Locums Digest 29: Solutions for Staff Burnout; New NALTO Officers Named; All Star & ICON News, Healthcare Staffing Growth, Retroactive Malpractice Coverage & More

In this issue:

Healthcare Staff Turnover: Let’s Talk Solutions

(Edited from Physicians Practice article by Lisa Hedges, 2/14/2022, and Harvard Business Review article by Berry, Awdish & Swenson, 2/11/2022)

Medical practices around the country are experiencing many challenges, including record levels of turnover, unrealistic expectations from patients, and burnout exacerbated by a virus that’s not going away completely.

It’s an unfortunate reality for physicians and healthcare practices, especially when it affects patient outcomes. In response, medical practices have been implementing new technologies and revamping employee benefits to improve work processes and incentivize healthcare workers to stick with the job.

Locumpedia recently covered CompHealth CEO Scott Beck’s thoughts about how hiring locum tenens physicians and other clinicians can help prevent or mitigate the burnout many healthcare professionals are feeling as the two-year milestone of COVID-19 passes. Beck’s list of how locum tenens can be part of the solution, as follows:

1. Focus entirely on patient care.
Locum tenens’ sole purpose is to care for patients; they don’t go to staff meetings or perform administrative tasks.

2. Work when, how, and where you want.
For physicians, finding vacation time can be hard. There are holidays to cover and nights to be worked. Meanwhile, locum physicians can control the days, weeks or months they want to work.

3. Get out of office politics.
Locum clinicians are temporary and don’t have to deal with office politics.

4. Experience working in a different setting.
Many locum physicians find that working in different settings shows them new practices, while allowing them to share their expertise with colleagues.

5. Travel–experience other parts of the country.
Whether it’s rural Wyoming or somewhere more exotic (like Hawaii or Alaska), there are many places to see and things to do.

Factors Driving Burnout and Turnover

Physician burnout was a big problem even before the pandemic, as physicians reported burnout from “excessive workload” and “work inefficiency,” according to a JAMA study conducted in 2018.

In August 2021, Software Advice surveyed healthcare professionals, including 207 family and general practitioners and 50 mental health therapists, to understand their experiences with burnout during the COVID-19 pandemic. The goal was to figure out what strategies work to mitigate the stress of treating patients during this time.

Healthcare providers are still experiencing crippling staffing shortages—including essential nurses, physicians, techs, and management. The mass exodus from healthcare is real and alarming. Thus, making healthcare harder to access, more expensive, and (in some cases) less effective for the public.

Here are Software Advice’s survey findings about burnout among providers:

  • 64% of providers surveyed considered leaving their jobs in 2021.
  • 25% of respondents have considered a career change during the pandemic, while 39% have considered early retirement.
  • 82% of providers said flexible work hours would help alleviate burnout, while 77% said increased paid time off would help significantly.

Unfortunately, only 29% of responding healthcare professionals have been allowed more flexible hours, while only 11% have enjoyed increased paid time-off. This could indicate a larger issue where management and staff don’t compromise, possibly leading to toxic work environments in which employees feel undervalued and start exploring career options.

Physicians and therapists aren’t the only ones suffering from burnout: Software Advice recently ran a survey of medical employees (excluding practice owners, founders, and executives). Among 278 respondents who’d considered leaving their jobs, burnout was a top reason they were exploring other options.

The two key retention methods they cited included increased salary (64%) and remote working options (59%). Outlined below are proven methods to help improve office morale, attract skilled workers, and retain staff.

Retention Solutions

Not all physician practices have adopted the newest technologies. However, many physicians tested or adopted new measures during the pandemic–including telemedicine systems for remote patient care and scheduling tools.

Investing in wellness and support programs—from free therapy to reimbursement for self-care activities (gym memberships, training, workout equipment, messages, etc.)—also incentivizes staff to take charge of their health and recharge in their off hours.

Recently published in Harvard Business Review, authors Leonard L. Berry, Rana L.A. Awdish, and Stephen J. Swensen identified 5 Ways to Restore Depleted Health Care Workers that were adopted by some of the healthcare organizations the authors analyzed.

