2015 SURVEY OF FAMILY MEDICINE RESIDENTS CERTIFIED BY THE JOINT COMMISSION AND THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE

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1 CERTIFIED BY THE JOINT COMMISSION AND THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE 2015 SURVEY OF FAMILY MEDICINE RESIDENTS 2015 Staff Care, Inc 8840 Cypress Waters Dr, #300 Dallas, TX (800) M e m b e r o f t h e N a t i o n a l A s s o c i a t i o n o f L o c u m Te n e n s O r g a n i z a t i o n s Preferre d Pa r t ner for Te m p o rary P h ys icia n a n d A d va n c ed P ra c tic e Sta ffin g o f th e N a tio n a l Asso c ia tio n o f Co m m u n ity He alt h Ce nt e r s

2 2015 SURVEY OF FAMILY MEDICINE RESIDENTS Overview Methodology Questions and Answers Trends and Observations Conclusion For additional information about this survey contact: 2015 Staff Care, Inc 8840 Cypress Waters Dr, #300 Dallas, TX (800) info@staffcare.com Survey of Family Medicine Residents

3 Summary Report 2015 Survey of Family Medicine Residents OVERVIEW Staff Care is a leading healthcare staffing firm specializing in matching temporary (i.e., locum tenens) physicians, physician assistants, nurse practitioners, dentists and other healthcare professionals with hospitals, medical groups, government facilities, Federally Qualified Health Clinics (FQHCs) and other healthcare organizations nationwide. Established in 1992, Staff Care is a company of AMN Healthcare (NYSE: AHS), the leader in innovative healthcare workforce solutions and the largest healthcare staffing organization in the United States as ranked by Staffing Industry Analysts. Staff Care is proud to be certified by the Joint Commission and by the National Committee for Quality Assurance (NCQA) and to be the sponsor of The Country Doctor of the Year Award. information concerning the rate at which hospitals, medical groups and other facilities use locum tenens providers, their reasons for doing so, how they rate the skill level of locum tenens clinicians and related data. Staff Care also conducts surveys on other staffing topics, such as our Survey of Nurse Practitioners, and produces a series of white papers on various healthcare staffing and delivery trends, including population health management, the rise of convenient care, physician supply and demand projections, the growing role of women in medicine, the aging physician workforce and related subjects. The 2015 Survey of Family Residents marks Staff Care s first effort to track the practice preferences and perspectives of family physicians in training who are soon to enter the workforce. Survey data may be useful to healthcare facility managers, policy makers, media members and others who track physician workforce and staffing trends. Each year, Staff Care conducts a survey to track trends in locum tenens staffing, both among healthcare facilities that use temporary doctors and among physicians choosing to work temporary assignments. Staff Care s Survey of Temporary Physician Staffing Trends is the industry s leading resource of 2015 Survey of Family Medicine Residents 2

4 METHODOLOGY Staff Care s 2015 Survey of Family Medicine Residents was conducted at the 2015 American Academy of Family Physicians (AAFP) Conference for Family Medicine Residents and Medical Students held in Kansas City, Missouri in July, The survey was self-selecting and was taken by family medicine residents attending the AAFP Conference who visited Staff Care s booth or otherwise interacted with Staff Care representatives at the conference. A total of 133 surveys were completed. The survey was only available to those conference attendees who had the opportunity to interact with Staff Care representatives, therefore no response rate or margin of error can be calculated and the survey should be considered anecdotal rather than scientific in nature. Nevertheless, it does provide what Staff Care believes is a useful indication of the practice preferences of family medicine residents, particularly in regard to locum tenens. The 2015 Survey of Family Medicine Residents is the only source of which Staff Care is aware that reflects how knowledgeable family medicine residents are about locum tenens and indicates their potential interest in this growing practice style Survey of Family Medicine Residents

