Healthcare Provider Shortage

Executive Summary
The healthcare sector in the United States is facing shortage of healthcare providers, particularly in rural settings. One of the most affected areas in the country is rural Maryland, especially Allegany County, which has been selected as the location for this project. The proposed plan seeks to help lessen the shortage of healthcare providers in the county using MedChi, an organization that provides public health resources in Maryland. MedChi could help address the problem through promoting adoption of technologies like telemedicine and expansion of the scope of practice of non-physician providers. To realize this objective, the organization needs to establish partnerships with relevant stakeholders within and outside the county’s health sector including policymakers. These partnerships should focus on identifying necessary resources for implementation of the proposed solution.
Provider Shortage Proposal
Shortage of providers in healthcare is a major issue facing this industry at a time when patient populations have continued to increase globally. The shortage of providers in healthcare has dominated the healthcare industry over the past decade. This problem is attributable to various factors including increases in chronic diseases, increase in the health needs of the aging population, and inadequacy of education programs. Additionally, the increased recruitment of primary care physicians and specialty providers by healthcare organizations is an indicator of the severity of this problem. Given the widespread nature of the issue, healthcare organizations, policymakers and other stakeholders are looking for measures to address the shortage of providers in healthcare. This proposal examines the issue of shortage of healthcare providers and recommends a solution to address it.
Organization Information
The shortage of providers in healthcare is an issue that has affected the capability of healthcare organizations to provide timely and high-quality care to different patient populations. One of the areas affected by this issue is rural Maryland, which has a shortage of primary-care doctors. Desmon (2009) states that rural Maryland continues to experience shortage of healthcare providers given the lack of adequate primary-care doctors to establish practices in these areas. Consequently, many residents in these areas are forced to grapple with lack of access to basic healthcare resulting in more costly and serious illnesses.
The Maryland State Medical Society, which is commonly known as MedChi, is an organization that could help address the issue of shortage of healthcare providers in rural Maryland. MedChi, an affiliate of the American Medical Association, would help address this issue as part of its commitment to provide resources to the State’s physicians, patients, and public health. As the shortage of healthcare providers in rural Maryland continues to escalate, MedChi is facing challenges in addressing this problem. However, Merritt Hawkins provides recommendations that can be adopted by MedChi to address the problem of shortage of healthcare providers in rural Maryland. Merritt Hawkins is a national healthcare search and consulting organization that specializes in recruitment of physician leaders, physicians across all medical specialties, and advanced practitioners (Merritt Hawkins, 2019). Merritt Hawkins regularly conducts review of the recruitment of physicians in all kinds of medical specialties and advanced practitioners. Merritt Hawkins is an industry innovator and the largest healthcare staffing organization, which implies its better-placed to recommend or provide solutions to the current shortage of healthcare providers in rural Maryland.
Background on the Issue
One of the issues that has dominated many conversations in the healthcare sector in recent years is the shortage of providers. This issue has dominated public health discourse over the past decade given the increasing healthcare needs and demands among different patient populations. Existing trends in the healthcare sector demonstrate that the shortage of providers is increasing since healthcare organizations are recruiting specialty providers and primary care physicians at an increasing rate (Heath, 2019). Despite increase in the recruitment of such providers, these organizations are facing numerous challenges in their attempts to maintain a staff that meets the ever increasing patient care access needs.
Rural Maryland is one of the most affected areas facing the problem of shortage of providers in healthcare. Over the past decade, primary care doctors have found it difficult to establish their practices in these areas. Consequently, many patients in rural areas in Maryland struggle with lack of access to basic healthcare services resulting in more costly and serious illnesses. There are various reasons that have contributed to the shortage of healthcare providers in rural Maryland including reluctance to leave the city for the country. Additionally, providers in these areas are paid much less than their counterparts in the city and are forced to work more. Providers in Maryland also find it difficult to establish their practices in rural settings because of the fewer job opportunities for their spouses.
The shortage of providers in rural Maryland has attracted considerable attention from policymakers and other relevant stakeholders within and outside the health sector. These stakeholders have worked toward identifying short-term and long-term solutions to the problem. Some of the proposed solutions over the past decade include establishment of a loan forgiveness program for primary care physicians. The program targets primary care physicians and other specialists willing to remain in rural areas for several years. The program was developed on the premise that rural providers are forced to contend with huge school debts, high medical malpractice insurance rates, and below average reimbursements for their services.
The other proposed solution to address this problem in Maryland is the establishment of rural residency programs that could enable providers to receive nearly all of their training in these underserved settings. Such programs would be established on the assumption that they would encourage the providers to stay and established their practices in these underserved areas (Desmon, 2009). However, the establishment of such programs is complex because of the need to develop them in partnership with a healthcare facility. The establishment process is likely to be characterized by high costs, numerous logistical issues, and need for oversight and training.
