Locums CME #13: How Retail Giants & Big Tech are Reshaping Primary Care, 12 Locum Tenens Career Tips, Dodging Common Contract Downfalls & More

Locums CME is a bi-weekly roundup of recent news that matters to locum tenens providers. Stay in the loop on what’s new in the locums industry, and make the most of the locum tenens lifestyle with our fresh finds. Here’s what’s in store for you in Locum CME #13:

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Primary Care Trends in 2023: Large Retailers, New Tech Helps Physicians Meet Growing Needs of Primary Care Market

(From AMN Healthcare, 4/11/2023)

The number of primary care physicians in private practice continues to decline, particularly in family and internal medicine. New technological advancements, as well as the addition of big box retailers into the primary care market, have helped primary care physicians and advanced practice providers meet the diverse needs of its patient population despite these physician shortages.

Primary Care Crucial to Ensuring Patient Health

Primary care is a key foundation of our health care system, but the United States is systemically underinvesting in it, according to Tochi Iroku-Malize, MD, MPH, MBA, FAAFP, president of the American Academy of Family Physicians (AAFP). Primary care accounts for 35% of healthcare visits but only receives about 5-7% of total healthcare expenditures.

According to Medscape’s 2022 Physician Compensation Report, family medicine physicians earn, on average, $255K annually, compared to specialties like plastic surgeons, who make, on average, $576K.

Trends in Primary Care

Telehealth is a significant primary care trend we’re continuing to see throughout  2023, with a market size of about $30.4B in the United States. We’re also seeing that more physicians are transitioning to telemedicine and remote roles, which gives them freedom and flexibility with their working hours.

Wearable health devices like the Apple Watch are increasingly being used by patients and physicians. Physicians in primary care have helped educate their patients on the device’s proper use so this health data can be beneficial to the health care provider. 

Major retailers like Amazon and CVS have entered the primary care market, and this has helped create an appetite for additional primary care doctors who will serve as medical directors and leaders of primary care. New medical schools are also training their students with this in mind, preparing them to be able to thrive in these new environments.

Supply vs. Demand

It’s been reported that about 48,000 additional primary care physicians will be needed by 2034, according to the Association of American Medical Colleges (AAMC). The number of working primary care physicians is declining, and difficulties accessing this care are growing. But there is hope as more medical school graduates choose to work in primary care, with the family medicine class of new residents in May 2023 being the largest in history. 

The demand for nurse practitioners (NPs) and physician assistants (PAs) is increasing in primary care, with NPs being the fastest-growing profession in the US, according to the U.S. Bureau of Labor Statistics. Currently, 26 states grant them full practice authority. NP employment is expected to increase by 45.7% by 2031.

Your Locums Prescription

(From All Star Healthcare Solutions, 4/11/2023)

Positive communication between healthcare providers and patients can lead to increased satisfaction, greater understanding of diagnoses, and more effective compliance.

This communication generates a rapport that isn’t just for patients; it’s something rewarding for physicians and advanced practitioners. According to the 2022 Medscape Physician Compensation Report, gratitude and relationships with patients is often the No.1 reward of the job. 

If you are a healthcare provider accepting locum tenens assignments in multiple facilities and communities, you can help them establish ways to make meaningful and rewarding bonds with patients.

Providers working locum tenens jobs can use several strategies to build meaningful patient relationships. Providers can seek longer assignments, accept repeat or recurring assignments, dedicate more hours to patient care, or focus on commonalities to enhance and promote provider-patient relationships. 

Longer stays and recurring contracts increase the chances of encountering some of the same patients and allow providers to get to know their coworkers better.

(From MPLT Healthcare, 4/19/2023)

Do you ever find yourself doubting your expertise as a locum tenens provider? Imposter syndrome is a common feeling among locum tenens providers, and it’s important to take action to combat these negative feelings to ensure long-term success in your locum tenens career. When you feel imposter syndrome creeping into your life, there are three steps you can take to push away these feelings.

  1. Reflect: Take time to reflect on your accomplishments and the progress you’ve made throughout your locum tenens career. If you find yourself reverting to these negative feelings, then you could be experiencing imposter syndrome. 
  2. Reach out for help: Tap into your support system. Your close friends and family can help lift your spirits and remind you that you are qualified and capable of more than you may have ever thought possible. 
  3. Prioritize mental health: Prioritizing mental health, including personal commitments, is crucial for maintaining fortitude and managing both locum tenens work and personal life. This also helps you get control of your emotions when imposter syndrome hits.

(From Integrity Locums, 4/18/2023)

Integrity Locums shares how providers can maximize their income by taking on locum tenens work in this blog post. Balancing both locum tenens and a full-time role as a physician or advanced practice provider (APP) is a viable option and route that many physicians and APPs have made work.  