1. Make the most of extended teams.
Well-executed, team-based care honors clinicians’ level of training and reduces the time and effort clinicians spend on the administrative tasks they so often find physically and emotionally draining.

2. Be a reliable advocate.
Healthcare workers’ emotional well-being depends on robust support from their employers, including an institutional commitment to protecting their physical safety and economic security.

For example, during the first wave of the pandemic in 2020, Torrance Memorial Medical Center committed to a no-layoffs policy, which persists today. Nearly 700 staff were sent home but received 50% of their pay, plus assurance their jobs would return.

Although temporary furloughs were necessary at Henry Ford Health System, it established a COVID-19 employee relief fund that accepted monetary donations for fellow coworkers in need. Senior leaders donated 10%-25% of their salaries to the fund–and some 92% of furloughed employees were brought back eventually.

3. Lead with kindness.
The Mayo Clinic has invested heavily in selecting and developing leaders who seek to combat depletion with kindness. Leaders are assessed annually with a survey, of all 73,000 staff, on five kindness-fostering behaviors:

  • Include: Treat everyone with respect and nurture a culture where all are welcome.
  • Inform: Transparently share what you know with the team.
  • Inquire: Consistently solicit input from the people you lead.
  • Develop: Nurture and support the professional development and aspirations of staff.
  • Recognize: Express appreciation and gratitude to employees in an authentic way.

4. Offer access to emotional support resources.
It’s essential for leaders to invest in mitigating the relentless stress of healthcare work. Providence, a healthcare system based in Renton, Washington, with 52 hospitals and more than 1,000 clinics in seven states, has taken steps to mitigate emotional depletion, including:

  • Providing curated content for staff on topics like “compassion fatigue” and parenting during a pandemic.
  • Instituting a “No One Cares Alone” program, whereby teams of behavioral clinicians, social workers, and chaplains consult with members of high-stress units (eg, ICU, emergency, respiratory therapy) and offer practical suggestions.
  • Giving unit leaders direct support to help them understand the importance of creating psychologically safe environments to promote team members’ mental health and well-being.

5. Allow time for what matters.
Rushing clinical interactions with patients has both human and financial costs. When clinicians are hurried, they may miss pertinent information, potentially undermining recommended treatment plans.

Placing value primarily on productivity disempowers patients, and ultimately depletes clinicians by diminishing their joy in work. Simple acts of connection and kindness can change the tenor of care for both parties.

Listen to Employees and Offer Creative Benefits

Now is the time to keep the economy in mind and get creative with your perks. What can you offer that sets your organization apart? Looking to alleviate some of those major pain points for your employees? Consider surveying employees anonymously to learn how they really feel and then taking action/

Making an investment in the form of raises, ultimately, is the top-cited reason for employees’ staying. It doesn’t have to be a huge raise to make a difference: 63% of survey respondents said they received between 1% and 3% of their base salary. Other benefits to consider include childcare stipends, commuter benefits, or even pet insurance—all of which can prove powerful in recruiting and retention.

All News Is Locums

The National Association of Locum Tenens Organizations® (NALTO®) Announces New Officers to Board of Directors

At its annual conference last week in Las Vegas, NV, the National Association of Locum Tenens Organizations® (NALTO®) announced its officers-elect for 2023:

All Star Healthcare Solutions Named #1 Best Place to Work in South Florida

(Edited from All Star Healthcare Solutions Blog, 2/18/2022)

All Star Healthcare Solutions® was honored at the South Florida Business Journal’s 2022 Best Places to Work Awards Luncheon on February 17 at the Signature Grand in Davie, Florida. The full-service healthcare staffing company, specializing in locum tenens and permanent job opportunities, ranked #1 in the large-company category.

“We are honored and humbled to be recognized for our amazing, highly engaged culture,” says Keith Shattuck, All Star’s CEO. “This award is especially meaningful as it is the result of our employees’ feedback and positive experiences, which include how they feel about everything from being appreciated for the important work they do, to our comprehensive employee benefits, to the world-class learning and development opportunities we provide, enabling them to set their own career paths. Our people make All Star the best place to work.”

