Healthcare Career Resources is a blog for those who work in the healthcare industry. We cover topics ranging from current events to medical humor as well as more career focused topics such as job search and interview tips. We also publish articles written for healthcare human resources and physician recruiters.
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Even as the pandemic highlights gaps in our health care system, individuals, organizations, and governments have stepped up to deliver innovations to fill these gaps. While this change has come amidst a crisis, there are important lessons in these emergency measures that have the ability to affect our profession into the foreseeable future....
The events of the last few weeks are unprecedented in our lifetime and have brought into sharp focus the pricelessness of healthcare access. Even as the pandemic highlights gaps in our health care system, individuals, organizations, and governments have stepped up to deliver innovations to fill these gaps. While this change has come amidst a crisis, there are important lessons in these emergency measures that have the ability to affect our profession into the foreseeable future.
In this age of social distancing, telemedicine has come out on top. While not a novel concept, virtual connectivity in healthcare has lagged behind other sectors as physicians struggled to implement services amidst concerns regarding reimbursement, privacy issues, and integration into the medical workflow. The emergency decision by the Center for Medicare and Medicaid Services (CMS) on March 17, 2020 (and retroactively in effect beginning March 6, 2020) to pay for telehealth visits outside of rural areas has eased physician concern. The decision allows physicians and other health care providers to charge the same rates for real time- audiovisual and in-person office appointments for new and established patients. While patients are subject to the same co-pay or deductibles as per their plan instructions, health care providers may be able to reduce or waive these fees (and all fees are waived when the visit concerns COVID-19). Established patients also have access to virtual check-ins (brief audio or audiovisual check-ins initiated by a patient concern) and e-visits (communications via established patient portals). CPT codes for billing purposes are available.
The Health Insurance Portability and Accountability Act (HIPPA) has been temporarily waived during the COVID-19 pandemic, allowing physicians and others to use any videoconferencing tool, including Facetime, Zoom* and Google Hangouts. However, these platforms typically do not utilize a business associate agreement (BAA) – which ensures protected health information is safeguarded – and their use will become illegal once the emergency declaration runs out. Luckily, there are several companies, such as Teladoc, Doxy.me and American Well that implement BAA safeguards and even provide practice management features such as scheduling and e-prescribing. The downside is that not all will incorporate into your existing EMR and patient portals, requiring the use of two devices – one for the virtual visit and the other for documentation. Several EMRs include basic videoconferencing tools, and with physician advocacy, the rise of telemedicine can encourage expansion or partnerships with telemedicine companies such as Cerner has done with American Well.
It makes sense for physicians to invest in a BAA compliant platform now to ensure continuity as telemedicine’s convenience will have patients requesting these appointments into the foreseeable future. Medicare Advantage, Medicaid, and many private insurers have already seen the writing on the wall and already have regulations regarding virtual visits in place, as do the majority of states. While previously, e-visits were not granted equity to in-person visits, physician and patient advocacy may well change these laws in the future. Taking some time now to implement a robust system allows you to continue to use this convenient, effective, and lucrative option in the future.
Additionally, remote patient monitoring (RPM) is on the uptick as mobile technologies and wearable, connected physiological measuring devices provide robust medical data to physicians from the comfort of patients’ homes. More hospitals will likely invest in telepresence robots, or computers on wheels that allow virtual communication and assessment in inpatient care areas. These “virtual” providers can limit overexposure of health care providers to the COVID-19 virus while permitting inpatient evaluation. Even following the pandemic, these virtual tools will be invaluable to care for patients in diverse settings and physician-limited areas.
For anyone who already provides telemedicine or works in multiple states, the impracticality of individual state licensure is well recognized. On March 13, 2020, the Health and Human Services (HHS) issued an emergency declaration allowing all physicians and other health care providers with any valid state medical license to provide care to Medicare and Medicaid patients across state lines. Physicians accepting Medicare and Medicaid patients will have fees, site checks, and criminal background checks waived. While this relates to Medicare and Medicaid only, individual states have the option to waive requirement for individual state licensure.
While these emergency measures are approved for a finite time, many healthcare providers may find the post Covid-19 period to be an opportune time to advocate for a transition to a nationwide system of medical licensing. Physicians can opine that national licensure can limit the shortage of healthcare providers, especially in rural and other underserved settings. COVID-19 only magnifies the existing problem that can be reduced by allowing physicians to supplement care across state lines, whether in person or virtually.
