Quantifying the Need

I am frequently asked by physicians, administrators and my colleagues on what is the best way to quantify the need for an additional physician. There is not a one size fits all when trying to determine the need for bringing on another physician. Many factors need to be considered and I will discuss a few of them below.

To start quantifying the need, there are many resources available online for physicians to investigate the lay of the land when it comes to the hospitals, groups and providers in any community you are considering. Failure to take the time to evaluate all the data, will typically lead to a less than satisfactory selection of your position.  You should speak with as many providers and staff as possible during the interview process. This will allow you to verify the need, from multiple sources. Anything that comes up that does not make sense, should be investigated further.

For me the primary service area for the hospital provides a starting point in evaluating the need. For every 100K in population each specialty will have a population/provider ratio.  An investigation into any outmigration patterns to surrounding area hospitals, outside our primary service area, will need to be conducted, and what percent of that outmigration can be reasonably captured with an additional provider. You should also gain an understanding to what extent will those competing providers continue to service patients within the primary service area. I suspect if a high percentage of those patients, that are leaving, have good insurance, and those providers they now see deliver great care, it may take longer than you think to change the referral patterns.

Determining how long the wait time is for a new patient to be seen, can provide additional data. If the wait times for a new patient to get in are less than 2 weeks, the need might not be as acute. However, if the wait times are 1-2 months, that typically indicates a greater need for another provider. Many times, there is a great need, but the patients that are currently waiting for extended periods of time, are primarily Medicaid or lower reimbursing insured patients. In a billing/collections type model, this may create more challenges in the physician earning a similar income, as their colleagues, based upon the number of patients seen. In the RVU model, the insurance the patients have, is not as an important factor, since you will be paid at the same rate per patient seen, regardless of the insurance.

For the non-primary care searches, we should determine how many primary care physicians refer to our current providers, and are their patients experiencing excessive wait times to get in. If there is a competing hospital, what percent of the primary care physicians and/or specialists do they have compared to the hospital/group you are considering? Depending upon the answer, this may warrant additional analysis.

Considering moving on to a new position should be done in a methodical evidence-based approach. Keep your emotions in check, by verifying all information from a secondary source.  Gaining the perspective of an attending, a mentor, or a recruiter can provide you insights that you might not have been considering.

Written by Chris Kahl, EVP of Recruitment Training