Continuing Trend

This marks the third consecutive year All Star Healthcare Solutions ranked within the top five Best Places to Work. The company is especially grateful and feels privileged to receive this distinction at a time many businesses continue to be impacted by the pandemic.

Best Places to Work finalists were chosen based on the results of a confidential online survey administered to employees by Quantum Workplace. The top 45 firms, based on employees’ feedback, were divided into one of three categories: small company (10–49 employees), medium company (50–99 employees), and large company (100 employees or more).

Earlier this month, All Star Healthcare Solutions announced it had been named among Energage’s 2022 Top Workplaces USA. The company also won Clearly Rated’s 2022 Best of Staffing Client and Talent Satisfaction Awards for providing superior service to its clients and the physicians and advanced practitioners the company places in locum tenens and permanent jobs. Fewer than two percent of all staffing agencies in the US and Canada earn the Best of Staffing designation.

“I Felt Like a Real Doctor Again.”

Dr. Vanessa Cook Joins Kittson Healthcare on Rotating Schedule

(Edited from article by Anna Jauhola, Kittson County (MN) Enterprise, 2/16/2022)

Dr. Vanessa Cook has had her eye on Kittson Healthcare for a while.

In 2018, Cook was working in Kansas when a physician’s position opened in Hallock. At the time, Kittson Healthcare employed a different candidate and Cook took a medical director position at Emporia, Kan.

“I thought I’d stay there until I retired,” Cook said. “I was the medical director—seeing patients, teaching with the nurse practitioners–it was fun because I lived in Emporia before. But there was a lot of stress and with COVID, there’s a lot more stress.”

When the physician’s position became available at Kittson Healthcare again in summer 2021, she jumped at the chance to further investigate it. She came to Hallock for an interview, to see the facility and tour the community.

Right People, Right Balance

And she loved all of it. The people really sealed the deal for her–not only those she met through the interview process, but everyone around town she met was welcoming and friendly, she said.
“When I knew there was a job that would offer semi-retirement and I could work hard for the two weeks that I work, and then be with my family the rest of the time, I jumped at it,” Cook said. “I like the setup, I like the clinic and being part of the hospital and nursing home. I could see forming relationships and getting to know people. I could see this as a place to hang my hat.”

Cook will be working two weeks each month, opposite Dr. James Surdy. The five to seven days they don’t work will continue to be covered by locum tenens doctors. So far, in her first few months here, Cook has not been disappointed. In fact, she feels invigorated.

At her previous positions, she was pulled in several directions. At Kittson Healthcare, she covers the emergency room, hospital, clinic, and nursing home. “I have a huge variety in the emergency room already,” she said. “It was trial by fire my first two weeks here. It was busier than all get-out, but I felt like a real doctor again.”

Cook has found this position to be freeing. The two weeks she works each month gives her a wide range in which to practice medicine and she enthusiastically enjoys each day she is here to serve the community.

The Healthcare Staffing Story

Alan McIver Joins ICON Medical Network Holding as COO

(Edited from Business Wire, 2/1/2022)

ICON Medical Network Holdings (ICON) has announced the appointment of Alan McIver as its chief operating officer (COO).

“Staffing as a whole has had two of the most tumultuous years to date, and the healthcare industry has been at the forefront,” ICON CEO Janet Elkin said. “I am pleased to welcome Alan to the ICON family and look forward to tapping his years of experience to expand ICON’s work across the country.”

McIver joins ICON with more than 40 years of management experience, 35 of them in healthcare staffing specifically. Most recently, he was the group president at CHG Healthcare where he oversaw five divisions and $175 million in revenue.

“It is rare when the stars align, and I get the opportunity to work alongside a former colleague in such a great endeavor,” McIver said. “It will be great to pick up with Janet to build out and further expand the locum tenens industry and create better solutions for the healthcare staffing industry as a whole.”

Healthcare Staffing Market Can Expect 5.2% CAGR, 2020-2027

(Edited from Digital Journal, 2/11/2022)

Global healthcare staffing market revenue had reached $30.3 billion (USD) in 2019. North America held the largest market share in terms of revenue. Market analysts attribute the healthcare staffing industry’s growth to the huge presence of market players, the growing geriatric population, and the shortage of doctors and other medical professionals.

