After decades of solid job security, many clinicians are facing challenges holding onto their positions or finding new ones, a new employment report says.
The coronavirus pandemic has dramatically reduced the demand for clinicians in the healthcare workforce, according to a new report from the clinician recruitment firm Merritt Hawkins.
Merritt Hawkins—a business division of San Diego-based AMN Healthcare—has documented strong demand for clinicians over the past three decades. However, the financial strain of the coronavirus disease 2019 (COVID-19) pandemic such as the suspension of elective surgery has led to healthcare organizations reducing their clinician workforce or cutting compensation.
"Over our 33-year history, most physicians had little difficulty finding a job opportunity, with multiple offers to choose from. Today, we are seeing a growing number who are unemployed with a limited number of roles available. This is unprecedented. COVID-19 essentially flipped the physician job market in a matter of 60 days," Travis Singleton, executive vice president at Merritt Hawkins/AMN Healthcare, said in a prepared statement.
The new Merritt Hawkins report, "2020 Review of Physician and Advanced Practitioner Recruiting Incentives and the Impact of COVID-19," examines clinician recruitment data for the one-year period ending March 31, 2020. Although the number of physician search engagements the company conducted during the period increased, search engagements conducted since March 31 have declined 30%.
"The 2020 coronavirus pandemic has changed the playing field in the physician recruiting arena, turning what was a buyer's market for physicians seeking practice opportunities into a seller's market for hospitals, medical groups and other healthcare facilities seeking to recruit physicians. As a result, for those healthcare facilities that are recruiting physicians or are planning to do so, conditions now are more favorable than they have been in years," the report says.
The new report is based on a sample of more than 3,000 permanent physician and advanced practitioner search engagements conducted by Merritt Hawkins.
The top five most requested job searches were as follows:
1. Family medicine
2. Nurse practitioner
5. Internal medicine
For physicians, the top five average income specialties excluding production bonuses and benefits were as follows:
1. Invasive cardiology: $640,000
2. Orthopedic surgery: $626,000
3. Urology: $477,000
4. Gastroenterology: $457,000
5. Pulmonology/critical care: $430,000
Assessing impact of coronavirus pandemic on clinician workforce
The new report includes several clinician workforce impacts from the COVID-19 pandemic and anticipated clinician workforce trends.
- Long-term supply and demand: The clinician workforce market is expected to rebound in the long-term. Factors such as the country's aging population, U.S. population growth, and the growing number of Americans with chronic conditions are likely to fuel demand for clinicians for many years to come. Factors such as physician aging and low physician morale are likely to lower the supply of clinicians over time.
- Independent primary care practices: Despite pivoting many in-person patient visits to telehealth, primary care physicians have experienced significantly lower revenues as patients avoid visiting their doctors' offices during the pandemic. "It is probable that some independently owned primary care practices will have to merge with hospitals or larger medical groups to survive post-Covid-19, further eroding the viability of the private practice model which has been in decline for years," the report says.
- Rise of telehealth: The pandemic is expected to increase patient demand for telemedicine visits. Merritt Hawkins data has found that the percentage of physicians treating patients through telehealth has jumped from 18% in 2018 to 48% this year.
- Primary care's bright future: Although Merritt Hawkins has found that annual starting salaries for primary care physicians have remained flat over the past three years at about $240,000, primary care services are expected to be in high demand in the future. Several factors are likely to drive demand for primary care services, including the key role of primary care physicians in care coordination and the importance of primary care physicians in value-base care models such as accountable care organizations.
- Decreased demand for some specialists: Market demand for some specialists is expected to be soft during the pandemic. "Medical groups performing a high volume of so-called non-essential procedures have been unlikely to recruit additional physicians during the pandemic. For example, small- to mid-sized dermatology groups and ophthalmology groups, many of which are still independent, are not seeing the volumes they need to add staff," the report says.
- Coveted specialists: During the pandemic and beyond, demand will be high for some specialists such as hospitalists, emergency medicine physicians, and infectious disease clinicians. "All of these types of specialists will be needed to both maintain population health should cases of Covid-19 persist and to prepare for the next pandemic or public health emergency," the report says.
- Pandemic spurs demand for psychiatrists: Mental health professionals were already in high demand before the pandemic, which has had a significant negative impact on people's mental health. An April 2020 survey by the Kaiser Family Foundation found that 45% of American adults said the pandemic had affected their mental health. "Today, it is widely acknowledged that the shortage of mental health professionals, including psychiatrists, has developed into a public health crisis," the Merritt Hawkins report says.
- Nurse practitioners and physician assistants: The number of Merritt Hawkins' search engagements for NPs and PAs increased 54% over the one-year period studied in the new report. NPs and PAs are expected to remain in high demand after the pandemic, the report says.
- Employed physician model: The pandemic is expected to accelerate the shift from independent practice to the employed physician model, with independent practices lacking the resources to rise to the pandemic's financial and operational challenges. The new report found that 95% of physicians accepting new positions are practicing as employees. In 2001, about 60% of physicians accepting new positions practiced as employees.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
At Merritt Hawkins, the number of clinician search engagements has decreased 30% since March.
In terms of annual starting salary, invasive cardiologists were the mostly highly compensated specialty in the year-long period ending in March, the clinician recruitment firm found.
The coronavirus pandemic has had a profound impact on the clinician workforce, including varying demand for specialists and increased demand for psychiatrists.