Take a cursory glance at most healthcare job boards and you will notice a plethora of physician jobs ready and waiting to be had. All those jobs are a symptom of an ongoing problem only made worse by the COVID pandemic: physician turnover. It is a serious issue faced by hospitals, family medicine groups, small-town clinics, etc.
Unfortunately, modest estimates suggest that physician turnover costs the healthcare industry in this country almost $1 billion annually. And that is just considering the amount of money it takes to replace doctors who have retired or taken positions elsewhere. Throw in lost production and other related costs, and the bill exceeds $4 billion annually.
Healthcare job boards do not reflect this reality. At least they don’t reflect it directly. If one actually takes the time to sit down and look through each and every physician job listing, it might eventually become obvious just how costly the problem is.
There are three main things that explain why physician turnover costs the healthcare industry so much money – over and above the cost of replacing physicians. The first is the effect turnover has on patient-physician continuity. That continuity directly affects quality of care. It also affects patient satisfaction. Both factors contribute to overall healthcare costs.
A lack of continuity often means overlap. It can lead to repetitive tests, unnecessary procedures, and more. This only drives the price up. Likewise, a lack of continuity serious enough to impact patient satisfaction can send some patients looking elsewhere for care. Every time a patient switches doctors though, things have to start over from scratch. That means more money to pay for care that has already been provided once.
The Loss of Primary Care
One of the more profound effects of high physician turnover is the pressure it puts on primary care. Again, take a look at healthcare job boards and it is easy to see that primary care physicians aren’t the highest paid in the industry. In fact, they tend to be near the bottom of the food chain. This suggests that primary care is more susceptible to turnover than other specialties.
The result is a loss of primary care options that ultimately sends patients to hospital emergency rooms and more expensive walk-in health clinics. Alternative options not only cost patients more, but they also drive up the bill for insurance companies. And when insurance companies spend more money on claims, they end up charging their subscribers higher premiums.
Substituting Low Value Care
The last point dovetails with the previous point: a loss of primary care leads some patients who cannot afford more expensive options to settle for lower value care instead. This saves money in the short term, but it often costs more in the long term.
Low value care is not necessarily the best possible care. It can meet immediate needs but still lead to future health problems that could have been avoided had high quality care been available. Once again, the result is higher costs. People are paying for healthcare services down the road they would not have had to pay for had they received high quality care right from the start.
It is clear that turnover and the ongoing physician shortage go way beyond logistics. They go way beyond so many listings on healthcare job boards. Physician turnover is simultaneously impacting patient care and driving up healthcare costs. The only way out is to find a way to address it is with a viable long-term solution. We haven’t found that solution yet, but it is imperative that we keep looking for it.