Locum tenens work offers a great deal of flexibility and opportunity for physicians and APPs. Opportunities are available for part-time and weekend shifts. Also, there are many rural areas in the US in need of physicians, and there is a constant demand for locum tenens work. 

The additional income you make from these locum tenens positions can help you pay off loans and fund future college or retirement plans because locum assignments pay more on an hourly or daily basis than permanent positions. 

Taking a locum tenens assignment provides the opportunity to care for patients from various socioeconomic and cultural backgrounds and enhance one’s skillset. Combining locum tenens with a permanent position provides a stable income and the freedom to explore other opportunities. The connections made during locum tenens assignments can be valuable for your future.

(From All Star Healthcare Solutions, 4/20/2023)

Entrepreneurs and healthcare providers have limited downtime, with each logging an excess of 60 hours a week. For both groups,  hours not committed to work (or sleep) are precious.

In “Nine Things To Do In Your Downtime To Propel A Successful Career,” members of the Forbes Young Entrepreneur Council (YEC) listed preferred activities that enhanced their personal and professional lives. This article adapts those for the life of a physician or advanced practice provider (APP). 

  1. Take time to think: Free moments are when your creative and innovative ideas take form.
  2. Improve non-work skills: Use your uncommitted time to pursue other hobbies and interests.
  3. Read more: Reading a well-written story can help you decompress from the daily stresses of locum tenens work.
  4. Participate in new activities: Push yourself outside of your comfort zone and join activities outside your network.
  5. Stay curious: Try to be a “curious customer” or someone who “takes note of various stimuli” in any new experience.
  6. Give back to the community: Locum tenens and community involvement complement each other. Take time to volunteer at your children’s school, a place of worship, or in community service.
  7. Meditate: Take time, no matter how short or long, for quiet reflection. This aids in preventing burnout.
  8. Improve physical health: The release of endorphins after a good workout can help you feel invigorated.
  9. Plan your work: Your schedule may vary from week to week. Take a moment to look ahead and make plans for yourself to prioritize downtime.

Physician Wellness Retreat

(From Forbes, 4/12/2023)

Artificial Intelligence (AI) is being explored in healthcare for many potential uses, such as diagnosing diseases, transcribing prescriptions, improving communication, and treating patients remotely. AI tools such as Nabla and Regard are now being tested to streamline administrative tasks and help reduce physician burnout caused by heavy administrative demands. 

Nabla can automatically summarize patient-doctor conversations in real-time, creating a report physicians can approve with a single click. Regard works alongside physicians to mine medical records and drafts clinical notes for physicians to review and sign. Regard diagnoses are based on patient-specific data, and supporting information is provided alongside the diagnosis to help physicians assess its accuracy.

Physician oversight is vital to handle ethical issues, bias, and fabrication, but AI tools can revolutionize healthcare by handling administrative tasks that take up a significant amount of a physician’s time. This helps free up more time for physicians to focus on patient care. Nabla and Regard can help streamline these tasks and improve physician well-being and patient care.

(From KevinMD.com, 4/14/2023)

Physician burnout is a critical issue in the medical community, with around 50% of physicians experiencing symptoms of burnout. The adverse effects of physician burnout include impacts on mental health, patient care, medical errors, and overall healthcare system functioning.

To address this, physicians should prioritize mental health and self-care with these seven steps:

  1. Recognize burnout symptoms: Being aware of symptoms such as exhaustion, detachment from work, irritability, and decreased sense of accomplishment is essential.
  2. Seek professional help: Acknowledge that you may need support in coping with the stresses of the profession and seek help from a mental health professional.
  3. Balance work and life: Set boundaries between professional and personal life, limit work hours, delegate tasks, and engage in relaxing activities.
  4. Prioritize self-care: Regular exercise, healthy eating, adequate sleep, hobbies, and spending time with loved ones is necessary for self-care and resilience.
  5. Build a support network: Connect with colleagues, friends, and family who understand the challenges of the medical profession for emotional support.
  6. Use stress-management techniques: Mindfulness, meditation, yoga, and deep breathing can help alleviate stress and promote relaxation.
  7. Advocate for systemic change: Advocate for policies that promote mental health, reduce workload, address the culture of overwork, and provide mental health resources to create a healthier work environment.

Physicians should prioritize their mental health and self-care to improve patient care and well-being. This process starts with recognizing burnout signs, seeking help, achieving work-life balance, and advocating for systemic change. Taking care of oneself demonstrates dedication to patients and is not a sign of weakness.