5 Questions Asked and Responses Received 1 Based on 133 Survey Responses What is your gender? 3 2 In what year will you complete your residency training? Male Female Which best describes your current job plans post-residency? 4 Which best describes your view of locum tenens? ALL 2016 I have put little to no time into considering job offers 50% 19% I am unfamiliar with the meaning of this term 2 I have considered job offers but have not interviewed 3 5 I am vaguely familiar with the meaning of this term 1 I have interviewed for jobs but have not accepted one 10% 20% I am somewhat familiar with the meaning of this term 3 I have accepted a job offer I am very familiar with the meaning of this term 29% Have you ever worked as a locum 5 during your residency? 6 Which best describes your attitude toward your first job post-residency? Will consider jobs in a wide number of locations Will seek a job out of state in a pre-determined location Will seek a job within the state where I trained Will seek a job locally where I trained 1 1 Yes No 2015 Survey of Family Medicine Residents 4

6 7 Rate your preference for the following practice settings: Little Preference Strong Preference Avg Group practice 0% Community health center 0% 19% Academic medical center 20% Hospital employed practice 19% Urgent care center 1 2 9% Locum tenens Concierge practice 1 20% 10% Veterans Administration 20% Independent solo practice Retail clinic % Indian Health Service 2 10% 1 2 0% 3.1 Military base facility 3 9% 1 1 0% 2.8 Correctional facility % 1 9% How open would you be to test driving various practice styles and geographic locations by working temporary assignments post-residency? What is your annual salary expectation for your first job post-residency? $100,000 or less $101,000 - $150,000 $151,000 - $200,000 50% 3 10% 1 $201,000 or greater Very Open Somewhat Open Not Very Open 10 What is your preferred schedule for your first job post-residency? 1 8 Full-time (31 hours per week or more) Part-time (30 hours per week or less) Survey of Family Medicine Residents

7 Trends and Observations Family medicine residents represent one of the most sought-after groups of professionals in the United States if not the most sought after. organizations take on responsibility for providing care to large groups of patients within a defined budget that includes rewards for quality/outcomes. In this rapidly proliferating model, the primary care physician is the patient s main point of contact and directs his or her care, incorporating other clinical professionals who are on the delivery team when needed. Due to a nationwide shortage of primary care physicians, doctors about to enter the primary care workforce are a key hiring target of hospitals, medical groups, community health centers, and other healthcare facilities nationwide. Staffing firms such as Staff Care receive more requests for primary care physicians, particularly family medicine physicians, than for any other type of doctor. Primary care physicians have been Staff Care s most requested staffing assignment for five consecutive years, including 2015, and that trend is not likely to abate soon. Primary care physicians are in growing demand due in part to patient demographics, including population growth and population aging, that accelerate the need for more doctors. Primary care physicians also are essential to the implementation of convenient care, a growing model of care delivery offered by urgent care centers, retail clinics, community health centers and other outpatient sites of service (for more information on population health management and convenient care see the Staff Care white papers Population Health Management and Convenient Care). The nation s 8,441 family medicine residents, all of whom will soon be entering the job market, therefor are a coveted resource. Staff Care s 2015 Survey of Family Medicine Residents reveals some insights into the practice plans of family medicine residents, particularly in regard to locum tenens. Demand also is being driven by changes in the healthcare system, which is becoming more primary care focused. Primary care physicians are essential to the implementation of population health management, in which healthcare 2015 Survey of Family Medicine Residents 6

8 LOCUM TENENS, AN EMERGING PRACTICE STYLE Physicians substituting for their peers filling in while their colleagues are absent due to illness, vacation, continuing medical education, or other reasons is a time honored tradition in medicine. Working as a substitute, or working locum tenens, is something physicians typically have done on an ad hoc basis for many years. Many locum tenens physicians are older doctors who may no longer be in fulltime practice. Staff Care s 2015 Survey of Temporary Physician Staffing Trends indicates that 6 of locum tenens physicians are 51 years old or older, but there is some data that suggests that younger physicians also are gravitating to locum tenens. Staff Care s 2015 Survey of Temporary Physician Staffing Trends indicates that 2 of locum tenens physicians began working temporary assignments right out of residency, up from 14. in FAMILIARITY AND INTEREST Since the late 1970s, however, locum tenens has become a significant part of the healthcare staffing industry, and most physicians now work locum tenens through staffing companies such as Staff Care. Staff Care estimates that approximately 44,000 physicians worked as locum tenens in 2014, up from approximately 26,000 in In a national survey of over 20,000 physicians conducted by Merritt Hawkins on behalf of The Physicians Foundation ( 9. of physicians indicated they plan to work locum tenens sometime in the next one to three years, up from 6. in The 2015 Survey of Family Medicine Residents confirms that the majority of residents in family medicine have at least some awareness of locum tenens. Sixtyseven percent said they are somewhat or very familiar with the term, while 1 said they are vaguely familiar. Only 2 said they are unfamiliar with locum tenens. However, only have worked as a locum during their training. The majority of family medicine residents surveyed, 5 of whom will complete their programs in 2016, are still undecided about their first jobs. Fifty percent said they have put little to no time into considering job offers, 3 said they have considered job offers but have not interviewed, 10% said they have interviewed but have not accepted a job offer, and only have accepted offers Survey of Family Medicine Residents