There are a host of other emergency declarations affecting inpatient, long term facilities, and home health services. Emergent declarations allowing nursing and medical trainees as well as recently retired health care providers to join the health care force will almost definitely expire following the crisis. However, this crisis has put a spotlight on short fallings of the health care system’s emergency preparedness. The shortages of personal protective equipment (PPE), medical equipment (including ventilators and other respiratory devices), and inpatient capabilities point to the inability of the health care system to support population health above and beyond provider man-power.
So far, the Federal Drug Administration (FDA) has invoked Emergency Use Authorization (EUA), expediating approval of testing kits and modified respiratory devices (including anesthesia machines, positive pressure devices, and ventilator tubing connections) in short supply. During this epidemic, we have seen that ingenuity and academic collaboration fill gaps and provide lifesaving equipment to the public. Moving forward, the FDA’s continued modification of its regulatory system can help provide improved implementation to health care innovations.
Health care providers are at the front lines treating their patients and protecting the public, while advocating for the health care tools necessary to support this mission. Despite the adversity, COVID-19 has encouraged us to rethink out healthcare system’s preparedness for pandemics and other emergencies. Employed physicians and physician groups can encourage investing in telehealth solutions within their organizations. Physicians and other health care providers can petition state medical boards and their US representatives to advocate for national licensure. To survive another day, our health care system must shift from a reactionary to an anticipatory point of view. In this way, we can ensure we truly learned the lessons from the past and will not be doomed to repeat them moving forward.
While many are staying home and working remotely, healthcare staff and supportive services have no choice but to work in the field. For those wanting to show support, the following is a comprehensive list of ways to help during this challenging...
This is an unprecedented time in our country. Covid-19 seems to have come out of nowhere and is spreading rapidly. While many are quarantined to their homes and working remotely, healthcare staff and supportive services have no choice but to work in the field. Long hours, a severe shortage of protective equipment, and high risk of infection have healthcare workers stressed and those quarantined to their homes wondering what they can do to help. For those wanting to show support, the following is a comprehensive list of ways to help during this challenging time:
While our nation walks through this difficult time, it’s wonderful to know that there is such love and support behind those of us who continue to work with patients. We are eternally grateful, and even if you are unable to give something physically, it’s amazing to know that you’re thinking of us! Please, please take care of yourselves and do everything you can to help prevent the spread of this nasty virus (wash your hands, limit exposure to others, cover your cough/sneeze with your elbow or a tissue) while we do everything we can to help those who are sick. We will all get through this together and will come out stronger on the other side!
Look back in history, and you’ll surely find that during every tragedy, war, or disaster, nurses were on the front lines.
Look back in history, and you’ll surely find that during every tragedy, war, or disaster, nurses were on the front lines. From Florence Nightingale roaming between rows of beds, filled with wounded soldiers, carrying an oil lamp to light her way, to modern day nurses who travel in dangerous, underdeveloped parts of the world to provide care to those who need it the most, we’ve always been there. Whether we’re fighting disease, famine, un-sanitary conditions, lack of education, or just lack of care, we’ve jumped in and done what needed to be done to care for others. It’s who we are. We are compassionate. We are selfless. We are NURSES!
Today, our world is under attack. Covid-19, also known as the Corona Virus, is attacking our nation and our world. Thousands have been infected and the death toll continues to climb. America’s President has become a “Wartime President” as he is forced to utilize resources usually reserved for a different kind of war, and nurses have become the front-line soldiers in fighting this attack. We are “essential” to the survival of our nation. Our people need us. And sadly, our country and our hospitals are un-prepared to protect us during the fight. While we’ve been thrust into this fight without the proper equipment (and very little warning), it’s more important now than ever for us to remain united in our cause. We need to remember who we are and what our purpose is. We need to stay positive!
The pivotal focus during this fight, is that Covid-19 is our enemy. “Friendly Fire” is a term used to describe when a soldier is under fire from someone on his own side. Sometimes it is a mistaken shot, but more often it is due to misplaced anger. Working without proper PPE has many nurses in a state of panic, and for good reason. We rely on that PPE. It’s what protects us, so we can protect the patient. But, the lack of PPE is not something that hospital systems and other organizations planned. They aren’t putting us at risk on purpose. They simply don’t have it. Whether due to hoarding, or just lack of supply, it just isn’t there to give. While it’s perfectly logical to be angry that we have been plunged into a situation where we are “at war” and now are personally at a higher risk, we need to remember who our enemy really is. We have to stop the Friendly Fire!
