Physician staffing shortages pose an ongoing challenge for healthcare employers nationwide, requiring innovative solutions and collaborative efforts. On November 14, 2023, Medicus Healthcare Solutions held an exclusive panel at the Beckers CEO + CFO Roundtable / CMO + CNO Forum in Chicago, Illinois, to address overcoming critical provider staffing shortages.

During the panel, Shannon Peterson, Vice President of Delivery at Medicus Healthcare Solutions, led a compelling discussion with four accomplished healthcare leaders to gain insight into overcoming critical staffing challenges. The panel included Mason Van Houweling, CEO of The University Medical Center in Las Vegas, Nevada; Dr. Matthew Broom, Vice President and Chief Medical Officer of BJC Medical Group in St. Louis, Missouri; Jamie Smith, President of Saint Joseph Hospital in Colorado; and Dr. O'Neil Pyke, Chief Medical Officer of the Jackson Health System in Miami, Florida.

As the conversation unfolds, each panelist will share how staffing shortages have impacted their facilities, ranging from unexpected provider turnover, increases in patient volumes, or moving from an outsourced to an employed provider program. Despite diverse obstacles, these leaders showcased remarkable proficiency in addressing staffing gaps, underscoring the strategic utilization of the Medicus Transition Program.

 

Unveiling the Driving Forces Behind Clinical Staffing Challenges: Supply versus Demand

 

Opening the discussion, Shannon Peterson asked Dr. Pyke for insights into the driving forces behind clinical staffing challenges. For Dr. Pyke, there are three: an aging population, heightened physician burnout, and insufficient residency positions to meet the rising demands for care. Dr. Pyke shared, "The aging population is probably the number one. I think the other one certainly is burned-out physicians and providers who probably thought they would have a career that spanned, you know, 35 to 40 years. But with COVID and with all the things that have happened over the last few years, we are recognizing that a lot of physicians are actually exiting stage left and saying that we can't do this the way we did before.". Dr. Pyke highlighted that we can't bridge that gap between supply and demand because there are not nearly enough residents in training programs to meet our patient demands. 

Overcoming Staffing Shortages: Navigating Staffing Changes with the Medicus Transition Program

 

Jamie Smith, President of Saint Joseph Hospital: Managing Change in an Outsourced Relationship - Outsourced to Outsourced

 

Amid a highly competitive job market in Denver, Jamie shared the changes his facility underwent, highlighting, "We had a roll-up of anesthesia across our metro Denver market, and that caused a lot of dynamics to change, and that was a big, big problem.".

Jamie and his team aimed to fully understand their staffing options and tailor a solution that aligned with the unique demands of their facility. Jamie expressed, "For us, we faced a short-term termination of our contract for anesthesia, and so, rather than jumping in and signing the next deal really quickly, we wanted to pause and do it right through an RFP process. Medicus allowed us to have that pause, and they allowed us to dovetail and feather in some local providers that were going to stay with us over the long term.".

Jamie highlighted that there is not always a single staffing solution for each specialty. Jamie's experience emphasized the necessity of strategic planning and thoughtful consideration when confronted with clinical staffing challenges, highlighting the importance of partnerships and initiatives when responding to the evolving healthcare landscape.

 

Mason Van Houweling, CEO of University Medical Center (UMC): Managing Change in an Outsourced Relationship - Outsourced to Employed

 

Over the past two years, Mason has navigated many organizational changes, including the transition of UMC's anesthesia service line from an outsourced to an employed model. UMC, renowned as the sole level-one trauma center, transit center, and verified burn center, provides critical services to the community that very few hospitals in the city do. Like Jamie, UMC faced an anesthesia contract termination, impacting the vital functions within the hospital. Mason emphasized, "We were looking at reducing and backing off some of our vital services, which we take very seriously at UMC. The team had a call to action and partnered up with Medicus. We had a very short time frame to do this; we had 3 months to bring on 45 providers. ".

Like his fellow panelists, Mason's facility faced staffing challenges, from physician shortages and elevated burnout rates to unfilled residency slots within the community. To address these challenges, UMC partnered with Medicus to help them take actions into their own hands. Mason highlighted, " We really felt we needed to take action into our own hands, and so we partnered up with Medicus to find a solution. We set out to bring in an employed model, and within a matter of weeks, we had anesthesiologists and CRNAs working.".

