Recruit beyond the physician and learn how to source and interview non-physician talent, such as advanced care providers, social workers, health coaches or care coordinators.

Recruitment will also be asked to ensure there is the right mix of specialists to manage “chronic care” patients – those with expertise in endocrine, geriatrics, palliative care, PMR, psychiatry and oncology. Like their primary care counterparts, these specialists will need to be comfortable addressing care needs without focusing solely on the patient visit.  Beyond patient care, these physicians need to be linked with clinical integration initiatives and working collaboratively with other providers to manage the population’s full care needs. This means recruitment has to:

  • More aggressively define the search criteria and opportunity offerings – beyond just getting a “body.”
  • Use behavioral interviewing techniques that ensure fit and focus on aptitudes, expertise and experiences — beyond simple productivity targets.
  • Involve more physicians, particularly those who have the future care delivery orientation, in the screening process to vet candidates at the clinical and collegial level.

Beyond recruitment, onboarding efforts will need to deepen into the inner workings of the system.  For example, onboarding efforts need to:

  • Go beyond a simple IT orientation to ensure that providers know how to navigate software and document correctly for effective care management.
  • Guarantee new physicians are familiar with the network’s full care continuum, including rehab, home care and long-term care.
  • Confirm these providers know the system’s contractual arrangements and obligations.

Those of us in physician recruitment must understand the impact of health reform and adapt our approach to help ensure success.  What we do won’t change as much as how we do it. Moving forward, we must take into consideration the type of clinical talent needed.  That means recruiting the right mix of professionals by focusing on both their attitude and care philosophy.  It also means onboarding new recruits to the systems and functions that go beyond “productivity” to achieve the desired “value” outcomes.

Source: The Medicus Firm 2012 Survey, “Physician Recruitment and ACOs”

Medicus Graph for AM Newsletter Article