While working without our PPE can feel a little bit antiquated, it’s important to take some time to consider what we DO have. We have modern day testing available so we know who has the virus. We have medication and equipment (such as ventilators) with which to treat them. We have rooms in which we can quarantine them. We have regulations that enable us to keep families/friends away in order to limit spread. We have sanitary conditions, cleansing supplies, proper nutrition, and the love and support of family, friends and our entire medical community. We have more in this country than most people in our world. We are really very fortunate.
I am a nurse. Covid-19 is invading our area. I have no PPE. I understand the fear. I don’t want to be responsible for spreading the virus to my patients, or my family any more than anyone else. I too am angry at the lack of supplies. But, every day I must remind myself of where my anger belongs, and remember that my organization is part of my team. While they aren’t able to provide me with the equipment that I would prefer to have, I know they aren’t holding back on purpose. It just isn’t there. I try to think back to the nurses who worked with Florence Nightingale. Those nurses made history! And they did so without PPE, and without proper training. They worked and cared for patients with a lack of resources that I just cannot imagine, and through it all, they brought us the environmental theory that has led to saving millions of lives! What a gift!
While the lack of PPE is scary, take heed, as resources are on their way! Construction companies and dentists are donating their un-used masks, new legislation is allowing companies that usually make masks for other occupations to make medical masks, and with urgent production, hundreds of thousands of masks are on their way to critical areas! This situation is not ideal, but it won’t last forever. Our country, our hospitals, and our government are behind us. They’re working every day to resolve our shortages.
Staying positive is difficult in this challenging time. It’s a hard concept to grasp when seeing patients and knowing that they could be infecting us. It’s terrifying to think that we could be spreading the virus unknowingly to our patients, family, and friends. We are living in an unprecedented time that will surely make history, and it’s just no fun. But, we have to try. We have to remind ourselves and each other that this is nobody’s fault. We must remain calm and cannot become a greater problem than the virus itself, or we will surely cause even greater risk. Let’s do what we know we are capable of! We are nurses! Let’s band together, stand strong, and fight this thing!
A new study from the University of Minnesota School of Public Health and Harvard researchers examined physician turnover, and where doctors are migrating when they change jobs or begin their career. The trend toward larger practices, mostly owned by hospital systems, is revealed by the...
A new study from the University of Minnesota School of Public Health and Harvard researchers examined physician turnover, and where doctors are migrating when they change jobs or begin their career. The trend toward larger practices, mostly owned by hospital systems, is revealed by the data.
Using almost a decade’s worth of Medicare claims information, the team identified physicians just beginning to treat patients in the group, as well as those who stopped. Using this data, along with the ownership and size of practices they entered and exited, several physician workforce trends were revealed.
The Physician Organization and the Role of Workforce Turnover study reviewed almost 650,000 data points and found an increase in physicians working in larger practices, rather than owning their own small group. This suggests many forces may be driving the decision, including mergers and acquisitions, administrative costs for a single practice, and even the desire for flexible scheduling.
The study found considerable turnover for physicians who treat patients utilizing Medicare. The data revealed 19% began treating them for the first time during the study, which pulled information from 2008 to 2017. During the same period of the study, 12.4% of physicians treated their last Medicare patient.
Age groups for entering and exiting physicians were also examined. New Medicare-treating doctors began at 35 years of age, suggesting they were new to medicine, while exiting doctors were 65, possibly retiring from practice.
In small practices, the ratio of doctors who entered the field versus those who exited it suggests problems for small practices in the future. For every physician who entered a small practice, three exited, according to the data.
Alternately, for every physician who left a larger practice, those with 50 doctors or more, 2.5 joined the group. For hospital owned practices, one exiting doctor was replaced with 2.8 new to the team.
The data revealed the largest shift to hospital-owned practices for physicians who specialized in ophthalmology, internal medicine, dermatology and neurology.
University of Minnesota School of Public Health study lead, assistant professor Hannah Neprash, commented the study is consistent with surveys of medical residents who show an increasing preference for hospital employment. “This pattern suggests that natural turnover in the physician workforce likely contributes to consolidation in physician markets.”
The data extends the trend uncovered by the National Center for Biotechnology Information in 2016. From 2004 to 2006, 26.6% of large practices (those with 20 or more physicians) were owned by hospitals. By 2012 to 2013, that number increased to 35.6%. For small to medium sized practices (less than 20) data pulled from 2007 to 2009 showed 8.3% owned by hospitals: by 2012 to 2013, that number increased to 11.3%.
