Half of Primary Care Jobs Go Unfilled
Here is what the statistics show:
Nearly 70% of organizations searched for a family medicine physician in 2013. The percentage of primary care positions that go unfilled every year “continues to be a problem,” says an Association of Staff Physician Recruiters executive.
A problem? You think? As I have blogged about before, you would assume that this problem would use normal economics of supply and demand and create new perks (higher pay) for family docs. You would be assuming wrong. In fact, the only change is the constant pressure for administrators to replace us.
The only answer for primary care to survive is to get off the grid. We should not be employed. We should unshackle ourselves from being paid by insurers or the government. Our only employer should be the patient.
Another way to deal with but too late for us is get a marketable set of skills and don’t go into primary care in the first place. That’s what I tell students. I tell the NP students to get a job in a specialty clinic when they are done.
Kurt
If I were a lawyer, I’d be looking at ways of proving collusion within the hospital business, in conjunction with some of these private agencies that publish “average compensation” data, because I have absolutely no doubt that that’s the way that they’re actively working to defeat the usual supply and demand process.
In my experience, when asking about salary levels, the administrators always say that they checked, and “it’s on par for the area,” or something like that. Bullshit – the “on par” numbers they use are cooked.
Except when they are looking to be a CEO somewhere else. Then the “on par” numbers for their salaries are inflated!
And yet, I have struggled mightily to establish myself as a primary care physician. I have lost many years of potential stability due to the chaotic nature of primary care engagement.
Primary care is largely commoditized into “locum tenens” positions. The HR people complain that they cannot hire or find primary care physicians – so they go to the McLocums market and rent them. Many positions are permanently unfilled because of the “discount” to the company or firm by renting Locum physicians for a term of employment.
Locums receive no job protection – since they are “contracts” they can be terminated summarily for practicing costly medicine (however the owner defines that), or complaining about “ethics.” Locums receive no benefits or health insurance (!) and can come in at $70 per hour – having to pay their own taxes, unemployment insurance, medicare, etc.
Some organizations such as the Air Force save tons of money running off the locums. They are not equivalent to a full-time permanent position – their duties are only to Da Boss, not to the patients.
The “shortage” of primary care physicians is no burden to the Staff Recruiters – they exploit the shortage, and even exaggerate its degree. That way, they can hire discount docs, or leave positions open for years with a shrug, saying “of course, there is a shortage…”
And patients cannot see a primary doctor for months or years, but hey now – what y’gonna do? Artificial shortages benefit bureaucrats by keeping the salary money (which they love) rather than providing services (about which they could care less). This allows for more workshops, retreats and brain-storming sessions about how to deal with the problem. Sounds pretty clever, to me.