The Healthcare Staffing Market research report 2022 describes the latest concepts of the market. The vital information featured in this report makes the research document a handy resource for managers, industry experts, analysts, and key professionals to thoroughly analyze the study on the market and in the form of graphs and figures. It has valuable and beneficial data, including financial strategies, applications, future growth, development, and advancements. Additionally, the report offers insight to study insignificant trends developing the growth possibility of the market.

Get a Sample of the Report: https://www.researchinformatic.com/sample-request/108

US Healthcare Staffing Market Should Reach $31B+ by 2028

(Edited from BusinessWire release, 1/25/2022)

The “US Healthcare Staffing Market Size, Share & Trends Analysis Report by Type (Travel Nurse Staffing, Locum Tenens Staffing, Allied Healthcare Staffing, Per Diem Nurse Staffing), and Segment Forecasts, 2021-2028” report has been added to ResearchAndMarkets.com’s offering.

The U.S. healthcare staffing market size is expected to reach USD 31.1 billion by 2028. It is expected to expand at a CAGR of 3.71% from 2021 to 2028. The growing geriatric population, and a shortage of nurses and other medical staff, are leading to rising demand for medical services. The cost-effectiveness of temporary (e.g., locum tenens) staffing is likely to drive the market in the coming years.

Geriatric Population Growing

According to the National Institutes of Health, the number of people aged 65 years and older in the US is projected to nearly double from 48 million to 88 million by 2050. 

Physician Workforce Shrinking

Additionally, the Association of American Medical Colleges projects a shortage of 21,000 to 55,200 primary care doctors across the US by 2032, a growing physician shortage that likely will drive the market.

In addition, an increasing need for home care workers–including dieticians, nutritionists, nurses, therapists, and home care aides–is expected to boost market growth.

During the COVID-19 pandemic, demand for staffing services and workforce technology solutions increased dramatically. The spread of COVID-19 infection fueled demand for travel and per diem nurses. A poll conducted by Avant Healthcare Professionals indicated 90% of medical facilities accepted using travel nurses to manage COVID-19 patients in 2020, compared to less than 60% in 2019.

On the other hand, the demand for locum tenens specialists and allied health professionals decreased as elective surgeries were canceled.

Healthcare Staffing Market Report Highlights

The travel nurse staffing type segment dominated the market in 2020. High demand for nurses is expected to continue driving the segment. BLS projects more than 1.1 million new registered nurses will be needed by 2022.

The locum tenens staffing type segment is anticipated to witness the highest growth over the forecast period because of the cost-effectiveness of hiring temporary employees and an increase in the trend of physicians opting to become locum tenens doctors.

Companies mentioned in the report include AMN Healthcare, Adecco Group, Aya Healthcare, Cross Country Healthcare, Inc., Envision Healthcare Corporation, LocumTenens.com. Maxim Healthcare Group, TeamHealth, and Trustaff.

Tools to Try/News to Use

Malpractice Insights: What is a Retroactive Date or Retroactive Coverage?

(Edited from Malpractice Insights with Jennifer Wiggins, 2/17/2022)

The malpractice insurance market uses a lot of acronyms, confusing terms, and other lingo that can be hard to understand if you’re not an industry insider. One of the items that doctors frequently stumble over is the concept of retroactive coverage. So, what exactly is it? What is a policy retroactive date? And why do you need to know about it? In this article, we’re going to explain what a malpractice policy retroactive date is, where you can find yours, and why it’s important.

Read / listen / watch the rest in your browser »

Rent an All-Wheel-Drive Vehicle for Winter Gigs in Ice & Snow

(Edited from The Locum Guy’s email, 1/24/2022)

OK… So you just landed a locum tenens job in the Northeast, Midwest, or who knows–maybe the mountains of Colorado. The point is: If you’re headed to any of those locations from about November to February, you should be prepared to drive in some snow.

And I’m NOT talking a little dusting of snow on the road… I’m talking piles of snow, can barely see the road, black ice, SNOW!

