Staff Care President Sean Ebner, working with the leadership of sister company Merritt Hawkins (a fellow physician staffing firm and company of AMN Healthcare), recently submitted a statement to the Committee of Veterans’ Affairs Subcommittees on Health and Economic Opportunities regarding VA physician employment, outlining how the experienced staffing firms can help alleviate current shortages and wait times being experienced across the country (as we reported a few months ago here at the Staff Care Insider).
The statement was submitted to Dan Benishek, MD, Chairman of the Committee of Veterans’ Affairs Subcommittee on Health, and Brad Wenstrup, Chairman of the Subcommittee on Economic Opportunity as an "exhibit for distribution" as part of a roundtable discussion on how to improve the ability of VA healthcare facilities to effectively recruit and retain high-quality physicians and advanced practitioners like physician assistants and nurse practitioners.
Recalling the prior role of AMN Healthcare leaderships in advising Congress on matters of healthcare staffing (such as when Merritt Hawkins president Mark Smith was invited in 2012 to provide expert testimony before the House Committee on Small Business on the decline of solo and small physician practices), the statement by Ebner and Merritt Hawkins Senior Vice President Travis Singleton put the case for handling the current VA physician shortage in the context of the existing physician shortage currently underway in the United States — a topic with which both companies have a great deal of experience.
As the Association of American Medical Colleges (AAMC) pointed out in March 2015, physician demand is widely expected to continue outpacing supply in the decade to come. By 2025, "demand for physicians will exceed supply by a range of 46,000 to 90,000," the organization reported. The shortfall is predicted to hit between 12,500 and 31,100 primary care physicians and 28,200 and 63,700 non-primary care physicians.
One of the key roles of the locum tenens and supplemental staffing offered by Staff Care is to help offset this deficit by helping physicians (as well as advanced practitioners like physician assistants and nurse practitioners) find employment in the areas most in need of their assistance. To this end, the ongoing staffing shortage faced by the Department of Veterans' Affairs poses problems that can be alleviated by the application of physician staffing, according to the statement.
Key Challenges to VA Physician Employment: "Candidate Sourcing and Processing"
Citing data from a 2014 Merritt Hawkins national survey of physician appointment wait times in 15 major metro markets, the statement shows that "average family physician appointment wait times exceed 14 days in ten of the markets, and equal or exceed 21 days in five of the markets. In other markets with fewer physicians per capita, it is likely that wait times may be more protracted.
"VA facilities face a variety of patient access issues typically not faced by private sector facilities, including a patient base that may have more limited options for care to choose from than private sector patients, and a patient base that has special needs relating to post-war physical and mental trauma that only VA facilities may be able to address," the statement adds.
Also to be considered is the impact on VA physician employment of the typically much longer processing times of VA facilities, which "can run as long as six months," per the statement. "By contrast, efficiently run private hospitals typically turnaround the same level of paperwork in no longer than four weeks. In the private sector, this process often occurs concurrently with the recruiting process.
There's more: "The type of physicians that VA facilities historically have been able to recruit, including active military and former military physicians, are increasingly being contacted and recruited by a wide range of private sector facilities. Due to this competitive climate, it is important for healthcare facilities to have a strategic recruiting plan, to accurately forecast their needs, to be nimble and responsive, to offer competitive incentives, an attractive work environment, and, of most importance, to bring a consistent sense of urgency to the recruiting process.
"Without an efficient, timely method for screening, credentialing and responding to candidates, the VA is losing well qualified and motivated physicians and other professionals to employers who do have such systems in place. This is particularly unfortunate as the VA offers a style of practice that is appealing to many of today’s physicians. The VA typically offers set hours, generous vacation times, the security of government employment, an absence of reimbursement and other practice management challenges physicians face in the private sector, freedom from the stress of malpractice, a rewarding sense of mission and various attractive locations.
"Many physicians are not aware of this, as a stigma about VA practice still is prevalent among some doctors, but these perceptions can be overcome. Indeed, none of the key physician recruiting challenges facing the VA are related to an inability to persuade candidates to accept VA employment. The key challenges lie in candidate sourcing and processing."
For our part, Staff Care already has a track record of VA staffing, having worked in 17 VISNs in the last two years, either directly or through small business partners. In 2014 and 2015, Staff Care is projected to fill 16,427 temporary physician and advanced practitioners days at VA facilities, and has had a variety of temporary physicians take permanent positions with the VA.
The statement goes into more detail on the challenges facing the VA and how they can be overcome, including specific compensation guidance and an overview of navigating contracting issues. You can download a complete version of the statement here. And if you represent an organization in need of improved physician staffing solutions, we encourage you to contact us via this quick form or call (800) 685-2272.