(From American Medical Association, 4/17/2023)

Dr. Stefanie Simmons, an emergency medicine physician, and resident, shared in an American Medical Association (AMA) news post her past struggles with postpartum depression after her second child’s birth. Initially, as a provider, Dr. Simmons felt she should handle personal challenges on her own, and she didn’t seek help. 

She later recognized her experience with depression lasted much longer than necessary because of her lack of care. As she recovered, she learned more about the resources available to deal with depression and began looking for ways to help her colleagues. 

She went on to work with Envision Healthcare‘s national medical group to create a program promoting wellness and mental health. 

Dr. Simmons is the chief medical officer of the Dr. Lorna Breen Heroes’ Foundation, where she advocates for preventing healthcare worker burnout and reducing suicide rates. Dr. Simmons has also led the effort to shift the focus of licensing and credentialing questions from “past diagnosis” to “current impairment,” which indicates to providers that seeking help is acceptable. 

The AMA provides an issue brief and additional resources for advocating mental health and wellness for providers. Dr. Simmons’s experience emphasizes fostering a culture where clinicians can comfortably seek care and support. 

(From the Coalition for Physician Well-being)

The Coalition for Physician Well-Being will host its 13th annual Joy & Wholeness Summit conference in person at the Grand Summit Resort in Park City, Utah, from July 10-12. The conference will provide tools and resources for physicians to improve well-being and combat burnout.

Speakers at the summit will share insights on business, quality, culture, resilience, and learning. Attendees will have ample opportunities to network, share, and learn from their peers in the healthcare industry.

Register now for the event to connect with like-minded individuals and gain valuable insights into enhancing physician well-being.

Socially Speaking

From LinkedIn

From Twitter

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Doctor’s Notes

(From Medscape, 4/17/2023)

This year’s Medscape Physician Compensation Report revealed that physician compensation continued to rise in 2022 while reducing gender-based pay disparity among primary care physicians (PCP). The annual report surveyed over 10,000 physicians in 29 specialties. The average compensation for specialties rose to $352,000, up 17% from the 2018 average of $299,000. The COVID-19 pandemic affected both physician compensation and job satisfaction.

The gender-based pay gap among primary care physicians also shrank, with females earning 19% less than their male counterparts, down from 25% in from recent years. Among specialists, the gender gap was 27% on average, down from 31% last year. The report attributed this reduction in the pay gap to increased compensation transparency, which should be the norm.

The report revealed that physicians who declined to take new Medicare patients rose, possibly due to Medicare reimbursements and staffing shortages caused by burnout or retirement. With the growing disparity between physician supply and demand, income increases will likely continue. Federal lawmakers are considering passing the Resident Physician Shortage Reduction Act of 2023 to add 14,000 Medicare-funded residency positions to alleviate shortages.

(From American Medical Association, 4/12/2023) 

A new bipartisan bill, H.R. 2474, called the  “Strengthening Medicare for Patients and Providers Act,” ties Medicare physician payment to the Medicare Economic Index, protecting care access for 65 million older Americans. The bill proposes an annual inflation-based update, placing physicians equally with other Medicare-paid health professionals. Physician payment rates have been frozen for six years and are now subject to 2% across-the-board Medicare pay cuts starting in January—this will last until 2026.

Physician payments have dropped 26% from 2001 to 2023 when adjusted for inflation. This change has disproportionately affected small, independent, and rural physician practices and doctors delivering care to economically marginalized patients and those from historically marginalized racial and ethnic groups. The bill’s introduction follows the Medicare Payment Advisory Commission’s (MedPAC) recommendation Congress increase 2024 Medicare physician payments above current law by linking the payment update to the Medicare Economic Index.

The Medicare Trustees Report issued late March said lawmakers should “expect access to Medicare-participating physicians to become a significant issue in the long term” unless Congress bolsters the payment system. To address this issue, the AMA, in collaboration with 120 other physician and healthcare organizations, has outlined the essential principles, including an annual inflationary update, that can put the nation’s healthcare system on sustainable financial ground. 

(From KevinMD.com, 4/23/2023)

A letter of intent, also known as a “term sheet,” is helpful for physicians and recruiters to ensure both parties agree on the main terms of the contract they plan to enter, but physicians should be cautious when agreeing to specific terms.

The terms in the letter of intent are generally not legally binding, but specific provisions can be.  So, it would be helpful to have a physician’s attorney review any letter of intent before signing if not all provisions are clear.

An employer may emphasize the letter of intent is not legally binding, but should not be treated as meaningless. Flexibility for negotiations can be retained by replacing hard numbers with phrases such as “approximately $X” for salaries.

Physicians should be cautious when agreeing to a specific term in a letter of intent, as this may affect the final agreement. It is better to err on caution to ensure no unintended terms are agreed upon.

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