Deciding to transition to an employed model was difficult for Mason and his team, and they worried about how they would even make it happen. However, they wanted to create their own independence at UMC. Mason recounted, "It was a very tough decision, lots of sleepless nights for me, how do we make this happen, you know we were seeing our services and surgeries going down, but I'll tell you, it was well worth it. " With the help of the Medicus Transition Program, UMC's anesthesia service line was able to gain stability again in 3-5 weeks. Mason highlighted, "Not only did I see our OR volumes come back but also exceed where we were previously by 20-25%, so it was a good ROI for us.".

The success of UMC's partnership with the Medicus Transition Program instilled confidence in Mason and his team. This success has positioned UMC to embark on another critical transition, this time within its radiology department. Mason expressed, "We now have experience, we're very comfortable doing this, and again, this has allowed us to create our own destiny.".

 

Matthew Broom, VP, CMO at BJC Medical Group: Navigating Opening a New Hospital

 

Dr. Broom navigated the complex landscape of opening a new hospital a year into the pandemic amidst physician attrition and growth plans, "We had a real problem as we were using 5-6 external agencies to try to prop up a single service line. Compounded by that, our organization, coming out of the pandemic, was not as fluent or nimble to pivot through talent acquisition and be able to have national outreach to really repopulate our deck. At one point, we had gotten down to 6 employed providers, and everything else in a department of nearly 30 anesthesiologists was external.".

Reflecting on his journey, Dr. Broom shared, "I would say over a period of about two years, you know, rebuilding back to initially 21 and then getting up to 30, looking at physicians and CRNA was quite a long walk.". He emphasized, "The key for me on that was that commitment to understand what we needed to do to really game plan out each site we were adding additional services on.". Dr. Broom emphasized the importance of strategic planning, particularly in terms of open communication and understanding the specific needs of each site, including the number of OR rooms, procedural suites, endo suites, and cath cases that would be done.

Dr. Broom also highlighted the differentiation brought by partnering with Medicus, stating, "A differentiator certainly with Medicus was not only on-site presence for us to really be able to communicate through that but try to understand where we were wanting to go in lieu of just having a plus one or plus two incremental FTE add on top of that.". Dr. Broom emphasized the positive impact of partnering with Medicus, stating, "With Medicus, we were able to at least pull ourselves out of that certain real chaos at the moment to really kind of rebuild and have established employed model, which was really great for us.". 

Identifying Physician Staffing Shortages Early Warning Signs

Recognizing the critical importance of early warning signs in strategic decision-making, our panelists—Dr. Matthew Broom, Dr. O'Neil Pyke, Mason Van Houweling, and Jamie Smith —offer insights into effectively recognizing and addressing staffing shortages well in advance, ensuring timely and proactive responses.

 

Dr. Matthew Broom: Assessing Service Line Vulnerabilities

 

Knowing where vulnerabilities are in your health system is important in identifying the early warning signs of clinical staffing shortages. Dr. Broom highlights using heat maps to determine where vulnerabilities lie by service line, position, and department. He shared, "We all think we know where our gaps are, but it was amazing in the moment of the lack of succession planning, of the lack of real preparation, how many single points of failure across critical departments we were at.". Building a heat map analysis of where your pressure points are can be pivotal for how your facility navigates staffing.

 

Dr. O'Neil Pyke: Investing in People, Partnerships, and Focus on Retention

 

Dr. Pyke emphasizes that as facilities strive to become more reliable and gaps in coverage continue to expand, it is important to invest in both partnerships and the people on your team to help avoid critical staffing shortages.

Dr. Pyke emphasized, "One of the big things about staffing is retention, is how do you actually meet the needs of your stakeholders in your respective institutions and make sure that their voices are heard? That you're actually listening and paying attention to who's there today because a lot of times, institutions don't realize who's there today and the value that they add to your respective organization's day in and day out. Even in a transition, one of the biggest things you need to actually smooth the ripples is to have some foundational people who understand your process, direction, and vision and how to take action on that.".

 

Jamie Smith: Culture, Listening and Learning

 

Jamie underscored the importance of listening to your physicians and groups, understanding the dissatisfaction, and investing in non-monetary solutions. These can be key in addressing potential gaps and influencing retention. Jamie shared, " We try to solve for non-monetary things and cultural things to differentiate us because there are still a ton of locums and other opportunities out there for these docs. That's one of the challenges we're competing with. We are not always going to be the highest paying gig in town by any means, so we have to have other things that attract them- it's omission, it's identity, it's quality of life, ease of practice, and familiarity of practice are some things we can offer that other jobs can't offer.".

