Practice Notes

The 5 biggest trends (and the data) affecting medical groups today

by Ken Wallace and Rachel Woods

A wealth of useful data for physician group leaders has come out so far in 2019. We've collected those data points and mapped them to the biggest trends affecting medical groups today. As medical group leaders shape their strategy and workforce, here are five trends (and the data) to know.

Tools to make the most of your advanced practice providers

1. Rising physician employment

More physicians are employees than are owners for the first time in the history of the American Medical Association's Physician Practice Benchmark Survey. According to the survey, 47.4% of practicing physicians were employed in 2018, compared to only 45.9% who were practice owners. And the percentage of employed physicians is likely to continue climbing—according to a 2019 survey from Merrit Hawkins, 9 out of ten final-year medical residents prefer employment.

2. Successful recruitment increasingly depends on lifestyle factors

Medical groups face significant competition when recruiting physicians, according to Merritt Hawkins' 2019 survey of final-year medical residents. Two-thirds of these survey participants receive more than 50 recruiting offers throughout their training. When considering these offers, final-year medical residents prioritize "adequate personal time" and "lifestyle" concerns as much as they do "geographic location" and "financial package."

3. Increased reliance on APPs

Medical groups already rely on advanced practice providers (APPs) for patient care, access expansion, and more. Expect APPs to play an even bigger role in the medical group moving forward. An article from NEJM Catalyst projects a 4.3% and 6.8% growth rate for physician assistants and nurse practitioners, respectively, compared to the 1.1% estimated growth rate for physicians.

4. Compensation is outpacing productivity

Overall physician compensation increased in 2018 despite work relative value unit (wRVU) production remaining stagnant, according to the American Medical Group Association's 2019 Medical Group Compensation and Productivity Survey. In particular, primary care physicians (PCPs) received a substantial bump in pay—the largest increase in four years—with the median compensation per primary care wRVU increasing by 3.5%. This continues a five-year trend of PCPs receiving greater increases in their compensation than specialists, according to the Medical Group Management Association's DataDive Provider Compensation.

5. Medical groups are underestimating burnout and turnover costs

The health care industry loses $4.6 billion annually when you factor in reduced productivity, turnover, and other burnout-related factors, according to calculations by the Annals of Internal Medicine. The price tag attached to position vacancies, recruiting a new physician, and searching for a replacement in two to three years can set medical groups back substantially. Just one example: Every day an internal medicine position remains unfilled, medical groups miss out on $7,300 in potential revenue, according to Merritt Hawkins' whitepaper on the Cost of a Physician Vacancy.

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Medical group leaders can use this three-step process to prioritize the system-level strategic imperative the group should own, identify which opportunities the medical group should take on, and learn from other groups who have successfully led system-level initiatives.

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