Top Methodologies for Determining Physician Need

Top Methodologies for Determining Physician Need

Recruit and Retain the Right Physicians for Your Market

By Lee Ann Lambdin

It’s well documented that there will be a continued shortage of physicians in the U.S. in the years to come. The Association of American Medical Colleges cites that there will be a deficit of between 61,700 and 94,700 physicians by 2025.1 This knowledge highlights the need for hospitals to regularly conduct a community physician and provider demand analysis to continue to meet the needs of their community, grow service lines, and recruit the physicians they need. In this post, we’ll discuss the best way to do this analysis—the different methodologies used and our recommended process.

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Foundational Steps for Determining Physician Need

There are two key first steps to determining physician need:

  • Define your service area
  • Establish a provider supply list (or physician database)

While there are many options when defining a service area, when the goal is physician recruitment, a Stark compliant service area is the best option. 2004 Stark regulations define this service area as “the area comprised of all of the contiguous ZIP codes from which the hospital’s inpatients are drawn when the hospital draws fewer than 75% of its inpatients from contiguous ZIP codes.”

Next, it’s key to create a current physician database. The details of a physician database—physician retirement dates, specialties, affiliation status, and so much more—provide a more complete understanding of what’s in your market. This database can help you answer questions such as: Where is there an oversupply (or undersupply) of physicians? What are the referral patterns of the physicians in my service area? Answers to these questions can directly impact your physician strategy.

With these two steps completed, you can move on to analyzing demand.

 

Top Demand Models for Determining Physician Need

When conducting a demand analysis, Stratasan uses the following five demand models. Our analysis will use a weighted average of these models in our final summary. 

AMA (US Supply): The AMA model uses the AMA Physician Masterfile to create a demand/utilization-based approach. This approach extrapolates current patterns of utilization of physician services taking into account changing demographics and projects into the future. This model assumes the U.S. is adequately staffed with physicians and applies these ratios to other populations. This model’s shortcoming is that because it extrapolates current healthcare utilization patterns into the future, inequities in the current system are carried into future requirement projections.  Its advantage is that it uses the most current data available. 

GMENAC: The GMENAC numbers are over 30 years old and are considered dated by many.  However, since they were issued from the government, they are frequently used to justify physician recruitment efforts.

Hicks & Glenn: This model projects physician-per-population needs based on the current rate of patient visits generated to particular specialists, as determined by the Department of Health and Human Services’ National Ambulatory Healthcare Administration report. That number is then divided by the number of patient visits physicians typically handle, as determined by the Medical Group Management Association.

Mature HMO: This is a benchmarking approach, using a certain standard of care and extrapolating that standard to a different population. This model takes staffing patterns of two managed care plans and applies them to the population. This model is best used when managed care is prevalent in the community. 

Kaiser Plans: This is also a benchmarking approach and is best used when managed care is prevalent in the community.

 

Why Demographic Adjustments Matter

As a part of Stratasan’s demand analysis, these models are then weighed by need and demographics. To explain why these adjustments are needed, consider this example. The overall demographics of Salt Lake City are very young. Winter Haven, Florida, by contrast, trends older. These two cities will have different medical needs based on age. Salt Lake City needs more pediatricians and Winter Haven needs more internal medicine, cardiology, and neurology. Demographic adjustments are a must to ensure an accurate measurement of the service area’s physician needs. 

The standard demographics adjustments Stratasan makes include the following:

  • Population age 65+ (males and females) for:
    • Anesthesia
    • Endocrinology
    • Cardiology
    • Gastroenterology
    • General Surgery
    • Internal Medicine
    • Nephrology
    • Neurology
    • Neurosurgery
    • Oncology/Hematology
    • Ophthalmology
    • Orthopedic Surgery
    • Pathology
    • Physical Medicine & Rehabilitation
    • Pulmonary Disease
    • Radiology
    • Rheumatology
    • Thoracic Surgery
    • Urology
    • Vascular Surgery
  • Females age 15-44 for Obstetrics and Gynecology
  • Population under age 20 for Allergy, Immunology, and Pediatrics
  • Females for Plastic & Reconstructive Surgery
  • The following need no adjustment:
    • Dermatology
    • Emergency Medicine
    • Family & General Medicine
    • Infectious Diseases
    • Otolaryngology
    • Pain Medicine & Pain Management

 

How All of This Helps to Determine Physician Need

Based on the results of this analysis, the following can be concluded in regards to provider surpluses and deficits in your service area. With this intel in hand, the right physician recruitment and service area growth plans can be made.

  • Is there an overall deficit in primary care specialty providers?
  • Is there an overall surplus in medical specialty providers?
  • Is there an overall deficit in surgical specialty providers? 
  • Is there an overall surplus in hospital-based specialty providers? 

 

The Takeaway

A physician and provider demand analysis is a crucial step for hospitals looking to meet the needs of their community by growing service lines through physician and provider recruitment. If your team needs help with conducting this analysis, then schedule a discovery call with one of our experts today. Let’s discuss how Stratasan’s physician and provider demand analysis can inform your physician needs analysis and empower your growth.

Article by Lee Ann Lambdin, SVP of Healthcare Strategy for Stratasan

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1 The Complexities of Physician Supply and Demand: Projections from 2014 to 2015, 2017 Update; Association of American Medical Colleges,  April 5, 2017, p. v. 

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