 

Mason Van Houweling: Partnerships and Proactive Staffing Changes

 

Mason shared that his tips for identifying service lines were two things: one, paying attention when the groups you're working with begin to experience delays and cancelations, but also the importance of heatmaps. Mason shared," I agree with what Dr. Broom said about looking at that heat map. We are too more than ever, and we have some things lined up.". By looking at a heat map, you are able to make proactive staffing changes and build a culture that people want to be a part of. Through strategic planning, UMC has been able to improve quality outcomes and care in their community.

Mason also highlights the importance of having a dependable staffing partner, "Medicus is really good at getting people on the ground and helping you. I now refer to them as our Cavalry. We know what we do is get Medicus on the phone, and let's start the process.".  

Advice for Other Healthcare Leaders Facing Staffing Shortages

Drawing from their experiences, the panelists provided valuable advice for healthcare leaders about navigating early clinical staffing shortages.

 

Mason Van Houweling’s Insight: Strong Leadership and Dependable Partners

 

Mason emphasized the crucial role of strong leadership and trusted partnerships when facing clinical staffing shortages. He underscored the importance of finding a local leader early on to establish trust and credibility, describing this as a key factor in navigating challenges, "The biggest thing, on the anesthesia side, was finding the leader early on to be able to help us build that we were going to be okay. He was a local gentleman, so he knew the market, and so he really brought trust and credibility right out of the gate. But that was important to me to establish that first before we started with anything else.".

Additionally, he highlights the significance of a dedicated recruiter for a smooth onboarding process, "The recruitment process, I think, for my colleagues was having a dedicated recruiter that can make sure that the onboarding process is extremely smooth, that they're welcome, and then having your physician leader work out the schedule.".

 

Jamie Smith's Perspective: Strategic Investment and Organizational Transformation

 

Jamie offered insights into the importance of strategic investment and organizational transformation during staffing transitions. He encourages healthcare leaders to creatively rethink their employment models, citing the positive impact of introducing CRNAs and fresh talent in his facilities experience, "We were, in hindsight, accepting less than we should have, less than we deserved. And so, it was a wake-up call to say, how can we really look at this creatively? How can we re-imagine?". Jamie continued, "We didn't have a team model at our hospital when we introduced CRNAs in this transition, which was a positive step for us. We had some new blood come to the facility. We had new trainees and new docs who had new skills. And so, it was an opportunity to shake it up a bit and, I think, grow from that. I wouldn't shy away from that as it's sort of a way to transform, even though it's challenging for sure for a short time period of time.".

Jamie ends his advice with, "We have to change, but there are things that are going to be better in the future.".

 

Dr. Matthew Broom's Strategy: Market Knowledge, Leadership, and Clear Goals

 

Dr. Broom stressed the importance of market knowledge, effective leadership, and clear organizational goals in overcoming staffing challenges. He advises leaders to understand the market dynamics to prepare and strategize effectively, "You know, know the market, right? And so, I think knowing the market which allows you to pre-game and prepare. Then, you've got to find a leader, who's the person people follow?". Dr. Broom shares an example of how finding the right leader can be instrumental, "Our anesthesia leader, who's great, gave me a very centering quote. And he said, 'Matt, I can always, you know, sell the sizzle. But at some point, you and I have to serve a steak.' … I think it was, what are we doing? What is our plan? So, we can take that out and understand so that we can market that across the way, not just for today, but where we grow. See, we all kind of have to know what our ‘steak’ is.".

 

Dr. O'Neil Pyke's Comprehensive Approach: Culture, Retention, Training Programs, and Locum Tenens

 

Dr. Pyke advises leaders to invest in culture, retention, and training programs for both short-term and long-term staffing solutions. This comprehensive approach addresses immediate challenges while creating a positive and sustainable work environment. Dr. Pyke shared, "Having their training program there in Jefferson, where they were; we're able to retain, what, 375, I think it was out of the 500. That's brilliant, and I think that part of it is really having training programs where you can actually have residents experience it.". Dr. Pyke continued, "When you train residents in your institution, 70% of those residents stay within a 60-mile radius. That is a brilliant medium to long-term solution. The short term is the solution that Medicus will bring with bringing other physicians into your facility.”. As for culture and retention, Dr. Pyke emphasizes the importance of changing with the evolving marketplace and workforce, sharing, “The reality is that as you look out in the marketplace, you have to realize that the work has changed, and we have to change with that. So, whether we use technology, machine learning, AI, or virtual care to complement, we have to figure out a new solution going forward.

Explore more key takeaways from the Medicus panel at the Beckers CEO + CFO Roundtable / CMO + CNO Forum in the latest Becker’s Hospital Review article here.

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