"There is naturally a certain rate of staff attrition which helps solve the problem. The way to reduce staffing costs without laying off people is simply not hiring as many. This is all part of a trend toward running leaner operations."
Hospital consolidation is also a factor. "Two merged hospitals don't need two CEOs and two CMOs. They can potentially eliminate positions that help reduce costs. The staff gets right sized. The community doesn't need two complete departments for a particular specialty," Powell says.
While it is indisputable that hospital hiring is down, Steinberg says the BLS data may not reflect the big picture because it does not account for hospitals' buying physician groups and other ambulatory services.
"If a hospital bought a physician practice and that practice continues to operate in an off-campus facility that would still be counted as a physician office for BLS data. So you have to be a little careful in terms how you are looking at the data. The data is collected at the establishment level and the establishment is a particular location," she says.