No shortage of reasons for doc shortage
The conventional wisdom behind today’s physician shortage centers on burnout, administrative burdens, and the like. However, the seeds of the crisis were surprisingly planted way back in the 1980s. In this edition of Locums CME, find out how some well-meaning changes led to a debacle of epic proportions.
Next, it’s a tip “three-fer”: what locum NPs should consider before an assignment, applying for new state licenses, and locum tax deductions. Also, how to choose your next hometown and a big survey that finds 50% of docs have considered quitting.
Continue your locums education with Locums CME 36 below!
The Current Physician Shortage Has Roots Going Back to the 1980s
June 19, 2024 | ACSH
There is considerable debate about the causes of today’s physician shortage, from big pharma and insurance to mismanagement within hospitals. For the American Council on Science and Health, Alex Berezow, PhD, drilled deeper than these current—and perhaps by now obvious—reasons for burnout to consider the historic systemic changes in government and academia that may have contributed to the shortage we find ourselves in.
An analysis from the Niskanen Center focused on key decisions made between 1980 and 2005 when it was believed that the US would soon have too many physicians:
- Medical school enrollments were capped, while federal financial assistance for students decreased and residency requirements increased.
- Few new medical schools opened.
Those actions severely limited the number of physicians who might have been hitting their stride now. A negative precedent was set—for example, Medicare continues to underfund residency programs today.
Additionally, the Niskanen Center analysis noted the US has always made it difficult for doctors from other countries to work here, requiring additional residencies and training for even the most qualified.
As the government and academia made decisions that set us on that path decades ago, they must think creatively again to address these systematic challenges now.
Your Locums Prescription
CompHealth: What Nurse Practitioners Should Consider Before a Locum Tenens Assignment
May 16, 2024 | CompHealth
Nurse practitioners (NPs) are a growing segment of the locum tenens industry, and more providers are considering this career path. For those planning for a locums assignment, CompHealth has created an overview of key things to remember.
1. Licensing and Training
You must be licensed in each state where you practice as a locum NP. Regulations for NPs vary by state, including continuing education and physician supervision requirements.
You must also be credentialed and trained for the facility where you accept an assignment, and your recruiter and the facility will assist with this.
2. Pay and Schedule
Locums work pays much more than permanent NP roles. The base pay is higher, and overtime compensation, travel, housing, and benefits are paid for.
As a locum NP, you control your schedule, deciding how much and when to work. Positions may offer the flexibility to supplement your full-time staff job.
3. Support and Relationships
Since you are not a full-time provider, you may not have your own dedicated support staff, so it is important to be flexible when working with a variety of team members.
Relationships with patients and fellow providers can be as robust as when you’re on staff. You are part of the team, but you start your contract knowing exactly when you’ll say goodbye.
As opportunities for NPs to shift to locums increase, locations and specialties more likely to need temporary help include:
- Rural communities
- States that allow NPs to work independently
- Primary care
- Behavioral health
- Acute care
8 Tips for Applying for New State Licenses—and Surviving the Process
May 30, 2024 | Locumstory
Locum opportunities come with many benefits: higher pay, tailored hours, and often a little adventure. To ensure you’re ready for your next assignment, begin your preparation well before you apply for a new state license or renew your current one.
Here are eight ideas to help ensure a smooth process.
- Keep digital copies of all certificates, transcripts, and other records. Organize them in one accessible place, such as Google Drive.
- Regularly update your education timeline, employment history, and other pertinent profile information. Share as many details as possible as soon as possible with the state board you’re applying to.
- Create a calendar of important dates to ensure you renew existing licenses or apply for new ones well in advance. For new licenses, it’s advisable to start the process at least 90 days ahead, and allowing even more time is always beneficial.
- Determine if your current state license is eligible for expedited licensure through the Interstate Medical Licensure Compact (IMLC) and use it whenever possible.
- Apply for the Federation Credentials Verification Service (FCVS). All medical boards accept FCVS, and 14 state licensing boards currently require it.
