Clinician Recruitment CEO: 2021 Market Conditions 'Point to a Looming Storm'

Recruitment statistics from 2021 show strong demand for physicians and advanced practice providers.

The market to fill physician and advanced practice provider positions is extremely competitive, according to a recent report from the Association for Advancing Physician and Provider Recruitment (AAPPR).

There are widespread workforce shortages across the country at health systems, hospitals, and physician practices. Clinical leaders say labor shortages are the Number One challenge facing their organizations.

The recent report is based on 2021 data collected from more than 175 AAPPR member organizations representing more than 23,000 employment searches. More than half of the searches were specific to physicians. The report includes several key findings:

• The percentage of physician searches filled decreased for the fourth straight year
   
• The most sought-after physician specialties were family medicine, internal medicine, and hospital medicine
   
• The physician specialty positions that were least likely to be filled included otorhinolaryngology, dermatology, and urology
   
• Nearly half of all physician searches were to replace a departing physician—this turnover rate has increased 16 percentage points since 2018
   
• The proportion of clinician searches open at year end spiked in 2021, reaching 47% for physicians and 32% for advanced practice providers (APPs)
   
• At 10% in 2021, APP turnover increased to a six-year high
   
• The top three active searches by provider category were physician (52.0%), nurse practitioner (26.5%), and physician associate (11.2%)
   
• The primary reasons for physician turnover at organizations with 300 to 999 providers were leaving for a similar position (74.6%), retirement (67.3%), geography (50.9%), burnout (34.6%), and compensation (30.9%)
   
• The primary reasons for APP turnover at organizations with 300 to 999 providers were leaving for a similar position (91.7%), compensation (68.8%), geography (43.8%), burnout (33.3%), vaccination or testing requirement (18.8%), and retirement (12.5%)

Interpreting the data

The extent of clinician shortages is mainly dependent on geography and specialty, says Carey Goryl, MSW, CEO of the AAPPR. "The shortage of physicians is impacting different communities differently. If you look at rural communities, that is where we are going to see the physician shortage being felt most acutely. It also depends on the specialty. We are already starting to see certain specialties with serious shortages such as urology, where they have an aging provider workforce. When you look at the data to see who is going into urology residencies, there are not big enough numbers to have enough providers five to 10 years from now."

Future clinician shortages will be driven by geography, specialty, and burnout, she says. "The trend is taking us into an area where different patients in different communities will feel the physician shortage differently. It is going to depend on where you are and what type of provider you are trying to see. The future trend is also associated with burnout. If you have a specialty that is already stretched thin, the challenges to impact burnout, engagement, and retention point to a looming storm."

For health systems, hospitals, and physician practices, there are three primary consequences associated with physician turnover, Goryl says.

"The first impact is cost to the organization. It is very expensive to replace a physician and it is also expensive to have a physician position vacant for long periods of time. The cost to recruit and the lost income from vacant physician positions can be millions of dollars. The second impact of physician turnover is continuity of care. It hurts patients when their provider leaves and they have to create a relationship with a new physician. They may have been seeing a provider for several years, and there is a lot of historical information and relationship building that can be lost when there is this break in the continuity of care. The third impact of physician turnover is the impact on their colleagues. When a provider leaves, that means their colleagues might need to pick up additional patients or call coverage. It stretches everyone even thinner and adds to burnout."

There are no easy fixes for high clinician turnover and increasing job openings, she says. "We must look at provider retention programs that address physician concerns. We must look at why physicians and APPs leave their positions. And we need to invest in workforce planning. We must get ahead of these numbers, so they do not continue to increase. In workforce planning, we need to look at everything from retirements to employee engagement data. We need to try to forecast what is going to happen because the sooner we can start developing relationships and start recruiting to fill openings, the easier it will be to address these turnover statistics."

Related: Physician Shortage Could Be As High As 124,000 by 2034, Study Finds