Doctor shortages add hiring pressure, create new opportunities.
By Ralph Henderson
It may be surprising, but a growing number of healthcare professionals are hired, not by hospitals and large health systems, but nontraditional retail clinics, such as the one in the supermarket down the block or the pharmacy across the street. They’re the professionals necessary to staff these clinics, sometimes referred to as convenient care clinics, which provide a limited range of basic preventive and primary care services to walk-in patients.
They appeal to many people who are, for various reasons, unable or unwilling to make a trip to a doctor’s office for a scheduled appointment. Many people find it easier and more convenient to drop into a retail clinic for a sore throat or a worrisome pain, especially in the evenings or on weekends when a doctor’s office would be closed. Whatever the cause, a growing number of people seek care at the facilities located in these retail environments.
What’s the impact on HR? The clinics are eagerly hiring nurse practitioners and physician assistants to provide basic primary-care services to walk-in patients. While many are run by physicians, nurse practitioners and physician assistants are also well represented among clinicians working in these centers. In fact, in 2012, more than 5,000 nurse practitioners and physician assistants worked in the convenience care industry, according to the book Convenient Care Clinics: The Essential Guide to Retail Clinics, published last year by Springer. Those numbers will likely grow, too, as the industry grows.
HR must also consider that the growing shortage of primary care physicians has created an increased demand for the services of advanced practice clinicians. So anyone looking to hire nurse practitioners and physician assistants will have to factor in the surging demand for their services. That means that owners of retail clinics and other types of healthcare facilities may have to strategically compete for them.
Industry Growth Trends
The industry experienced rapid growth between 2003 and 2008. The biggest growth tailed off at that point, but even then, it continued to grow steadily each year, according to global management-consulting company Accenture. For example, 2013 was not considered a year for significant expansion for retail clinics, according to Merchant Medicine, LLC, which tracks the growth of the convenient care industry. But even so, nearly 200 new retail clinics opened between March 1, 2013, and March 1, 2014.
And 2014 is shaping up to be a better year, Merchant Medicine is predicting. Even with mixed growth in 2013, some of the biggest players in the market had banner years, most notably MinuteClinic, the business unit of CVS Caremark, and the Walgreens Health Care Clinics. And they’ll likely have an even bigger year in 2015, Merchant Medicine predicts.
Accenture is also forecasting some major growth in the industry. In a report released last summer at the annual America’s Health Insurance Plans (AHIP) Institute, it predicted that the number of retail health clinics in the United States will double in the next three years, at least partially as a result of the increase in newly insured patients under the Affordable Care Act. By 2015, there could be nearly 2,900 clinics.
This all translates into more job opportunities for advanced practice clinicians and the support staff who work in retail clinics.
Retail Clinic Staff
The demand for nurse practitioners and physician assistants has increased with both the increased physician shortages and the onset of the Patient Protection and Affordable Care Act; however, the future for these advanced practitioners continues to brighten. According to an AMN Healthcare 2013 survey by the physician brand, Merritt Hawkins, search assignments for nurse practitioners and physicians increased by 164 percent from the year prior. Both of these advanced practitioners ranked in the top 20 most requested physician searches by medical specialty for the first time in the 20 years of this survey.
In February, the American Medical Group Association published the results of the 2013 Advanced Practice Clinician Compensation and Pay Practices Survey Report. The report emphasized that the already high demand for nurse practitioners and physician assistants will continue.
As demand for physician assistants has increased, the profession has grown by 34 percent since 2006, according to the American Academy of Physician Assistants. The nurse- practitioner workforce continues to grow, too. The U.S. Health Resources and Services Administration forecasts 30 percent growth from 55,400 primary care nurse practitioners in 2010 to 72,100 in 2020.
The question is this: Will the supply keep up with demand? As the RAND Corporation noted in the 2010 paper “Policy Implications of the Use of Retail Clinics,” health reform and the ongoing shortage of primary care physicians has already created growing demand for more nurse practitioners, irrespective of the rise in retail clinics. “If the number of retail clinics grows, the number of nurse practitioners required to staff these clinics will also rise,” the RAND study said.
The bottom line: With millions gaining new access to health insurance, someone has to care for them. Many are counting on nurse practitioners and physicians assistants, which puts them in the driver’s seat. They can choose to work in a regular office setting, a hospital, or a retail setting. Potential employers will have to determine how to successfully persuade these professionals to pick them.
Hospitals Getting in the Game
Even hospitals and health systems are recognizing the potential of the retail clinic industry and are beginning to partner with existing companies to operate them. Many people who use retail clinics do not have primary care physicians, and by partnering with the clinics, health systems can sign-up patients with their own primary care practitioners. It’s a win-win, they say, because it creates additional access points to the healthcare systems, while providing the retail clinics with useful patient care resources.
Accenture’s report entitled Retail Medical Clinics: From Foe to Friend? notes that the venture can give larger hospital systems a chance to expand their reach. It could be more challenging for smaller systems, but the possibility is still there. In the future, retail clinics will remain a viable option for many common health conditions. And their clinical reach will likely expand to more diagnostic and treatment choices in coming years. And as staffing and employment opportunities, retail clinics could provide expanding possibilities as their growth continues.
Ralph Henderson is president of healthcare staffing for AMN Healthcare.
Doctor shortages add hiring pressure, create new opportunities.