Federally qualified health centers that serve mostly poor and low-income families in distressed or rural communities have always had a tough time recruiting physicians. And now, it's getting even harder.
Health Center Partners of Southern California, a consortium of 17 community healthcare organizations with 126 sites, is in desperate need of 50 primary-care physicians. The patient population at the federally qualified health center network has grown significantly over the past few years.
“It's a problem that's always been there and it's getting worse,” said Henry Tuttle, CEO for Health Center Partners. “When care reimbursement equations call for higher rates for specialty services, it also tends to drain what was originally available in the primary-care pool. Physicians who come through training … select a specialty rather than to stay in primary care.”
To address the need, Health Center Partners has contracted with national search firms to identify more potential workers, increased the starting salary for would-be physicians, and is developing a loan forgiveness program as an added financial incentive. Tuttle sees such strategies as vital for attracting qualified candidates.
The limited supply of primary-care doctors and other clinical staff dedicated to the field has increased competition among healthcare providers to attract these key personnel. Federally qualified health centers often lose out in the scramble.
The larger health systems and hospitals have the wherewithal to offer lucrative signing bonuses and financial incentives to prospective employees. Community health centers do not.
“In any given market, whether it be small or large, there are at least 10 different delivery systems a family practitioner can practice in,” said Travis Singleton, senior vice president at physician search firm Merritt Hawkins. “That wasn't the world that we had 10 years ago.”
Many factors fuel the trend. One of the largest came with the implementation of the Affordable Care Act, as millions of newly insured Americans gained access to routine healthcare. Other causes include population growth, an increased elderly population and the likelihood that as many as one-third of the current physician workforce will retire over the next decade.
The confluence of factors has raised the possibility of a shortage of primary-care providers over the next decade. The Association of American Medical Colleges estimates the shortfall will reach between 14,900 and 35,600 physicians by 2025, according to a recent report.
A recent survey on physician recruiting by Merritt Hawkins showed family physicians are the most sought-after specialty for the 10th straight year. Urgent-care physicians, a growing alternative, have moved from 20th most requested in 2015 to ninth in 2016. Average starting salaries rose 13% to $225,000 in 2016 from a year earlier.