Demand for Psychiatrists at All-Time High, New Report Shows
By Phillip Miller, Vice President of Corporate Communications, Merritt Hawkins
Demand for psychiatrists has risen sharply in recent years and currently stands at an all-time high, according to an annual report tracking physician recruiting trends.
The 2015 Review of Physician and Advanced Practitioner Recruiting Incentives, by Merritt Hawkins, an AMN Company that is the nation’s leading physician search firm, found that psychiatrists trailed only primary care doctors on the list of the firm’s 20 most in-demand medical specialties. The report indicates that Merritt Hawkins was retained to conduct more searches for psychiatrists in the last year than in any other similar period in the company’s 27-year history.
“Psychiatrists are aging out of practice at a time when demand for their services is spiking,” said Travis Singleton, senior vice president of Merritt Hawkins. “Finding a psychiatrist willing to practice in an inpatient setting is like looking for a needle in a haystack.”
The federal government has designated 3,968 whole or partial counties as Health Professional Shortage Areas (HPSAs) for mental health, Singleton said, defined as areas where there is less than one psychiatrist per 30,000 people. In Texas alone, 185 of 254 counties have no general psychiatrist, according to separate Merritt Hawkins report.
Disparities by state are dramatic. While Massachusetts has 18 psychiatrists per 100,000 population, Idaho has only five. Approximately 40 % of psychiatrists are likely to retire over the next five years, Singleton said, with few available to take their place.
“Mental health is a topic that the health system and patients themselves often avoid,” Singleton said. “For that reason, psychiatry can be considered the ‘silent shortage,’ even though shortages in psychiatry may be even more acute than they are in primary care.”
King v. Burwell and doctor demand
The Merritt Hawkins report also found that the recent Supreme Court decision in King v. Burwell will keep healthcare reform on its current trajectory, boosting demand for certain types of physicians. Emerging delivery models promoted by the Affordable Care Act (ACA), which was upheld by King v. Burwell, encourage the use of healthcare teams led by primary care physicians. These teams include physician assistants (PAs) and nurse practitioners (NPs) and may incorporate physicians who provide women’s health or who manage chronic diseases.
Demand for primary doctors, PAs, NPs, obstetrician/gynecologists, and physicians who manage chronic illness, such as psychiatrists, pulmonologists, and cardiologists, all increased over the previous year, the report showed. Implementation of population health management through integrated systems such as accountable care organizations (ACOs) is likely to keep demand strong for these types of clinicians, Singleton said.
Physician Employment and Value-Based Incentives
The Merritt Hawkins report indicates that the prevalence of private, independent physician practices continues to decline. Only about 5% of Merritt Hawkins search assignments in the previous year featured an independent practice setting, while 95% featured employment by hospitals, medical groups, urgent care centers, Federally Quality Health Clinics (FQHC) or other employers.
The new report also suggests that the use of value-based physician incentives has stalled. Of those clients offering physicians a production bonus last year, only 23% based the bonus in whole or in part on value-based metrics such as patient satisfaction, compared to 39% two years ago. Despite the national movement from volume- to value-based payments, Merritt Hawkins’ report indicates that physician compensation continues to be driven by volume based metrics such as relative value units (RVUs), patient visits, and net collections.
An info-graphic on results of Merritt Hawkins’ 2015 Review of Physician and Advanced Practitioner Recruiting Incentives can be accessed here and a complete report can obtained by calling Merritt Hawkins at 800-876-0500.