An annual Physician Retention Survey from Cejka Search and the American Medical Group Association (AMGA) finds that medical groups had an average physician turnover rate of 6.8 percent in 2012, up from 6.5 percent in 2011 and the highest rate since 2005. The increased turnover correlates with the nation’s economic recovery; improvements in the housing market and recovery in stock prices may have made physicians more likely to move or retire, experts say.

The survey, which drew responses from 80 medical organizations that collectively employ more than 19,000 physicians, also finds that medical groups expect an increase in turnover in the coming year due to accelerating retirement and competition to hire and retain top physicians. Seventy-six percent of respondents plan to hire more primary care physicians in the next 12 months.

“The survey findings provide evidence that recruitment and retention continue to be major challenges for health systems,” Donald W. Fisher, PhD, CAE, president and chief executive officer of AMGA, said in a news release about the survey. “To rise to these challenges, medical groups are demonstrating remarkable leadership by investing in new staffing and delivery models, building and nurturing their teams in a strategic way, and making accountable care work for their patients and their communities.”

For the second year, the survey also asked about turnover among advanced practice clinicians, including physician assistants and nurse practitioners. That turnover rate in 2012 was 11.5 percent, essentially unchanged from the previous year.

Read more about the survey.

Enrollment at U.S. medical schools is growing, according to new data from the Association of American Medical Colleges (AAMC). The annual Medical School Enrollment Survey finds that first-year medical school enrollment is expected to reach 21,376 by 2016, an increase of 29.6 percent since 2002. Combined first-year MD and DO (Doctor of Osteopathic Medicine) enrollment—which has already increased by 28 percent since 2002—is projected to reach 26,709, an increase of 37 percent, by 2016.

Forty-three percent of the schools surveyed say they have plans to target—or have already targeted—specific populations that are underrepresented in medical schools, including minorities and people from disadvantaged backgrounds, rural and underserved communities. Among the tactics the schools are using: scholarships, modified or targeted admissions criteria and outreach efforts, and branch campus locations.

Medical schools are also using other approaches to increase their enrollment and quickly put physicians to work. At least four schools have recently begun offering programs that allow medical students to get degrees in three years, instead of four, American Medical News reports. In addition, a consortium of six schools has applied for a $23 million federal grant from the Center for Medicare and Medicaid Innovation to expand the three-year model to more campuses.

Former Health & Human Services Secretary Louis Sullivan, MD, penned an op-ed in yesterday’s New York Times making the case for devising more effective ways to deliver dental care to poor or rural communities across the nation.

The Secretary notes that, in 2009, 83,000 emergency room visits resulted from preventable dental problems. “In my state of Georgia,” he writes, “visits to the ER for oral health problems cost more than $23 million in 2007. According to more recent data from Florida, the bill exceeded $88 million. And dental disease is the No. 1 chronic childhood disease, sending more children in search of medical treatment than asthma. In a nation obsessed with high-tech medicine, people are not getting preventive care for something as simple as tooth decay.”

He goes on to list several reasons: 50 million of us live in poor or rural areas without a dentist; most dentists do not accept Medicaid; and we have a dentist shortage that will only be exacerbated when 5.3 million children are added to Medicaid and the Children’s Health Insurance Program by way of the Affordable Care Act.

Sullivan argues that the federal government should put programs in place to train more dentists. But more than that, he argues for training dental therapists “who can provide preventive care and routine procedures like sealants, fillings and simple extractions outside the confines of a traditional dentist’s office.” He says such an approach has been particularly effective in Alaska, where the state has recruited and trained dental therapists to serve many of that state’s most remote communities, including many that are accessible only by plane, dogsled or snowmobile.

A recently announced effort by the Robert Wood Johnson Foundation (RWJF) takes aim at the very same problem. The Oral Health Workforce initiative is designed to improve access to oral health care by identifying and studying replicable models that make the best use of the health and health care workforce to provide preventive oral health services.

The Department of Health & Human Services (HHS) has awarded $9.1 million to medical students participating in the National Health Service Corps’ Students to Service Loan Repayment Program. In exchange for funds to repay their medical school debts, the 77 students in the pilot program commit to provide primary care services in communities with shortages of health professionals and limited access to care.

After their residencies, participants will spend three years full-time, or six years half-time, working in clinical practice in underserved or rural communities. They can receive annual student loan repayment funds of up to $30,000 while in the program.

The pilot program, created by the Affordable Care Act—the health reform law—aims to help alleviate a shortage of primary care professionals. “This new program is an innovative approach to encouraging more medical students to work as primary care doctors," HHS Secretary Kathleen Sebelius said in a statement.

