Locums Digest 5: Spotlight on Mental Health for Patients — and for Clinicians

Locums Digest is Locumpedia’s roundup of hot topics, top stories, and social media posts of interest to the locum tenens and medical communities. Subscribe to our newsletter to receive Locums Digest before it’s published here.

Clinicians’ Mental Health Matters.
Locum Tenens Can Prevent Burnout.

Now months into the COVID-19 pandemic, we know that helping healthcare providers stay mentally healthy figures almost as prominently as maintaining their physical wellness. In discussing what we’ve learned from the COVID-19 outbreak so far, Interim Physicians’ Dr. Ken Teufel referred to a May 6 article in the LA Times about the “wave of mental health disorders” hospital administrators anticipated among clinicians as a result of the COVID-19 pandemic.

“As many as 20 to 25 percent of healthcare workers in hard-hit areas, experts say, are likely to develop disorders such as anxiety, depression or post-traumatic stress—a rate similar to what is reported in soldiers returning from combat,” LA Times staff writer Del Quentin Wilber noted.

Hiring locum tenens providers as part of a burnout-prevention staffing plan could help relieve some of the pressure today’s clinicians feel.

Well before we knew about COVID-19, between August and October 2019, Staff Care queried physicians for its 2020 Survey of Temporary Physician Staffing Trends report, finding that 72% of healthcare facility managers said they were seeking locum tenens physicians–an increase of 47% from 2016 findings. This was the highest percentage Staff Care ever recorded in 14 years of conducting annual surveys.

Furthermore, LocumTenens.com’s 2019 Locum Tenens Engagements survey report indicated that healthcare executives and administrators have begun to consider locum tenens a key part of longer-term staffing strategies. Rather than simply a way to fill gaps in staffing, they now view temporary clinicians as an option for balancing staff workloads and enabling greater flexibility in facility operations.

Burnout Is Common

“Burnout” presents the biggest mental health risk among today’s clinicians, according to data and reports from many reliable sources. In its National Physician Burnout & Suicide Report 2020: The Generational Divide, Medscape noted, “Burnout has been described as long-term, unresolvable, job-related stress that leads to exhaustion, cynicism, feelings of detachment from one’s job responsibilities, and lack of a sense of personal accomplishment.”

Among more than 15,000 US physician-respondents to this year’s survey between June 25 and September 19, 2019, 42% reported feeling burned out–down 4% from 2015. Specialties ranking highest in reported physician burnout over the past five years were critical care, emergency medicine, family medicine, internal medicine, neurology and urology.

Medscape’s survey report quoted Yale New Haven Hospital physician Frank John Ninivaggi, MD, author of Learned Mindfulness: Physician Engagement and MD Wellness: “The percentage of physicians feeling burned out remains fairly consistent. The leading cause is administrative burden, as driven by the workplace and organizational culture.” Medscape’s findings supported his claim.

Medscape Offers Snapshot

Here are some salient highlights from Medscape’s latest survey report.

  • Sixty percent of specialists and 54% of primary care physicians reported being happy with their work lives.
  • Physicians from Generation X reported “noticeably more burnout than other groups”.
  • Women physicians (48% in 2020) consistently have reported higher percentages of burnout than men (37% in 2020) over the past five years.
  • About half of physicians overall (49%) would choose more free time for less pay–53% of women versus 47% of men.
  • While 15% of millennials, 18% of Gen Xers, and 16% of boomers reported being depressed, “less than one-third described it as ‘clinical’ depression (prolonged severe depression not caused by a grief-associated event).”
  • Only 1% (men) to 2% (women) of physicians had attempted suicide, but 22% (women) to 23% (men) reported having had suicidal thoughts.
  • The highest percentages of respondents were in family medicine (11%), anesthesiology (10%), internal medicine (10%), pediatrics (10%), emergency medicine (9%), and psychiatry (7%).

Note to Readers: The  Medscape data highlighted above was gathered before the COVID-19 pandemic hit the United States.

All News Is Locums

Providers Want to Work

In a June 1 article that ran on MedPageToday.com, Weatherby President Bill Heller discussed results of a more recent survey conducted by Weatherby’s parent company CHG Healthcare.

Seventy-four percent of respondents said they were working less than before the pandemic hit, with 56% working “significantly less.”

Only 11% reported working more hours than before COVID-19 struck. While 7% were laid off and another 6% furloughed, only 2% of providers voluntarily had cut back work hours.

Interestingly, however, fewer than half of respondents (44%) planned to stay with their current employers. CHG reported that 37% planned to work locum tenens assignments and 30% hoped to work in telehealth. Almost a quarter of respondents (24%) planned to change employers.

AHTG and AHSA to Support CommonSpirit Health

(Edited from Cision/PRWEB) EDMOND, OKLA., JUNE 19, 2020–American Health Technology Group (AHTG), a next-generation healthcare workforce technology provider, and American Healthcare Staffing Association (AHSA), a pioneer and leader in healthcare workforce solutions, will provide staffing support and other services to CommonSpirit Health, one of the largest nonprofit Catholic health systems in the United States. AHTG and AHSA are part of the American Health Staffing Group (AHSG) suite of companies.

The Trio VMS+ solution will provide vendor management system (VMS) software from AHTG and management and consulting services from AHSA to support CommonSpirit as it builds an internal locum program management office for the health system, providing cost savings and effective oversight of all locum tenens use.

