Physician Recruitment, Workforce Lead Healthcare Challenges

As the new year gets rolling, dealing with workforce challenges, including physician and specialist recruitment, is a top priority, say executives at The Iowa Clinic and MercyOne, two major healthcare providers in Iowa. 

“We know we need to have a strong healthcare workforce, to be the experts in the community,” says Troy Cook, MercyOne, Division Director – Business Health Solutions, representing one of the largest multi-specialist physician group practices in Iowa.

Part of Livonia, Michigan-based Trinity Health, MercyOne provides services through Wheaton Franciscan Health – Iowa, offering care at Covenant Medical Center in Waterloo, Sartori Memorial Hospital in Cedar Falls and Mercy of Franciscan Sisters in Oelwein, as well as the Covenant Clinic at various locations in Iowa.

Filling gaps in the healthcare team can be challenging and calls for creativity, says Mr. Cook. “There are not an unlimited number of cardiologists” available to provide cardiac care, especially preventive care, for the state’s aging population, he says. One innovation is utilizing remote patient monitoring and telehealth to use doctors’ and specialists’ time most effectively.

“We lean in a lot on technology,” he says.

Tech is key to meeting the challenge of a shortage of counselors in the growing mental healthcare space, says Mr. Cook. MercyOne partners with the Carebridge Employee Assistance Program, which has counselors across the country who provide services via telehealth. “Patients don’t have to wait weeks and weeks. It’s been very successful and allows doctors of psychiatry to focus on more severe needs,” Mr. Cook says.

“How can we get creative with recruiting difficult specialties when we don’t have oceans or mountains to compete with?” asks Jodi Schweiger, The Iowa Clinic’s Executive Director Business Development.

Endovascular neurosurgeons and gynecologic oncologists, for example, are the types of specialists critically needed in Iowa to lower wait times for patients to be seen by a physician hours away. These specialty physicians have years of education and residency and don’t typically enter the workforce until they are in their 30s, so they tend to gravitate toward higher paying areas. 

“We would love to have some grants or educational loan forgiveness opportunities awarded so we can make it attractive for these types of physicians to come to Iowa,” says Ms. Schweiger. “We know Iowa is a wonderful state and has a ton to offer especially when it comes to cost of living.”

It’s not only physicians and specialists that are needed. “This I am sure is no surprise but since Covid, the data reveals that 100,00 nurses left the workforce during the pandemic and by 2027, almost one-fifth of the 4.5 million total Registered Nurses, intend to leave the workforce, threatening the national healthcare system at large if solutions are not enacted,” says Ms. Schweiger.

The Iowa Clinic tackled the shortage of nurses and CMAs by starting and fully funding an internal, 20-week, self-paced Certified Medical Assistant program, finishing with a paid externship within The Iowa Clinic.

The largest physician owned multi-specialty group in Central Iowa, The Iowa Clinic employs more than 250 physicians and healthcare providers practicing in more than 40 specialties. The provider is recruiting heavily to fill new positions as it continues to grow. It has recently opened clinics in Grimes and Adel, expanded its clinic in North Waukee, and is preparing to add a new multispecialty clinic in South Waukee with an ambulatory surgery center. The South Waukee location alone will need 20 additional clinical and support staff members, Ms. Schweiger says.

Healthcare Culture Changes

The culture of healthcare has changed since the recent pandemic, say both Mr. Cook and Ms. Schweiger. The changes are both internal and external, extending to the ways employers view healthcare and the range of services consumers seek.

“There is not one singular lever but several levers that require time and dedication to achieve the best employee and patient experience in Central Iowa,” says Ms. Schweiger. On the workplace culture side, The Iowa Clinic last year launched an employee feedback initiative, including engagement surveys, listening sessions and focus groups to identify areas of opportunities for efficiencies and improvements for both patients and employees. Other programs include a partnership effort focused on patient experience and quarterly financial bonuses tied to organizational goals.

“Covid brought a change in culture, especially in the area of mental health. It brought forward the opportunity to walk with each individual on their health journey,” says Mr. Cook. 

Mental health issues surfaced during the isolation of the pandemic and are continuing to be addressed, by both employers and individuals.

Recent changes in employer insurance plans are focused on the total health approach, “how mental health affects total health,” he noted. “Employers are really digging in deeper on understanding and crafting benefits to fit employee needs.”

“We’ve seen employers really looking to enhance their benefits. Companies are trying to get more creative (asking) ‘How can I retain top talent, how can I recruit?’” says Ms. Schweiger. “We’re seeing an uptick in high performance network, incentivizing employees to come to The Iowa Clinic for their care with a lower copay.”

Acceptance of telehealth continues to grow in some areas, including in behavioral and mental health, but overall the number of telehealth visits is down since COVID. “We learned there are areas of need that aren’t suited,” she says.

Telehealth, however, is continuing to evolve. It can, for example, serve as an effective follow-up tool after an initial in-person visit. MercyOne is piloting a telehealth program to follow up on workplace injuries.

Mr. Cook and Ms. Schweiger also agree that people are tending to pay better attention to their health these days.

“Most people don’t wake up and want to be unhealthy. They want to find as healthy a path as they can. They don’t always have good information. People are getting back in the habit of preventive care,” Mr. Cook says.

MercyOne works to help clients understand why that’s important. “Once they have experience with the benefits of preventive care, they don’t often steer away from that,” says Mr. Cook.

The shift to back toward preventive care is apparent at the Iowa Clinic as well.

“I would say from COVID, we definitely saw a lag in care, people not going to doctors or getting routine screenings when they were due. We’re having to work through a backlog,” says Ms. Schweiger. “Coming out of COVID, we hit the ground running to make sure we’re getting all our patients in and getting appropriate screening.

“Patients eager to get back in and have that face-to-face experience with physicians. We’re about meeting the patient where they are and how they want to receive service. We’ve learned to really be flexible in how we deliver care.”