Read more about the shortage of primary care providers and efforts to recruit primary care physicians in underserved areas.

Convincing a medical student, sometimes tens of thousands of dollars in debt, to take a lower-paying job or move to a low-income, rural community can be a tough sell. So perhaps it’s not surprising that many new physicians gravitate toward high-paying specialties or urban sprawls with modern-day conveniences. But with an aging population and millions of people poised to gain insurance coverage under the health reform law, the nation is in desperate need of general primary care physicians, particularly in rural and underserved areas.

Last week, NPR reported on a technique that one rural community has used successfully to recruit primary care providers – “mission focused medicine.” At the Ashland Health Clinic in southwest Kansas, CEO Benjamin Anderson is recruiting primary care providers not by pointing to all the advantages the community offers, but by highlighting its most severe needs. And to further appeal to prospective providers’ desire to do meaningful work, Anderson offers candidates eight weeks off to do missionary or other service work overseas. Anderson hopes to find providers who are engaged and motivated by the challenges associated with providing care in a rural community.

“When you recruit a mission-focused provider…,” Anderson said, “they want to know that there's no Spanish-speaking provider in more than a one-hour drive. They want to see houses that are falling down, widows that are uncared for. They want to know that there's need and that by them coming there, they would fill a disparity that would otherwise not be filled.”

Specialization also poses a challenge to building the primary-care workforce, the Washington Post reports. A medical resident who chooses a specialty over general primary care has the potential to earn millions more over a lifetime, making it an attractive option to the often deeply in debt medical student.

Last summer the White House launched the Primary Care Residency Expansion, providing financial support for three-year primary care residency training programs at 82 hospitals around the country. Participating residents are required to work in underserved areas. All of the 172 slots funded in the first year of the program have been filled, the story reports.

What do you think? How can we recruit more primary care physicians for general practice or in underserved areas? Register below to leave a comment.

Listen to the NPR story.

Read the Washington Post story.

A recent study from the Robert Wood Johnson Foundation-funded RN Work Project takes a close look at state rules capping nurses’ mandatory overtime hours. As of 2010, 16 states had imposed such caps, with the goal of avoiding errors caused by long hours and insufficient rest between shifts.

The study concludes that the laws seem to be working. “It’s important to policy-makers to understand the impact of the remedies they devise for particular problems,” says study co-author Sung-Heui Bae, PhD, MPH, RN. “What we learned in this study is that it’s working. The tool is effective. Other states with similar objectives can follow suit and expect similar results.”

“The purpose of capping mandatory overtime is to make hospitals safer for patients and nurses,” says co-author Carol Brewer, PhD, RN, FAAN. “Nurses routinely work long shifts, often as long as 12 hours straight. These laws were intended to prevent hospitals from piling mandatory overtime on top of such shifts—a practice that research shows can increase the likelihood of mistakes. The laws seem to be accomplishing their objective.”

A new study in the Archives of Internal Medicine finds that some of the key characteristics of medical homes promote stronger morale and job satisfaction among providers and staff at community health centers.

In a survey of more than 600 employees at 65 clinics participating in the Safety Net Medical Home Initiative, more than half (53.7 percent) reported being satisfied with their jobs. About one third (32.8 percent) rated their morale as good. In particular, clinics with high scores on three key characteristics – access to care, communication with patients and quality improvement – enjoyed higher morale and job satisfaction among providers, and higher morale among other staff.

While employees at clinics with the characteristics of a patient-centered medical home reflected positively on their jobs, the study also finds that they are at higher risk for burnout. Only half of the respondents (49.5 percent) at such facilities agreed with the statement, “Occasionally I am under stress at work, but I don’t feel burned out.”

Read more about the study.

New data released by the Irvine, California health care marketing firm SK&A shows that the “move rate” of physicians has declined for a third straight year. SK&A tracks job turnover among a group of 664,000 physicians across the country, using an annual survey designed to determine whether the physicians have remained at their jobs or have moved, retired or passed away during the previous year.

According to the report, the move rate for physicians in 2010 was 11.3 percent, down from 12.4 percent in 2010, 15 percent in 2009 and 18.2 percent in 2008. The increasing stability reflected in those numbers could be an indication that the nation’s economy is dissuading or preventing physicians from changing jobs or retiring.

What do you think of the report’s findings? Do you think the economy is affecting physicians’ willingness to move or retire? Register and leave a comment below to let us know.

Read the American Medical News story on the report.

Learn more about the report from SK&A.