Looking into crystal balls and performing balancing acts aren't just the work of circus performers. They're also great skills for medical staffs to exercise.
For example, being able to predict practitioner placement trends in your medical staff can help you budget for enough FTEs in your medical staff services department, update privileging forms before a new wave of specialists arrive, and prepare for a shift in medical staff culture.
The Delta Companies is one organization that can help your medical staff plan for the future. Delta is a practitioner placement group that publishes free, quarterly resources providing summaries of physician and healthcare specialist compensation, placement data, and market trends in recruitment.
The quarterly reports provide a snapshot of the current healthcare environment, but analyzing several reports at once can help identify trends. "If you look at three or four [reports] over a period of time, I think that gives you a good indication of what trends are beginning to occur and what trends are starting to decline," says Shannon Penney, director of recruiting at Delta Physician Placement, in Dallas.
Forecasters see several noticeable trends around the country that can potentially affect the work of the medical staff. For instance, many specialty surgeons are staying put and not transitioning out of their current medical staff placements, says Penney. "With an economic downturn, that stops retirement, [surgeons aren't] as likely to retire, they'll stick it out another year, another year and a half to pad their retirement," Penney says.
Specifically, Delta has seen a decline in the need for cardiac surgeons. "Any form of cardiac surgery has been on the decline with the advances in cardiac medicine," he says. "From the pharmaceutical standpoint, many things are controlled by pharmaceuticals rather than corrected by surgery."
Although the need for surgeons is down, Delta did see an increase in cardiologist specialist in general. Cardiology ranked 10th on a list of the most requested searches initiated by Delta Physician Placement in the fourth quarter of 2008. Compare that with a fourth place ranking for the same quarter in 2009.
Delta isn't the only organization watching the growing cardiology trend. The medical staff service professionals at Scripps Centralized Credentialing Service are anticipating an increase in applications from cardiologists, but for different reasons.
"Scripps has implemented the first phase of a cardiovascular institute," says Maggie Palmer, MSA, CPMSM, CPCS, director of Scripps Centralized Credentialing Service in San Diego. "That is going to take on a whole new face for us and we've seen a rise in the fellowships in cardiovascular disease."
Another regional trend that Palmer has seen is in the rise of perinatologists. "That trend is growing to provide 24-hour care, kind of like hospitalists, but for labor and delivery," she says.
San Diego has a need for more labor and delivery practitioners because it is a town with a lot of young residents; however, the need for those services follows a particular cycle. Because there is a large military population in the city, hospitals see an increase in births after deployments.
Trends can showcase declines as well as increases. "One decline we've seen is anesthesiology and one of the reasons why we've seen a decline is because those spots are being filled by CRNAs," says Penney. "In most climates, they're overseen by an anesthesiologist so you may have one anesthesiologist and four or five CRNAs who can take the place of an anesthesiologist."
Perhaps one of the most important tips to remember when tracking practitioner trends is to observe national trends, but never forget the particular needs and interests of your local patient base.
By watching trends and taking actions based on those findings, hospitals can have more control over their work flow and improve budget management.