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Survey Reveals Effects of Recession on Physician, Nurse, and Allied Recruiting
Jan. – Feb. 2010
Source: Phillip Miller is vice president of communications for AMN Healthcare, the largest health care staffing organization in the United States and the parent company of Merritt Hawkins & Associates (permanent physician staffing) and Staff Care (locum tenens staffing). He can be reached at pmiller@mhagroup.com. Clinical Workforce Issues: 2009 Survey of Hospital Chief Executive Officers can be accessed at www.amnhealthcare.com.
Health care has long been thought to be immune from the downsizing and hiring freezes other industries typically experience in a recession. Has this been the case in the current recession?
AMN Healthcare recently conducted a survey of 285 hospital chief executive officers nationwide to examine this question and other trends in physician, nurse, and allied health care professional recruiting. Entitled Clinical Workforce Issues: 2009 Survey of Hospital Chief Executive Officers, the survey focuses on how hospital recruiting efforts have been affected by the recession and where hospital CEOs see their clinical staff recruiting efforts going in the next six months.
One finding of the survey of particular note to physician recruiters is the distinction between how the recession has affected physician recruiting relative to other clinical areas. In general, hospital CEOs reported that their physician recruiting efforts have been less constrained by the recession than have been their efforts to recruit nurses, pharmacists, and allied health care professionals such as therapists and imaging technologists. Indeed, in some cases, rather than causing them to cut back on physician recruiting,
the recession has caused hospital CEOs to accelerate their physician recruiting efforts.
When asked how the number of physicians at their facilities had changed in the last six months, more than 34 percent of hospital CEOs said they added physicians during
that time. A significantly smaller number – 13 percent – said their facilities had experienced a net loss of physicians over the last six months. The majority (53 percent) said the number of physicians at their facilities had not changed. So the survey suggests that even during a historically severe recession, more hospitals added physicians to their staffs than either lost physicians or let them go. The same trend was exhibited in other clinical areas, though to a lesser degree. For example, 11 percent of CEOs said the number of pharmacists at their facilities had increased in the last six months, while 7 percent said the number
of pharmacists at their facilities decreased.
These numbers indicate that the recession has not had the effect of reducing physicians and other clinical staff at most hospitals. However, the survey does demonstrate that the recession has altered the recruiting behavior of some facilities. When asked how the economic downturn has affected their physician recruiting efforts, approximately 8 percent of CEOs said the downturn caused them to decrease physician recruiting activities at their facilities. Interestingly, a considerably larger number (about 25 percent) said the recession caused them to increase their physician recruiting efforts. This may be imputed to the fact that physicians are a primary source of revenue for hospitals, and physician recruiting is a way to bolster the bottom line during tough economic times.
When asked about the importance of physicians as revenue drivers for their hospitals, more than 94 percent of CEOs said physicians are a “very important” source of revenue for their facilities. Other clinicians also are considered to be important revenue drivers by CEOs, though not to the same extent as physicians (see chart below).
Importance of Clinicians as Hospital Revenue Drivers |
| |
Not Important |
Somewhat Important |
Very Important |
|
Physicians |
1.4% |
3.9% |
94.7% |
|
Nurses |
9.6% |
50.7% |
39.7% |
|
Allied Professionals
|
9.2% |
44.0% |
46.8% |
|
Pharmacists
|
16.8% |
52.8% |
30.4% |
The majority of CEOs indicated that the recession has not caused them to change their recruiting efforts in any clinical area, but a significant number (over 24 percent) said the recession has caused them to decrease their nurse recruiting efforts, while only 12 percent said the recession had caused them to increase those efforts. In addition, a greater number of CEOs said the recession has caused them to decrease allied professional and pharmacist recruiting activities than said the recession had caused them to increase such activities. While many hospitals have proceeded with recruiting efforts in all clinical areas during the recession, the survey suggests that physician recruiting has remained the most robust clinical recruiting sector.
The survey also indicates that the recession has not made physician recruiting any easier for most hospitals, and that in some cases, recruiting doctors became more difficult during the economic downturn. When asked how difficult it is currently to recruit physicians, approximately 86 percent of CEOs said it was either “somewhat difficult” or “very difficult.” The remaining 15 percent said it is either “somewhat easy” or “very easy.” By contrast, only 55 percent of CEOs said that recruiting nurses was either “somewhat difficult” or “very difficult.” CEOs also rated allied professional recruiting and pharmacist recruiting less difficult than physician recruiting.
CEOs were asked if recruiting physicians had become more difficult during the last six months, whether it had become easier, or if there had been no change. The majority (55 percent) said there had been no change. However, close to one-third (31 percent) said physician recruiting became more difficult during the last six months, a time when the recession was particularly severe, while only 13.5 percent said it became easier. By comparison, only 11 percent of CEOs said nurse recruiting became more difficult during the last six months, while over
36 percent said it became easier.
The relative difficultly of physician recruiting is underlined by the vacancy rates for various clinical professionals as reported by CEOs in the survey (see chart below), which indicate that physicians are the hardest staff opening to fill.
|
Hospital Vacancy Rates |
|
Physicians |
10.7% |
|
Nurses |
5.5% |
|
Allied Professionals
|
4.6% |
|
Pharmacists
|
5.1% |
The majority of CEOs concurred that shortages of all types of clinical professionals persist in the United States, but cited the shortage of physicians as the most serious. Approximately 54 percent of CEOs said there is a “serious shortage” of physicians in the United States. In contrast, only 40 percent said the same about pharmacists, 38 percent regarding nurses, and just 19 percent said there is a “serious shortage” of allied health professionals. The majority reported no change in the shortage of clinical professionals over the last six months, though a significant minority (37 percent) said the shortage of physicians had worsened. By comparison, only 13 percent of CEOs said the nurse shortage had worsened over the last six months, only 13.5 percent said the allied professional shortage had worsened, and only 14.5 percent said the same regarding the pharmacist shortage.
In a message to health care reformers, the majority of CEOs (70 percent) said there are not enough physicians in their service areas to meet the increased demand that would come with covering more patients. More than 45 percent said physician shortages already compromise access to care in their service areas, while 19 percent said physician shortages already compromise quality of care.
As for the next six months, the majority of CEOs (over 54 percent) said they expect physician recruiting activity at their facilities
to increase, while 38 percent said they expect no change. Only 7.5 percent said they expect physician recruiting activity to decrease.
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