“The AHTG team is thrilled that Trio VMS+ was selected as CommonSpirit’s VMS platform. This further demonstrates that with Trio, we hit the mark in our unwavering commitment to addressing and managing the nuances of healthcare contract labor,” AHSG CEO Mark Smith  said.

“In addition, AHSA is excited to consult and provide support as CommonSpirit ramps up its own program management office. Trio VMS+ is our latest solution that leverages AHSA’s 17 years of MSP (managed service provider) expertise as well as Trio’s best-in-class functionality all while providing clients what they have been asking for–a path to controlling their overall contract labor program,” Smith said.

American Health Staffing Group is a portfolio company of BelHealth Investment Partners.

LocumTenens.com Adds Psychology Staffing

(Edited from Cision/PR Web) July 14–LocumTenens.com is expanding its behavioral health services by adding psychology staffing to its provider mix. This addition complements the psychiatry staffing services the company has been offering for the past 25 years.

“The United States is currently facing a mental health crisis exacerbated by the COVID-19 pandemic,” LocumTenens.com President Chris Franklin said. “Mental healthcare clinicians, particularly those residing in limited-resource areas, are overwhelmed…Our psychology staffing services will help increase access to behavioral health care.”

According to a recent LocumTenens.com survey, 73% of responding psychologists said they expect to see more mental health issues arise in patients post-COVID-19. Additionally, 52% of clinicians across all specialties reported experiencing increased stress, burnout or mental health issues due to COVID-19.

Anna Shaw Children’s Institute is already experiencing the benefits of its partnership with LocumTenens.com.

“We are thrilled with our Locum Tenens psychologist, and our families and patients are able to receive much-needed assessments and counseling,” Children’s Institute Executive Director Terri Woodruff said. “Because of how the pandemic has disrupted their routines, children are vulnerable and may need additional resources and support during this time.”

LocumTenens.com also announced that part of its psychology expansion will include telepsychology services via secure video conference connection. The company’s survey of clinicians revealed 74% of respondents’ organizations increased their telehealth service offerings due to COVID-19.

The Healthcare Staffing Story

COVID-19 Reducing Physician Job Options, Comp

(Edited from Healthcare Finance News) The coronavirus pandemic has significantly altered the job market for physicians, leading to lower starting salaries and fewer practice options for doctors, according to an annual report tracking physician-recruiting trends. 

Prepared by physician-search firm Merritt Hawkins, the 2020 Review of Physician and Advanced Practitioner Recruiting Incentives tracks a sample of 3,251 physician and advanced-practitioner recruiting engagements the firm conducted from April 1, 2019, to March 31, 2020. It includes analysis suggesting the previously robust physician job market has softened since the emergence of COVID-19.

While the number of physician-search engagements increased over the 12-month period ending March 31, demand for physicians since March 31–as gauged by the number of new search engagements–has declined by more than 30%. At the same time, more physicians are inquiring about job opportunities, which has created a “buyers’ market” for healthcare facilities seeking physicians.

The soft physician job market results from the devastating economic impact COVID-19 has had on the healthcare industry (as Locumpedia.com has covered previously). As a result, fewer physician practices and hospitals are seeking physicians as they struggle with lower revenue and also focus on treating COVID-19 patients.

Starting Salaries Lower

The decrease in demand for doctors is likely to be temporary, though. The various underlying dynamics driving physician supply and demand remain, including a growing and aging population, a limited supply of newly trained physicians and an aging physician workforce. COVID-19 will not permanently change these market conditions, and demand for physicians will begin to rebound before the end of year, the report projects.

The report also tracks physician starting salaries and other incentives based on data gathered mostly prior to the emergence of the coronavirus. The data shows an average starting salary for family doctors of $240,000–compared to an average $423,000 for radiologists; $464,000 for urologists; $640,000 for invasive cardiologists; and $626,000 for orthopedic surgeons.

Physician starting salaries are likely to decrease temporarily as a result of COVID-19, though it’s difficult to project by how much. The way physicians are compensated likely will change, also: physician bonuses increasingly will be tied to their telehealth usage and more physician reimbursements will be monthly payments, rather than based on average daily patient or work volumes.

Demand Likely to Increase

This projection is in line with a report released by the Association of American Medical Colleges on June 26. The AAMC report projects a shortage of up to 139,000 physicians by 2033, an increase over its 2019 projection of 121,900 doctors by 2032. 

The 2020 Survey of Temporary Physician Staffing Trends from AMN Healthcare, released in February, indicates that 85% of hospitals, medical groups, and other healthcare facilities used temporary physicians in 2019. Known as “locum tenens” doctors, they’re typically hired to maintain services until permanent physicians are found, and to fill gaps caused by turnover.

Tools to Try

  • DocCharge, a subscription-based service with a 30-day free trial, was designed by a physician to make physicians more productive. Touted “real-world benefits” include
    • Saving 30-60 minutes/day.
    • Avoiding errors and eliminating denials.
    • Tracking missing charges.
    • Reducing A/R days.
  • Clinical Advisor, from Haymarket Media, is “the first app created specifically for nurse practitioners and physician assistants, from the publishers of the number-one print journal for these healthcare professionals. It aggregates the best NP and PA information from several partners–including free CME/CE courses form myCME.com and drug information from NPPR/PAPR, plus all of the content from our website and print journal.”
  • Physician’s Weekly CME allows physicians to stay current with continuing medical education needs. Allows downloading of course material for offline viewing, completing assessments and evaluations, and receiving certificates via phone.