Three Perspectives on the Physician Shortage Crisis: An HCE Original Report (Part 2 of 3)

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healthcareix-itunes-artworkOn Monday, we began a three-part series on the differing perspectives among healthcare leaders regarding the physician-shortage crisis. In Part 1, Rob Coulton, executive director of professional affairs at the Cleveland Clinic, explained how academic medical centers are confronting the shortage from a long-term perspective.

Today, we continue our series with Marissa Schimmel, director of education outreach for Sheridan Healthcare, a contract management group. Sheridan reaches out to residents and new physicians on a regular basis and has found that their concerns don’t necessarily lie with the physician-shortage crisis, but rather with the many other transformative changes occurring in healthcare.

As a result, Sheridan isn’t necessarily focused on the shortage as much as it is on giving physicians the backing they need to be successful in the current marketplace.


Perspective #2: The Contract Management Group

Sheridan Healthcare is one of the country’s leaders in multispecialty practice management. As director of education outreach, Schimmel is constantly engaging residents who are looking for a job and educating them on the trends in their specialties and the various practice models that will be offering them employment.

She said residents are primarily worried about finding ways to align themselves with the changes occurring in the U.S. healthcare system and frequently ask themselves the following three questions:

1.)  Where should they go?

Should they stay in academics, follow the traditional path and go into private practice, or join a partnership group? Or should they sign with a contract management group or accept employment with a hospital?

“One of the things I spend the most time talking about is just how years ago the only option for physicians was joining a private practice, and they pretty much all wanted to be partners, and that was the only thing to do unless you were going into academics,” she said.

The more residents explore the private-practice option, however, the less it appears to be a viable one, she added, even though many still have the notion that this is where their career trajectory should be leading them.

2.)  What will happen if they don’t go into private practice?

If they deviate from the traditional path and avoid private practice, Schimmel said many students worry about making enough money.

On the other hand, they’re also concerned about the stability of private practices and worry about being bought out by a larger company before they have had the chance to make partner. And if the practice isn’t bought out, what are their chances of actually being made partner?

“I also talk to them about, ‘What are you a partner of?’” she said. “I think years ago everybody kind of knew what they were going to be a partner of. But you know the playing field has changed a lot, and I think they’re really concerned about that.”

3.)  Will reimbursement rates for their specialty go down?

One reason why Schimmel freely promotes the contract management model is declining reimbursement rates across several specialties, a factor that compounds the worries of new physicians.

“One of the things that I want them to understand is the whole concept of strength in numbers,” she explained. “We [the contract management group] potentially do have a lot more negotiating power than a group of 10 physicians. And so I think that that’s a lot of what’s happening now.”

She added, “I think that they all know that healthcare might have been one way when they finished up their bachelor’s degree and decided to go into medical school… Nine years later, they’ve realized the reality of that change and now it’s a waiting game to see how it will play out.”


Every provider model has its pros and cons, Schimmel said, but she tells residents that joining a contract management group like Sheridan has two primary benefits:

1.)  Job Stability

2.)  Job Security

Sheridan has been a healthcare leader since 1953, and the organization is still based in its original practice. With over 60 years of expertise at its disposal, 2800 providers, and 351 hospitals and medical facilities around the U.S., Sheridan is able to efficiently and effectively negotiate and maintain physician contracts, she said.

Sheridan provides physicians with the backing of a corporate infrastructure that is able to support contracts and eliminate worries about malpractice, billing, collecting, negotiating, etc.

Of course, some residents are unsure about joining a large group practice like Sheridan because in their view, it limits earning potential.

“Well, I can see how someone may think that,” Schimmel said. “In private practices, it’s not only what you bill, you have to also be able to collect it, so if reimbursements are going down…it may be the days of potentially making what they used to make is most likely not going to be there. So, you might not hit the ceiling with us salary-wise, but we’re always going to be making sure that we’re offering a competitive compensation package for that local market. And your paycheck comes every two weeks no matter what’s happening. So it’s kind of the pros and the cons all mixed into one.”

She readily agreed that the Sheridan model may not be right for everyone. Because of this, she stresses how important it is for physicians to have a vision for their career and what model suits them best.

“…[T]he number one reason that people leave their job within the first few years is that they just don’t fit in culturally,” she said. “You just don’t fit into the department. I really want them to focus on that as opposed to focusing on having income be the number-one important factor, because at the end of the day it’s really not going to make or break the bank when you’re already at that salary of a physician.”

-by Pete Fernbaugh

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