As the nation's physician shortage begins to accelerate, more health care facilities are using temporary workers to fill staffing gaps. The U.S. has a current shortfall of over 20,000 doctors. This number is expected to climb to between 46,000 and 90,000 by 2025, according to a new report from the American Association of Medical Colleges, as over half the nation's 800,000 doctors retire within the next decade. Increased demand from aging baby boomers and millions of new patients with access to care under the Affordable Care Act will continue to pressure a dwindling physician population with the highest turnover rate since at least 2005.

"The doctor shortage is real – it's significant," said AAMC President and CEO Darrell G. Kirch, MD., in a release accompanying the report.

Physician shortage contributing to deficits across medical specialties
The potential crisis may appear a simple, though serious, case of physician supply-and-demand imbalance. However, the simultaneous acceleration of doctor attrition rates and demand for medical services may cause a widespread deficit in health care workers across medical specialties. This is because hospitals and health systems are relying more on physician assistants and nurse practitioners to address the scarcity of doctors. In addition, a looming nurse shortage threatens to exacerbate the problem over the next 10-15 years, as the Health Resources and Services Administration expects the retirement of over 1 million nurses.

Temporary workers ensure continuity of care, prevent revenue loss and reduce burnout
In response to the shortfall, demand continues to increase for temporary workers to fill gaps in a number of medical specialties. Ninety percent of hospitals and medical group administrators used temporary physicians in 2013, up 16 percent from the previous year, according to Staff Care, a health care staffing firm. Demand is "rapidly accelerating" for temporary nurse practitioners and physician assistants. The use of NPs more than doubled from 2012 to 2013, and PA temp hires rose from 4.7 to seven percent. Demand for hospitalists, behavioral health professionals and other medical specialists also increased.

Health facility administrators cite three main benefits to using temporary physicians: ensuring continuity of patient care, preventing revenue loss and reducing staff burnout. Health facilities are turning to HR outsourcing services to find temporary doctors who can fill vacant positions after others have left, maintain care during the search for a permanent physician or treat patients when full-time doctors are absent. This not only ensures access to treatment for new patients and care continuity for existing patients, but it also protects revenue by providing care to clients who might seek treatment elsewhere if a doctor is unavailable.

Physicians and nurses experience high burnout rates. Employee burnout can negatively affect quality of care, patient outcomes and staff turnover rates, all of which contribute to revenue. To increase employee retention rates and reduce stress on workers, health facility administrators are using temporary doctors, nurses and other medical specialists to fill in while regular, full-time employees take time off. Improved work-life balance not only reduces burnout and turnover, but also positively affects patient outcomes and quality of care.

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