Moderator Christopher J. Gearon, a freelance journalist and U.S. News & World Report contributor, kicked off the discussion by noting that more than 87 percent of CEOs responding to a recent U.S. News survey said they planned to reduce reliance on independent physicians in favor of a staff model.
But the challenges of such a staffing shift are not insignificant. Meanwhile, shortages of skilled healthcare workers are a pressing problem, causing many institutions to take measures such as upgrading worker retention programs. In a November 5 panel discussion held at the U.S. News Hospital of Tomorrow event in Washington, D.C., three health care veterans -- President and Chief Executive Officer of UnityPoint Health William B. Leaver, AMN Healthcare President and CEO Susan Salka, and Scripps Health Corporate Vice President Vincent Buzachero -- discussed their experiences with the staff physician model and propose creative solutions to the shortage problem.
[More Hospital of Tomorrow Forum coverage: usnews.com/hospitaloftomorrow]
Gearon asked the panelists if they are staffing for the hospital of today -- that is, fee for service -- or for the value-based hospital of tomorrow.
"We're all in for the hospital of tomorrow," replied William B. Leaver, President and Chief Executive Officer of UnityPoint Health. UnityPoint Health entities employ more than 24,000 employees, with more than 280 physician clinics and 30 hospitals in metropolitan and rural communities in Iowa and Illinois. UnityPoint Hospitals, UnityPoint Clinic and UnityPoint at Home provide coordinated care for more than 4 million patient visits annually to deliver the Best Outcome for Every Patient Every Time. UnityPoint Health is the nation’s 13th largest nonprofit health system and the fourth largest nondenominational health system with annual revenues of $2.7 billion. By January, UnityHealth will include 16 hospitals across multiple states.
Other key takeaways from the session:
- Salka: Health systems need to push care as far down the "cone of complexity" as possible, from tertiary care down toward outpatient settings. That requires the right level of staffing at all levels of the care continuum.
- Buzachero: Building teams is critical. Scripps has assembled physicians, nurses, pharmacists and allied professionals into teams that work together seven days on, seven days off.
- Salka: Hospital systems that are less innovative and progressive than Scripps and UnityPoint don't necessarily have the talent on staff to adapt to tomorrow's world. That's where staffing organizations like AMN are finding a lot of hospitals that need fresh blood and fresh approaches.
- Buzachero: Hospital workforces are growing, but no nearly as quickly as non-hospital healthcare workforces. The latter has been growing in a linear fashion, year after year, even through the recession. Scripps has cut hundreds of millions of dollars in costs without layoffs, just by empowering staff to eliminate waste.
- Leaver: UnityPoint is inviting physicians, including non-employed physicians, to participate in the financial upside for creating cost savings. "I don't think you need to employ" all your doctors in order to align them with the hospital's objectives.
- Leaver: Physicians of today don't want to run a small business. They want the security and simplicity of being employed, and they want to be part of a larger operation.
- Salka: Hospitals and health systems are being pushed to provide more care to more patients. Providers "want just the right amount of workforce to deliver that care, no more and ideally no less," she says.
Panelists agreed that physicians and other providers need to be retrained and rewarded for adapting to the new world older: The value-based medicine that penalizes hospitals, rather than rewarding them, for providing wasteful care.