Troubling yet predictable findings emerge from the 2010 Review of Physician Recruiting Incentives, the annual survey from physician recruiters Merritt Hawkins/AMN Healthcare, which reflects the market realities of the past year for healthcare in a down economy.
The survey also provides clues for the near term. It's based on 2,812 permanent physician and certified registered nurse anesthetist searches in 48 states which the Irving, TX-based recruiters conducted from April 1, 2009, through March 31, 2010.
First, recruiting was down in 2009-10 for the first time in the 17-year history of the survey, even though there is nothing to suggest that demand has abated.
"This is quite possibly our most accurate survey ever because the decisions that were made from the client base were 'had to,' and not 'want to' decisions," says Merritt Hawkins Senior Vice President Travis Singleton. "We have a bottleneck. The needs didn't go away. In fact, they compounded. But our clients said there was an almost complete stop, wait, and hold. In that respect, the survey is the truest representation of what these different clients had to do to survive."
Among the contributing factors, Singleton says, were the overall poor economy, a corresponding lack of capital, the uncertainty of healthcare reform, falling medical utilization and reimbursements, and an unwillingness of many physician-candidates to relocate in a challenging economic climate.
Second, hospitals, health systems, and medical groups in more-populated areas were doing the bulk of the hiring. In 2008-09, hospitals, physician groups, and other healthcare entities in communities with less than 25,000 people conducted 39% of the Merritt Hawkins searches, and communities with 100,000 or more people conducted 26% of the searches. That's a flip-flop from 2008-09, when smaller communities conducted 39% of the searches, and larger communities conducted 26% of the searches.
"You can tie that to financial woes," Singleton says. "The smaller groups and hospitals were on the front line. When you saw capital dry up, when you saw the pressures of having to put guarantees out to recruit physicians becoming tougher, the ones that flat out couldn't do it were the communities with 25,000 or less. I'm not saying it was easier for the larger systems, but the larger metro and health system-oriented clients had the wherewithal and resources to recruit."