Why the shortage? First, fewer physicians are choosing to practice general medicine, either as an internist, family practitioner, or hospitalist. A recent study found fewer medical students were planning to concentrate on internal and family medicine, and that those who did planned to go into a subspecialty later.1 Dr. Parekh attributes this to a combination of reasons. “Most internal medicine residents are subspecialty oriented and may have decided their specialty early on,” Dr. Parekh says. “They may choose a subspecialty for financial reasons or prestige,” he continues, “but they may also be unclear about what a hospitalist career really is.”
Second, hospitalist programs have begun to expand from large metropolitan regions to smaller and rural areas. The result is an even greater demand for hospitalists.
Meet the Need
“There are no saturated markets within hospital medicine,” Dr. Holman says. “That is, most groups are always actively recruiting. [Cogent develops] full hospitalist programs, including recruiting, employing, managing, and training for new and existing hospitalist groups.”
Who is being recruited? Many recruiters approach residents who have not chosen a subspecialty to offer a staff position after they finish the residency. Although a recruiting firm may not offer financial aid during the residency, an employer may provide some sort of stipend if the candidate commits to remain on staff for a specified time after residency. “Recruit and retain” is the operative phrase in these cases.
Recruiters also are approaching generalists just entering the market to point out the advantages of avoiding the startup costs of establishing an outpatient practice. Further, many hospitalists are emerging from the ranks of solo practitioners interested in the financial and personal advantages of belonging to hospitalist groups. Not only does that eliminate the practice overhead (including the burden of regulatory compliance), but it also may offer additional administrative and academic opportunities. As Dr. Amin says, “There are more MD-MBA combos out there.”
Are incentives the answer to the shortage? Perhaps for now. With time, hospital medicine’s built-in perks may end the shortage and the need for added incentives. TH
Ann Kepler is a medical writer based in Chicago.
Reference
- Croasdale M. Primary care doctors in demand; signing bonuses and higher pay for some. American Medical News. June 19, 2006. Available at www.ama-assn.org/amednews/site/free/prl10619.htm. Last accessed March 19, 2008.