Still other data shows physicians decreasingly identify as independent practice owners or partners. According to The Physician’s Foundation, only 33% of doctors identified as independent in 2016, a decrease from 48.5% only 4 years earlier.
Some speculate younger physicians are leery to take on the administrative challenges of a new practice. They look to bigger, hospital-owned groups that can provide support in addition to a more advantaged position negotiating with insurers. They may also be looking at economies of scale when it comes to purchasing everything from daily supplies to large equipment. Whatever the reasoning, if the trend continues, the independent physician practice may one day become a thing of the past.
Choosing your next physician job takes a bit of groundwork to make sure it’s the right fit. Don’t overlook the practice type when choosing a position— it can affect all areas of your work life, from the practice culture, your ability to provide quality care, and how your work is...
Fair compensation, location, and practice type almost always round out the top three when it comes to signing on the dotted line for your next physician job. While compensation and location may be non-negotiable for many entering the job market, there is a quite a bit of wiggle room when it comes to practice type.
The nostalgic notion of the solo physician delivering babies and making house calls has been replaced by a dizzying array of practice types and patterns. For the first time in 2018, the percentage of physicians that were employed surpassed those who owned a private practice; currently almost 80% of young physicians under the age of 40 are employed. These changes aren’t happenchance and reflect a shift in the practice of medicine. Astute physicians will want to take a close look at what it means to be hospital-employed and if this practice type is the right career move.
Many physicians chose medicine to care for patients and to stay on the cutting edge of medical innovation, not to focus on marketing or operations strategies. While many physicians in private practice eventually figure out a balance between the business and art of medicine, it is by no means a simple feat.
Choosing a hospital position allows you to leave the headaches of overhead costs and contracts to others who enjoy this work. Offloading this labor helps manage the ten plus hours the average physician spends on administrative duties and shift that time back to patient care, continuing education, and even (gasp!) a little more work-life balance.
Of course, choosing a hospital-employed practice doesn’t mean that you can completely ignore your future employer’s business plan. It’s up to you to inquire about the hospital’s strategic plan and ensure it is well thought out and will drive business forward. For example, physician job-seekers should check that there is a market for their unique skill set in the local community and that the hospital will support their new practice. Asking pointed questions about the hospital’s financial record and plans for expansion will allow you be confident that the administrators will do their job well, so you can do yours.
As with any large organization, hospitals have a number of policies and business rules that employees have to follow. Unlike private practice, where physicians make the policies, hospital leadership will often comprise a majority of non-physicians. Bridging the gap between business-minded professionals and physicians can lead to certain strife if there is constant turnover in the leadership or no real support for physicians concerns. Talking with current physicians or recruiters about the relationship between physicians and hospital management will help assess if a particular hospital-employed position will be a good fit for you.
Similar to work at a large academic center, hospital-employed physicians often have set avenues for collaborating with other physicians and health care providers. Since everyone is under the same umbrella, it’s relatively easy to coordinate your patient’s care and ensure that follow ups don’t fall through the cracks.
At large hospitals systems, you’ll likely be supported by a well-rounded group of ancillary staff— including physical therapy and rehabilitation services— that can be quite challenging to coordinate with the private-practice setting. It also tends to be easier to ensure that your patients’ care will be covered as they are staying within the same hospital system.
At its best, the large hospital system can recreate the easy flow of ideas and knowledge that is a hallmark of residency. Having a wide range of specialties under one roof that are easily available makes for a learning environment that is much more difficult to recreate in smaller practice-based groups in the community.
Currently, hospital-employed physicians are among the best compensated physicians, second only to young physicians in single-specialty practices. While these single-specialty practice physicians have higher salaries in their early years, hospital-employed physicians surpass them later on in their careers.
Moreover, as a hospital-employed physician, none of your compensation is funneled back into the practice to cover business expenses like overhead, marketing, or ancillary staffs’ salaries. Apart from Uncle Sam’s cut, your paycheck is all yours. You’ll also gain significant cushioning against job loss or a significant pay cut due to unforeseen business downturns like a new competitor in town or sudden insurance reimbursement changes.
New hospital-employed physicians should be aware, however, that compensation often goes hand in hand with productivity. While many physicians fresh out of residency will get a one or two year reprieve to meet productivity targets, most hospitals will eventually base physician compensation on meeting these targets.
Some physicians are concerned that reaching these productivity targets are unsustainable, leading to less face-to-face time with patients or even a drop in quality of care. It’s vital that you talk with current physicians in the hospital-employed practice to get an in depth sense of physicians’ recourse for managing productivity concerns.