While policymakers and other stakeholders in rural Maryland have attempted to address the issue, the shortage of healthcare providers in such settings continues to worsen. Researchers and healthcare workforce training leaders have opined that rural areas face severe healthcare workforce shortages (Daly, 2018). Based on recent testimonies given to the Senate Health, Education, Labor and Pension (HELP) Committee, rural areas including Maryland need approximately 13,800 extra primary care physicians. According to estimates by the Health Resources and Services Administration, project shortages of primary care physicians is expected to reach 20,000 by 2025, which will increase by nearly six times in 2030 (Daly, 2018). Therefore, the health sector needs short-term and long-term solutions to address this problem, especially in rural/underserved areas.
Statement of Need
Allegany County in Maryland has been selected as the location for this project on addressing the shortage of providers in healthcare due to its demographics. The county has a population of more than 72,000 people with low education levels, a largely elderly population, limited racial diversity, and low household incomes (Western Maryland Health System, 2011). The county also has a high unemployment rate estimated at 8.9% as of 2012 while the average household size is 2.25. Allegany County is a suitable location for this project since it’s ranked 20th out of 24 Maryland jurisdictions on health factors and 21st out of 24 on health outcomes. Healthcare needs and demands in this county continue to increase due to its largely elderly population. However, despite the increase in health needs and demands, the county is facing shortage of healthcare providers. Wolford (2018) states that many job openings for medical personnel in Allegany County remains unfilled as county employers experience difficulties in recruiting and retaining skilled applicants. Some of the current vacant positions in Allegany County’s health sector include physicians, certified nursing assistants, licensed practice nurses, and registered nurses.
As evident in the assessment of the health needs and healthcare workforce status in Allegany County, there is a great need for addressing the shortage of providers. The current problem is caused by various factors including increase in the elderly population. The increase in the elderly population generates additional demands and burdens on the healthcare professionals and contributes to increase in shortages. Secondly, difficulties in identifying, recruiting and retaining skilled medical personnel exacerbates the problem. There is mismatch between the education and skills of new generation workers and job demands. The health sector including Allegany County’s healthcare industry is faced with a shortage of adequately trained and skillful personnel, which increases the shortage of providers. The other factors contributing to the problem include the geographic location of the county, less pay, and reluctance by primary care providers to leave the city for the country.
To help address the problem, relevant stakeholders in the county have undertaken various measures and initiatives. One of the initiatives adopted in recent times is improving education and training for medical personnel. For instance, Allegany College of Maryland provides various on-campus and online programs to improve the knowledge, skills and experiences of medical personnel. Education and training initiatives adopted recently have proven unsuccessful in addressing the problem. Educational institutions like Allegany College of Maryland experience challenges in identifying staff with advanced nursing degrees, which leaves its academic programs short-staffed. In addition, some of these institutions struggle to maintain adequate nurse practitioners to staff student healthcare centers (Wolford, 2018).
Potential Opportunities for Implementing Change
The failure of educational and training initiatives to address the problem of shortage of healthcare providers has provided an opportunity for implementing change. Currently, most of the efforts in Allegany County toward addressing the problem are initiated by academic institutions in collaboration with other stakeholders like hospitals. Even though there is hope that these initiatives will yield positive results, they are far from addressing the problem. The programs have been characterized by numerous challenges and complexities, which demonstrates the need for a different approach to deal with the problem. The Maryland State Medical Society should collaborate with relevant stakeholders in Allegany County’s health sector to identify suitable approaches for addressing the problem.
Proposed Plan
As a national healthcare search and consulting organization that specializes in recruitment of providers, Merritt Hawkins proposes concerted efforts between MedChi and Allegany County’s health industry to deal with healthcare provider shortage. These efforts should be geared toward finding short-term and long-term fixes for the provider shortage facing this rural setting. The solutions should focus on addressing the current root causes of the problem in an efficient, timely, and effective manner. Since there are various factors contributing to the problem of healthcare provider shortage in Allegany County, a multi-faceted approach would be the most suitable solution.
Proposed Solution
Merritt Hawkins proposes the adoption of a combination adoption of new technologies and expansion of non-physician providers’ scope of practice to address the problem. According to Antonelli (2019), some of the most suitable solutions to the shortage of healthcare providers include expansion of non-physician providers’ scope of practice and adoption of new technologies like telemedicine. The proposed solution would help deal with the problem through enhancing the skills and competencies of non-physician providers who will in turn provide necessary healthcare services to the ever-growing patient population in Allegany County. Non-physician providers will provide necessary support to physicians in the county through providing necessary care services, which in turn deals with the problem. On the other hand, embracing new technologies like telemedicine would help address the issue through increase access to basic healthcare services. The elderly population in the county will benefit from improved access to basic healthcare services following the adoption of new technologies like telemedicine.
