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This Business Solutions episode of the Insights podcast features Chris Franklin, president at LocumTenens.com.
Franklin shares highlights from LocumTenens.com’s recent white paper, "The Future of Work: The Role of Physicians in the Gig Economy." The paper was made possible by nearly 2600 survey respondents over 46 different medical specialties and touches on topics including burnout, telehealth and technology.
Editor’s note: The following Q&A has been edited for length and clarity.
Q: Give us a little background on LocumTenens.com.
A: Locumtenens.com matches physicians and advanced practitioners with healthcare organizations to address their staffing needs. Our flexible staffing model encompasses both traditional on-premise and virtual approaches to mitigating the physician shortage. We also operate the industry's largest and most visited job board, which is locumtenens.com. (The site) connects healthcare organizations with medical professionals to make certain that patients get access to care.
Q: What inspired this research?
A: Every year we conduct a set of surveys with our clinicians - which are physicians and advanced practitioners. (We survey) those who work in temporary settings as locum tenens, as well as those who are permanently employed. And the goal of the study was to understand clinicians’ attitudes about the gig economy, kind of where they fit, as well as understanding how they're reframing their definition of work, because that's something that is continuing to evolve. We feel like hearing directly from our workforce about their feelings on their definition of work and their long-term career goals gives us a timely picture of how the industry is moving and evolving, which then allows us to equip our clients … to get ahead of the changing needs of the workforce, and to be able to respond more proactively.
Q: We’re starting to hear the term “gig economy” more, what does it really mean and how does it fit within healthcare?
A: Temporary clinicians that are engaged through a staffing company or through a platform, or even that a practice may engage with directly - those are all included in this definition of the gig economy, which at this point is estimated to be sized at about $1.3 trillion. So it's a huge part of our of our total economy and is believed to be growing at a rate three times faster than the rest of the economy.
Q: What findings from this study do you find particularly interesting?
A: One, I think as we're all aware, the healthcare labor shortage is not going away. The pandemic kind of cast a spotlight on a lot of the challenges in the market. And so many of the attitudes and key learnings were around really trying to articulate and rise up to meet some of those challenges. From a thematic standpoint, I think if there were one word that I would take away from what we learned through this study, it's flexibility. And so, clinicians are people too. They want the same things that we all want relative to flexibility; to be able to control their work environment, which is really kind of a key component of the whole gig economy mindset.
I think the other one is … that clinicians are exiting the workforce at younger ages. Many are not practicing medicine during what's considered their peak earning years. You know, they're retiring at early ages - 38% of the clinicians that indicated they were leaving medicine were in their 50s or younger. And so again, those are really the peak productivity years, peak earning years. When you line that up with what's already a dire situation based on the aging population - you have that impacting demand, an aging populace, larger consumers of health care - that's kind of the good news for those of us who provide healthcare. The bad news is the same demographics are also at play on the supply side of the equation where you’ve got four in 10 physicians nearing retirement age in the next 10 years.
Q: What did the research find regarding burnout in traditional hospital or practice settings versus these gig opportunities?
A: I think, probably not surprisingly, full-time employed physicians cited much higher levels of burnout. Whereas 71% of contracted clinicians - those who are either contracting directly or maybe doing locum tenens work through an agency - indicated little to no burnout. If we look at the total universe of clinicians who are employed, 77% of them indicated some level of burnout, 40% of that indicated moderate burnout, and 17% indicated complete or (being) significantly burned out. …
One of the things that I think was also interesting was that 88% of the survey respondents indicated that alleviating or adding some scheduling flexibility would help diminish the amount of burnout that they feel. So just that one component alone, and it kind of gets back to that concept of flexibility, that 88% said if there was more flexibility around scheduling, that it would alleviate what they were feeling relative to burnout.
Q: Can you give us some practical steps that healthcare organizations can take to improve their staffing issues?
A: First and foremost, it's just adopting a more strategic mindset. And it's not only being more strategic relative to recruitment, but I think leveraging some of these flexible models to really help drive retention. Staffing doesn't need to look like what it's always traditionally looked like; meaning, it doesn't have to solely be a full-time, boots on the ground clinician that's in that role. I think if we can start from the outcome that we're looking for - which is providing tremendous patient care for the patients that we serve - and then working backwards from there and thinking about how we can leverage some of these models, whether that's bringing in part-time clinicians, whether that's a combination of utilizing physicians and advanced practitioners … it not only is going to allow you to serve your patient population better, but it's also going to afford your existing staff, your full time clinicians, additional flexibility. It can help improve morale, and ultimately, I think help improve patient care.
The second piece of that, that you touched on initially, is leveraging telehealth. And what we're finding is that being open to telehealth solutions is good for physicians in certain specialties who enjoy the flexibility. They're not always having to commute, they're not always having to be there in the practice. You can leverage them in a different capacity. Patients like it; they don't have to sit for an hour in your waiting room. And it's really good for clients in that it generally has higher fill rates, faster fill rates, and typically a lower cost basis that can really extend what your clinicians are able to do in the practice. And so I think the point of kind of combining thinking about it more strategically as well as leveraging telehealth is it allows you to really craft a customized solution that works for your practice.
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