- Anticipate the need for a new DEA license or arrange to have yours transferred.
- Practice patience with state medical boards, with others you’re seeking information or copies of records from, and with yourself.
- Seek assistance from the locum tenens agency you’re working with, or if you are managing the licensing process independently, reach out to state medical boards or fellow locum doctors for support.
All Star: 3 Ways to Choose Your Next Hometown
June 18, 2024 | All Star Healthcare Solutions
Considering your next locum tenens assignment may, on the surface, feel a little like choosing your next vacation spot—where would you like to explore next? Of course, you are not traveling for leisure but to fill a crucial medical role and become part of a community, perhaps for up to a year. Make the following three items a part of your to-do list when considering a new assignment location, and feel confident that you’re making your choice thoughtfully.
1. Do your homework.
Research communities and facilities, including asking for personal perspectives from other locum professionals and your recruiter.
2. Be clear about your preferences, and be open-minded.
List where you want to go and be open to considering other locations.
Prioritize your criteria regarding schedule, job requirements, patient population, facility size, and other factors, and note how you’d be willing to compromise in one area to benefit in another.
3. Consider returning to previous work assignments.
While variety is often the spice of life for locum tenens providers, you may find you like one or more communities or facilities, and returning to preferred locations is also a perk of this type of work.
Barton: From Tips to Wheels—Major Locum Tax Deductions
June 20, 2024 | Barton Associates
Every locum tenens assignment is as unique as every practitioner’s personal tax situation. Still, one thing is the same for every provider: you are considered an independent contractor who must report your income and tax deductions independently (or hire a tax professional to do it for you).
Income is often relatively easy to note as long as you keep track of the 1099s you’ll likely be issued each January. Deductions are trickier because neither your agency nor your facility will tell you what expenses you had.
So, talk with a tax professional or research what your situation allows. Here are some common categories of bigger deductible expenses, with a few possibly surprising elements:
- Rent, if you need to relocate; some of the cost of RVs or other portable lodging may also be deductible
- Home office, if your assignment is via telehealth
- Transportation for assignments or house calls, including Uber, Lyft, and personal vehicles
- Meals, including tips and groceries
- Individual and family health insurance
- Membership in professional organizations
Physician Wellness Retreat
‘You Have a Stronger Canary; Now Build a Better Mine’: Going Beyond Physician Resilience Training
June 16 and 21, 2024 | KevinMD and KevinMD
Dike Drummund, a Mayo-trained family practice physician and consultant, estimates that half of physicians suffer from burnout; the other half are steps away. They are constantly at the front—the proverbial canary in the coal mine—with support offered only to make them more resilient.
Drummund suggests a smarter approach is to support the physician and improve the environment so that physicians do not have to be more resilient just to survive. In tandem with offering physicians training in mindfulness, for example, facilities must thoughtfully survey their physicians about their stressors, keep them informed on improvement plans in response to their concerns, and actually act on those plans.
One approach to addressing physician burnout where it starts is to begin in medical school. Student Liza Rosenbloom wrote about a survey of 107 third-year medical students at one US institution. More than half said they were not participating in self-care and felt increased loneliness. Based on her own experiences and research, Rosenbloom suggests that medical schools formally teach self-care and prioritize patients and their future doctors.
‘We cannot pour from an empty cup’: Boundaries, connections can help ensure work-life balance
June 23, 2024 | Healio
There is no doubt that practicing medicine today is very different than it was even a generation ago. But most of that difference has nothing to do with actually practicing medicine. More than ever, systems-level issues can leave physicians feeling like they have little freedom or flexibility to help their patients or to manage their work-life balance in a healthy way. For example:
- Administrative tasks are more complex and fall to physicians to manage directly.
- Patients can contact their physicians in different ways, including by text. This has increased not only because of technology but also because the pandemic changed perceptions around availability.
