By Cheryl DeVita
The Provider Shortage Intensifies
Recruiting for mental health and behavioral health providers is fiercely competitive and projected to only get worse. The primary reason is a shortage of supply. A 2014 report to Congress showed that 55% of the nation’s 3,100 counties had no practicing psychiatrists, psychologists or social workers due to budget cuts and doctors leaving the profession. Now, as reform goes into effect requiring that all insurance carriers in the federal and state exchanges include mental health coverage, some 6.8 million1 newly insured people with mental illness are expected to begin seeking care.
Exacerbating the shortage even further is the fact that about 57%2 of the estimated 39,000 practicing psychiatrists today are over the age of 55 and approaching retirement. That leaves only 16,770 psychiatrists under the age of 55, and medical schools are not graduating enough new doctors to make up the shortfall. The number of psychiatrists expected to graduate in summer 2016 is only 1,185.3
Attracting Psychiatrists is About More than Just the Numbers
Above is the statistical backdrop of the shortage. But in order to compete for mental health providers as a healthcare employer you must also consider the changing mindset of a younger population of doctors in high demand. Here are the most significant trends I have observed in my twenty-five years as a physician search consultant:
- Increased financial debt — The majority of recently graduated psychiatrists is U.S.-trained and therefore carries higher student debt than in years past. Also, reduced insurer payments have made psychiatry less lucrative, with the median income for a psychiatrist today ranked 19th out of 25 medical specialties4.
- Focused on sub-specialties – Whereas Baby Boomer psychiatrists often saw a wide range of patients, including child and adolescent. Subsequent generations have more sub-specialty training, such as addiction, adolescent or geriatric psychology, and want to practice within their chosen sub-specialty.
- Outpatient care preference – A decade ago it was common for psychiatrists to have privileges at the local hospitals with Psychiatric units and treat patients both outpatient and inpatient when they were admitted. Today, doctors tend to be one or the other and, in my experience, have a preference for outpatient care which makes filling inpatient positions ever more difficult.
- Desire for work-life balance – Consistent with doctors across all specialties, physicians since the Baby Boomer generation place an increasing priority on work-life balance and flexibility.
How to Successfully Recruit Mental Health Providers
Despite the challenges, there are several strategies that can help a healthcare employer to stand out from the competition and make successful mental health physician hires. Here is the most common advice I share with my physician search clients:
Build an Employer Brand of Choice
How many times have you heard someone say, “I wouldn’t work there for all the money in the world?” In today’s 24/7 connected society with access to an abundance of information, your public-facing brand can play a key role in determining whether a physician wants to take the next step in the interview process. Check your company website, check your social channels, look at your marketing materials—are they in-sync with the organization you are today?
Lessen the Financial Burden
As with any skill in high demand and short supply, mental health practitioners can afford to be choosy. In many cases, providing some form of assistance with student debt can encourage doctors to forego other requirements, such as location and outpatient care preferences. Some employers, planning ahead, have signed psychiatrists early by offering an education stipend in exchange for a specific work commitment upon completion of training. Those who need experienced providers that can hit the ground running have offered signing or retention bonuses.
Be Creative. Keep an Open Mind.
With a growing focus on individual career goals and work-life balance, be as flexible as possible in creating a position that will appeal to a physician’s personal objectives. Consider offering two solo psychiatrists part-time employment instead of one full-time position. If you have several physicians approaching retirement, perhaps offer a younger psychiatrist an inpatient, salaried position with the opportunity to build an outpatient practice. To address lifestyle concerns, offer fixed schedules and minimal on-call duty. If geography is a challenge, consider the use of tele-psychiatry to help bridge the gap.
Monitor The Marketplace.
Yes, employers and search consultants have access to comparative compensation data, but in a tight labor market compensation and other trends can change very rapidly. Find out which other organizations physician candidates are interviewing with, ask about compensation and other perks being offered, and compare and gather information with other medical search consultants working in the area to stay as timely and competitive in your job offer as possible. Candidates who declined a job offer can be a valuable source of feedback not to be overlooked. Finally, remain flexible and be prepared to make adjustments in your search strategy.
In a nutshell, the more creative and flexible you can be in constructing job requirements and a compensation package that meets both the facility’s and the doctor’s goals, the more success you will have in filling a mental health physician position in a timely manner in today’s competitive market.
About the Author: Cheryl DeVita is a Senior Search Consultant with Cejka Search, a top-ranked healthcare recruitment firm since 1981. She has 30 years of experience in healthcare, recruiting and consulting, and earned a MBA in Health Services Management from the University of Dallas.
1) National Association of State Mental Health Program Directors, 2) Association of American Medical Colleges, 3) American Medical Association, 4) Medscape, a unit of WebMD Corp.