Driving in the snow can get kind of tricky, so here are a few tips.

Make sure your car is all-wheel drive.

Rear wheel cars (typically sports cars or some trucks) are way more slippery on the ice. You DON’T WANT THAT. My recommendation is to go with the 4-wheel drive SUV or pickup if you can get that.

This may sound obvious, but a lot of docs are too shy to ask their locum tenens agencies for this upgrade.

I’ve never had any push backs on my car upgrade requests, but if your staffing company does, simply tell them you don’t feel safe driving in the snow and explain you may not make it on time for your assignment due to the weather conditions unless you drive an SUV.

This should convince them.

Make sure your car has GOOD tires. If you’re renting from Hertz, they offer a winter tire package. With other car rental agencies, you’ll need to ask them if their cars are equipped with the proper winter tires (snow tires) or at least all-season tires.

Oh… and one last thing: DRIVE SLOWLY! And don’t get too close behind people.

I know this sounds like a no-brainer, but I’ve seen so many California transplants in WA state mountain passes driving like it’s 80 degrees outside.

Good luck with your work in the frigid North! It may be cold, but there are a lot of fun winter activities to do when you’re not working.

Socially Speaking

From Twitter:

From Instagram

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How ‘Bout This?

Gap Between CEO Pay & Average Worker Pay Varies Widely

(Edited from Becker’s Hospital Review article by Ayla Ellison, 2/15/2022)

Nonprofit hospital CEOs make an average of eight times more than workers without advanced degrees, according to an analysis by the Lown Institute of more than 1,000 hospitals.

The study, published in Health Affairs Feb. 10, found the gap between CEO pay and average worker pay varied widely. Some hospital CEOs were paid twice the rate of other workers, while the highest paid received 60 times the hourly pay of general workers.

The analysis revealed a relationship between hospital size and executive compensation.

Across all nonprofit hospitals, the average CEO compensation per hour was $249, and the average hourly worker wage was $29.

The analysis supported previous research showing hospital CEOs are compensated primarily for the volume of patients entering their hospitals.

“This is part of the underlying business model that drives the nonprofit hospital landscape: Volume matters and high-margin volume matters the most for the bottom line,” the Lown Institute researchers said.

Staffing-Related Snippets

License Wait Times Reach Crisis Levels for Healthcare Workers

(Edited from Becker’s Hospital Review, 2/14/2022) 

Licensing agencies were understaffed and used antiquated workflows pre-pandemic. Now, facing an influx of applicants, the delays are affecting healthcare workers’ ability to get to work and patients’ access to care, NBC News reports.

Healthcare workers, from Wisconsin nurses to New York psychologists, said they are waiting months more than usual for approval to work. In New Jersey, some social workers have been waiting more than 18 months. NBC News spoke to leaders with nine healthcare professional organizations in three states who said wait times for licenses are worse than they’ve ever been.

Regardless of position or state, licensing and healthcare leaders say the solution is increased staffing at licensing agencies…

In Wisconsin, healthcare workers say licensing delays have reached a crisis level…At the Wisconsin licensing agency, staffing is so lean that one worker’s illness or parental leave curbs productivity. Entry-level salaries start around $17 an hour.

Read the article in full here.

1. Lisa Hedges is a senior medical analyst for Software Advice, a company that helps businesses, including some in healthcare, navigate the software buying journey.

2. https://jamanetwork.com/journals/jama/fullarticle/2702871

3. Physician Burnout Survey 2021: In August 2021, Software Advice conducted this survey of 257 healthcare providers to learn more about pandemic-related burnout and how healthcare providers should address burnout. Respondents were screened for general and family practitioners (207) and mental health therapists (50) currently working in U.S. practices with 20 or fewer licensed providers.

4. Healthcare Employee Retention Survey 2021: Software Advice conducted this survey in October 2021. Screening questions identified 987 healthcare employees (excluding practice owners, founders and executives) who had worked at a healthcare facility with no more than 20 licensed providers for at least six months. From there, Software Advice narrowed respondents down to 278 who had considered leaving their current jobs since the pandemic’s onset.