- The already significant and worsening physician shortage has created waiting rooms packed with patients and overworked doctors.
- The number of women in the profession is greater than ever before. Yet women continue to bear most domestic work, including child care, even in dual-physician households.
These challenges are more extensive than any one facility and certainly more than any physician can mitigate or eliminate. However, there are many ways to prioritize physicians on a meaningful scale.
These are just a few:
- Meetings and emails are kept to a minimum when it is not work hours
- Social interactions outside of work
- Available crisis management and stress reduction processes
- Open and mindful communication about what is being done to support physicians
- A workplace culture that values physician autonomy and input
- Adequate time to catch up on administrative tasks at work
- Fair time off, including parental leave
Sponsored Content
A Full-Time Locum Tenens Salary Guide: 9 Factors that Determine How Much Can You Earn by Specialty in 2024
June 6, 2024 | OnCall Solutions
More and more physicians are turning to locum tenens work around their staff jobs or full-time. They are doing so for several reasons, including the opportunity to earn significantly more than they can in other roles. Locum tenens work usually pays a premium for many reasons, including high demand and low supply, experience and credentials, and cost of living. In a recent article, OnCall Solutions walks readers through nine factors that affect pay and provides a chart of earning potential by specialty, with comparisons across hourly rate, full-time locum tenens, and permanent positions.
Embracing Flexibility: Dr. Abegunde’s Journey to Finding Work-Life Balance in Locum Tenens
May 28, 2024 | Interim Physicians
This profile of Dr. Veronica Abegunde, who grew up in Nigeria, attended Morehouse School of Medicine in Atlanta, and made her life as a hospitalist in Chicago, is also a celebration of locum tenens work. The two are entwined: Dr. Abegunde’s natural desire to be active and challenged, to build relationships with a variety of people, and, yes, to lessen the toll of workplace bureaucracy on herself led her to locums tenens work, which supports all of that. Interim Physicians is the recruiting agency that helped her redirect her career in a way that worked more for her.
Doctor’s Notes
New Training Helps Primary Care Physicians Treat Headache Sufferers
June 24, 2024 | Medscape
Headaches are a major pain in primary care, and the American Headache Society (AHS) is trying to help physicians alleviate them. An estimated four million visits to primary care physicians (PCPs) annually involve headaches. Yet PCPs are not required to have adequate training in headache management, and referral times to see specialists can be prohibitive. In response, AHS piloted the First Contact education program in 2020 and 2021 to help PCPs offer their patients a higher level of care.
The results, presented last month at the American Headache Society (AHS) Annual Meeting 2024, were positive. Of those who responded, nearly 86% said they were confident in their ability to diagnose headache disorders, and almost as many said they could create individualized treatment plans. More than 90% said they would implement changes in their practice because of their experience with First Contact. Respondents also asked for more advanced education, such as becoming skilled in nonpharmaceutical treatment options like occipital nerve blocks and acupuncture.
The survey uncovered issues unrelated to education as well. More than 45% said a lack of time greatly affected their ability to treat patients with headaches; more than 48% cited cost constraints, including insurance reimbursement issues, as barriers to strengthening their practice with headache treatment.
Doximity Survey Finds Half Physicians Have Considered Quitting
June 21, 2024 | Becker’s ASC Review
The physician shortage in the US is negatively impacting those physicians who have remained in numerous ways, and many are responding in one loud and clear way: by considering leaving.
Drawing from more than 33,000 physician compensation surveys completed in 2023 and data from 150,000 such surveys over the last five years, Doximity recently reported that half of all physicians have thought about leaving the profession. They cited the negative effects of the physician shortage as directly tied to their reasoning.
Between one-half and two-thirds said workplace culture was in decline and they themselves felt lower job satisfaction. They were overworked or burned out. Nearly 40% reported feeling concerned about medical errors due to the shortage as well as feeling threatened by patients. Twenty-seven percent said they were anxious or depressed and frustrated by the limited ability to see new patients.
