Facing a growing physician shortage, area hospitals have developed a variety of recruitment strategies to bring new doctors to the region.
In the next decade, the United States will face a shortage of at least 62,000 doctors, according to last year’s physician workforce report by the Association of American Medical Colleges.
The shortage hits harder in rural areas and smaller communities, where longtime independent physicians are retiring and new graduates are more interested in major population centers, Conemaugh Health System Chief Medical Officer Dr. Susan Williams said.
“Primary care is where we are feeling this particularly acutely,” Williams said. “We have a number of excellent independent primary care docs, but none of them are adding. Unless we want to wait until suddenly one day they retire and we’re short, we need to backfill that.”
While Conemaugh continues to include independent doctors and physician groups, such as Western Pennsylvania Orthopedic and Sports Medicine, the health system hires others to fill important roles.
“The philosophy is to employ all the physicians we need in the community,” Conemaugh President and CEO Steve Tucker said.
“We have a mixed model,” Williams said. “This positions us well for what is coming in health care. Our best model is a mixed model.”
As a Level 1 trauma center, Conemaugh Memorial Medical Center is required to have certain specialties available around the clock.
“If you don’t happen to have those in the community, you need to recruit and employ,” Williams said.
As the health care world continues to move toward preventive medicine, also called population health, communities are developing clinically integrated networks to combine all areas of patient care, Tucker said.
“What we are pursuing in a clinically integrated network is truly a combination of independent and employed physicians.”
Employing physicians is not always Conemaugh’s first choice in recruiting, Williams added.
“We look to augment and complement an existing group of independent with employed physicians,” she said.
Chan Soon-Shiong Medical Center at Windber has had success in partnering with independent physicians and groups.
Cardiologist Dr. Samir Hadeed is spearheading Windber’s new cardiac catheterization lab and orthopedic surgeon Dr. Brian Gunnlaugson has led a resurgence, helping double inpatient surgery at Windber.
“A lot of it is orthopedics,” Windber President and CEO Tom Kurtz said. “We focus on our surgical volumes. We just recruited another general surgeon, and we are actively recruiting another orthopedic surgeon.”
Although Windber continues to employ some physicians directly, specialists such as Gunnlaugson and Hadeed are contracted through a physicians group, Alleghenies Independent Physicians.
“It’s a good model for us,” Kurtz said.
“They do the records and they do the billing. The benefits are through them. We can pick and choose what specialties we want and what coverage they want.”
Since the physicians are owners in the group, there are advantages to participate.
“They can build some equity,” Kurtz said.
“They can pay themselves better benefits than we can offer.”
Since many of Windber’s patients come from the Richland area, Kurtz said it made sense to work with Hadeed to create an outpatient care center in the East Hills.
Windber will rent the 14,000-square-foot second floor suite of Hadeed’s new Johnstown Heart and Vascular Center at Schoolhouse Road and Eisenhower Boulevard in Richland.
The location worked for Hadeed as well, who noted many patients travel from Ebensburg, Somerset, Windber and other areas.
“It makes it closer, having my home office right in the middle,” Hadeed said. “Plus, it gives me an opportunity to grow and expand. Most of the growth in the area is in Richland.”
At Somerset Hospital, difficulty in attracting new doctors to the rural area has led to expanded partnerships with larger networks, including Conemaugh and Allegheny Health Network of Pittsburgh, Somerset President and CEO Craig Saylor said.
While the partnerships allow Somerset to continue such important services as cardiac catheterization, cancer care and urology, it wasn’t enough to preserve the obstetrics program.
Although Dr. Charles Camacho’s office in Somerset still offers prenatal, postnatal and gynecology services, all babies are delivered at Memorial in Johnstown.
Obstetrics is just one of the areas challenging the medical community, Saylor said.
“It is not just a challenge for us,” Saylor said. “It’s a challenge for urban areas. The supply does not meet the demand.”
Sometimes, recruiting takes a little creativity.
When Conemaugh was unable to bring in a new vascular surgeon, leaders found two experienced surgeons who were willing to split the job.
Dr. John Gray of Lewisburg and Dr. Stephen Lalka of Charlotte, North Carolina, are alternating two-week stretches in Johnstown.
Both were working as substitute doctors, known in the industry as locum tenens, and had both been assigned to Johnstown.
“The first (temporary) job they had me sent to was Conemaugh,” Lalka said. “I really liked the hospital. I was used to a teaching hospital with residents.”
Lalka is semi-retired after 29 years of practice and teaching, most recently at Sanger Heart and Vascular Institute at Carolinas HealthCare System in Charlotte.
Gray had a similar path to Johnstown, stepping back from is practice at Geisinger Health System to work part time filling in as needed.
Both said they were looking for something more stable, but not full time.
“In the fall I had the opportunity to do the job share,” Lalka said. “It was like the perfect opportunity to work at a place I like.”
The arrangement will help Conemaugh build its vascular surgery program and attract full-time surgeons to continue the service.
They would love to have two full-time people living in Johnstown,” Gray said.
“But they got two very experienced physicians. The plan is to build the practice back up to what it was, and then recruit a younger individual who is interested in a full-time position here.”
New physicians are reluctant to step into programs in need of rebuilding, he added.
“Younger people are looking to come to a place where they feel supported and there is infrastructure in place,” Gray said, adding that the new doctors feel comfortable with experienced backup during transitions.