The goal of the proposed solution is to lessen the shortage of healthcare providers through better knowledge, skills and competencies. The objectives of the proposed plan include to enhance access to basic healthcare services; to lessen healthcare burdens faced by providers; and to improve healthcare workforce productivity in Allegany County.
To achieve these goal and objectives, MedChi should work together with the county’s health department to formulate plans for technology adoption and expansion of programs offered by existing academic institutions. The first step would entail develop of regulatory proposals for the increasing the scope of practice of non-physician providers. MedChi should consider working with policymakers in the county to develop and enact regulatory proposals for increase in scope of practice. The process of developing and enactment of the proposals will take a duration of one year. Upon enactment of such regulations, the organization should partner with the Allegany College of Maryland and other nursing education institutions in the county to establish training programs that enhance the competencies of non-physician providers to offer healthcare services. The establishment of relevant educational programs to achieve this will take a period of 2 years. This should be combined with public awareness campaigns that seek to enhance the attractiveness of the educational programs to potential medical students during the 2-year period. MedChi should also partner with healthcare facilities in the county to identify relevant technologies to be adopted in the clinical setting. The partnerships should incorporate identification of necessary financial resources for these healthcare settings to purchase and utilize these technologies in their clinical settings/environment. This activity will be carried out for a period ranging between 6 months to one year. The required resources for the implementation of this proposed plan include technological equipment, financial resources for lawmaking and other processes, and educational and training resources.
Project Evaluation
A critical aspect toward determining the effectiveness of this proposed plan is examining the achievement of measurable outcomes. The evaluation process will be carried out periodically i.e. once every quarter after the implementation of the proposed solution. First, the evaluation will measure the number of providers before and after the implementation to determine the effectiveness of the proposal. Secondly, healthcare access data among patient populations in Allegany County will be collected and evaluated by comparing to the pre-implementation period. Third, data on health outcomes will be analyzed to help determine any improvements brought by the program. Therefore, data on any increases in the number of providers, improvements in healthcare access and improvements in health outcomes will be used to determine effectiveness.
In conclusion, shortage of healthcare providers remains a major issue facing the United States health industry, especially in rural areas. Allegany County, Maryland is one of the affected rural settings with this issue due to various factors including poor pay and difficulties in recruiting and retaining skilled workers. Given its role in enhancing public health outcomes in Maryland, MedChi could play a critical role in addressing the problem through partnerships with Allegany County’s public health department. In light of the issues facing the county’s health sector, MedChi should work toward promoting the adoption of new technologies like telemedicine and expansion of the scope of practice of non-physician providers.
References
Antonelli, A.F. (2019, May 14). Does America Have a Physician Shortage – or Are Our Doctors ‘Just Bad at Managing Time’? Retrieved August 5, 2019, https://www.advisory.com/daily-briefing/2019/05/14/physician-shortage
Daly, R. (2018, May 22). Healthcare Workforce Shortage Worsening: Senators. Retrieved August 5, 2019, from https://www.hfma.org/topics/news/2018/05/60811.html
Desmon, S. (2019, March 1). Doctors in Short Supply in Rural Maryland. Baltimore Sun. Retrieved August 5, 2019, from https://www.baltimoresun.com/bal-id.rural01mar01-story.html
Heath, S. (2019, July 11). What Clinician Recruitment Tactics Say About the Physician Shortage. Retrieved August 5, 2019, from https://patientengagementhit.com/news/what-clinician-recruitment-tactics-say-about-the-physician-shortage
Merritt Hawkins. (2019). 2019 Review of Physician and Advanced Practitioner Recruiting Incentives. Retrieved August 5, 2019, from https://www.merritthawkins.com/uploadedFiles/merritthawkins_2019_incentivereview.pdf
Western Maryland Health System and Allegany County Health Department. (2011, November). Allegany County Community Health Needs Assessment. Retrieved August 5, 2019, from http://www.alleganyhealthplanningcoalition.com/pdf/ACHD Community Health Needs Assessment.pdf
Wolford, H.B. (2018, May 28). Allegany County Sees Shortage of Health Care Workers. Time News. Retrieved August 5, 2019, from https://www.times-news.com/news/local_news/allegany-county-sees-shortage-of-health-care-workers/article_28b1030d-4403-5d84-aa26-fe17d61b8561.html