Choosing your next physician job takes a bit of groundwork to make sure it’s the right fit. Don’t overlook the practice type when choosing a position— it can affect all areas of your work life, from the practice culture, your ability to provide quality care, and how your work is valued.
While younger physicians are more likely to choose hospital employment compared to their older colleagues, there are a range of personal factors that physicians should take into account when choosing practice type. Being honest about your clinical efficiency, ability to fit into a large multi-specialty organization, and your career must-haves will help determine if hospital employment makes sense for you.
Take the time to match your career goals with the practice setting, and you just might find that a hospital-employed position is your next best career move.
The role of technology is advancing in healthcare for patient-centric tasks. But intelligent tools are also making it easier to recruit, screen, and fill jobs more quickly. AI can take on rote tasks and complex ones, freeing recruiters to spend time on more important tasks. The following are the top ten ways that artificial intelligence boosts healthcare recruiting....
With talent shortages in healthcare far above national averages, the need to recruit smarter has never been more important for healthcare institutions. Some estimates put the US understaffed by over 100,000 physicians by 2030. With the average time to hire at over one year and a workforce that’s more than 40% over the age of 55, healthcare providers must look for every possible tool and advantage to maintain staffing levels.
The role of technology is advancing in healthcare for patient-centric tasks. But intelligent tools are also making it easier to recruit, screen, and fill jobs more quickly. AI can take on rote tasks and complex ones, freeing recruiters to spend time on more important tasks. Relationship-building with potential hires is critical to successful recruitment in every industry. In healthcare, where the competition is fierce, it can be vital.
AI can screen thousands of resumes faster than most recruiters can open their inbox. With the rote task of reviewing resumes off their plate, recruiters can leverage their time more effectively on people-focused duties. This arduous task is one of the first and most common ways institutions are leveraging AI in recruitment.
AI can help with another time-drain: verification of credentials. In healthcare, tech can easily capture needed data and move on to the next. This time consuming task is better and more quickly handled with technology.
Many healthcare providers use short or even lengthy online assessment tools to assure a job seeker will be a good fit for their facility. Whether assessing aptitude, personality, or skills, AI can help increase the potential for a great hire and a long-term employee.
Hiring from across the globe or across the street, virtual interviews leverage everyone’s time as efficiently as possible. But more than just a convenience for those who can attend, video interviews are captured and can be reviewed by others at a later date.
Depending on the sophistication of the interview platform, some tech even analyzes candidates’ speech, gestures and mannerisms during the discussion and can suggest potential problem areas (like untruthfulness) and areas of strength.
Many healthcare providers are taking their recruitment needs to the cloud. Here they access applicant information from anywhere at any time. Beyond information storage, some cloud apps allow facilities to post positions from a single portal that sources active and passive talent pools from a multitude of other platforms.
Yes, you’re looking for talent that’s looking for an opening, but there are millions of candidates that might be interested in your facility who aren’t currently in the market. AI can reach passive talent with algorithms that search social and professional media sites for talent that matches your needs exactly and invites them to apply. No recruiter can match that capability.
AI doesn’t care about an applicant’s name, gender, ethnicity or background. Removing bias in the hiring process is yet another benefit of tech. For institutions looking to build a more diverse and inclusive workplace, AI can help. Even the best recruiters carry some unconscious bias – technology is impartial.
When it comes to diversity and inclusion efforts, the job description is often a barrier to application. Tech can help remove language that tends to exclude and create more engaging posts that attract talent, rather than sending them on to the next posting.
Virtual assistants are a must for healthcare recruiters who rely heavily (or even those who don’t) on a contingent workforce. This tech can improve workflow, guiding recruiters through workforce management. Programmed correctly, they can even include institutional preferences and policies.
One of the best aspects of AI is its ability to find patterns. Hiring peaks are commonly recognized by healthcare facilities. AI can dig deeper into data and produce revelations you hadn’t considered. With the right technology, facilities could uncover data that helps reduce attrition and increase recruitment success.
In the future, the most tech-savvy institutions may be able to use AI to monitor patients and assess risk with algorithms that predict contingent staffing requirements.
Even with only the most basic screening technology, healthcare providers are realizing a boost in their recruitment effectiveness. With rote duties off their desk, staff members have more time for people-centric tasks that can boost hiring and retention metrics in any facility. The more healthcare providers allow technology to help, the better position they’ll be in to spend time on talent acquisition, rather than task completion.
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