9 Though they are highly recruited, the survey indicates most family medicine residents, even those coming out of residency in less than a year, are still considering their job options. candidates, even though residents are highly recruited and even though most locum tenens physicians traditionally have been older, more experienced doctors. FINANCIAL EXPECTATIONS, SCHEDULES AND LOCATIONS When asked to rank various job settings that typically employ family medicine physicians, residents surveyed picked group practice as their highest preference, followed by community health centers, academic medical centers, hospital-employed settings, urgent care centers, and locum tenens. At the bottom of the list was correctional facilities and military base facilities. Locum tenens is a non-traditional practice option for medical residents but nevertheless ranked 6th among 13 common career choices for family medicine physicians responding to the survey. In addition, 8 of family medicine residents indicated they are either somewhat open or very open to testing driving various practice styles by working locum tenens post-residency, while only 1 said they would not be very open to doing so. The survey therefore suggests that family medicine residents represent a logical resource of potential locum tenens The majority of family medicine residents surveyed (7) expect to make $151,000 or more in their first practice post-residency. This is in line with market realities, as Merritt Hawkins, a permanent physician search firm which, like Staff Care, is a company of AMN Healthcare, indicates the average starting salary for family medicine physicians is $198,000 (see Merritt Hawkins 2015 Review of Physician and Advanced Practitioner Recruiting Incentives). In general, locum tenens physicians earn less than physicians in permanent practice, though their incomes can be comparable depending on the number of locum tenens assignments worked and the availability of higher paid overtime hours. The majority of family residents surveyed (8) would prefer a schedule of 31 hours or more a week, while 1 would prefer a part-time schedule of 30 hours or less. These numbers reflect a growing preference among physicians for flexible schedules, particularly as more women enter the medical field in their child-bearing years. Reflecting this trend, the majority of family medicine residents who completed the survey (6) are female, while 5 of all family medicine residents are 2015 Survey of Family Medicine Residents 8

10 female. Among male survey respondents, 9. expressed a preference for a parttime positions, while 16. of female respondents expressed an interest in a part-time position. Locum tenens may be an increasingly attractive option for younger doctors, both male and female, as it allows for the flexible hours and schedules that many younger physicians prefer. The survey indicates a near equal division between family medicine residents who are open to a variety of job locations in their first practice and those who have a more specific location in mind. A bare minority (5) of family medicine residents indicated they would consider jobs in a wide number of locations, while the remaining 49% have a predetermined location in mind or will limit their job search to within the state where they trained or the locality where they trained. It is widely perceived in staffing circles that medical residents generally base their first practice selection on a preference for a particular geographic location, and may subsequently leave shortly thereafter when they discover the practice itself does not fit their needs. The 2015 Survey of Family Medicine Residents, however, suggests that over half of family medicine residents are not committed to a specific geographic location and therefore could be amenable to working locum tenens, which requires geographic flexibility Survey of Family Medicine Residents

11 Conclusion Due to demographic changes and the current rapid evolution of the healthcare delivery system, primary care physicians are in increasingly high demand. Family medicine residents are particular targets of recruiting activity. The 2015 Survey of Family Medicine Residents indicates that the majority of family medicine residents are familiar with locum tenens, are open to considering this emerging practice style, and may make appropriate candidates for locum tenens assignments. For additional information about this and other Staff Care surveys and white papers, contact: 8840 Cypress Waters Dr, #300 Dallas, TX Survey of Family Medicine Residents 10

12 Certified by Joint Commission 8840 Cypress Waters Dr, #300 Dallas, TX Staff Care, Inc (800)