Author: Robert Moghim, M.D.

What practice owners are REALLY looking for in a physician hire. The medical profession is currently in a state of upheaval.  There is massive professional dissatisfaction among longtime physicians as well as those just entering the field. This has created an environment of heightened migration, as doctors move from organization to organization to find a more satisfying setting. This general dissatisfaction has led many physicians the desire to leave the profession all together. Furthermore, the general consolidation throughout the industry has shunted many private practice physicians into employment situations. A report from Accenture reveals that the number of independent physicians has dropped from 57 percent in 2000 to 33 percent in 2015. This is a staggering trend that has put doctors in a precarious situation and reminds me of a…

Hospitalists have existed as a specialty for only a decade, but they have quickly become the most popular specialists in the medical community and in the locum tenens market.  These physicians who are primarily tasked with caring for patients in a hospital setting are among the most sought-after due to their skills in patient treatment, hospital administration, research and teaching. According to the Society of Hospital Medicine, the number of hospitalists has increased to 30,000, an almost 170 percent increase from 2003 to 2010. According to a 2011 Staffing Industry Analysis, hospitalist locum tenens generated the most revenue of any medical specialty. Almost 17 percent of all locum tenens revenue—totaled at $548 million—was from hospitalist placements, followed at 14 percent by emergency medicine placements. This hospitalist-generated revenue was 34 percent…

The health care analytics group Leavitt Partners reports that 744 Accountable Care Organizations or ACOs have been created since 2011.  These conglomerations of physicians, allied health professionals and hospitals exist to improve patient outcomes, optimize patient satisfaction and minimize cost. The number of Americans currently receiving care through an ACO totals more than 23 million; ACOs operate within all 50 states and typically correlate to population density. Initially created by the Affordable Care Act under the guidance of the Centers for Medicare & Medicaid Services, ACOs are now found within the public and private sectors. What began under the Pioneer ACO Model will soon transition to the Next Generation ACO Model, a higher risk/greater reward model that seeks to further improve on advances forged in early ACO systems. Despite continuing…

The business environment for health care organizations has changed significantly in recent years. Consumers are increasingly more savvy about getting the greatest medical bang for their buck.  This has fostered a closer examination of recommended tests, drugs and therapies not only for their therapeutic value but also for their cost effectiveness. More patients are now broaching the subject of cost with their physicians and asking hard questions. Unfortunately, most physicians are less than knowledgeable about how much many of their recommendations cost, but there are a growing number of services that can help them. Price transparency has been slow to arrive in the health care system, but there are finally some organizations that are letting consumers view costs before they choose a provider. With the average annual health care cost…

The enormous number of cases of superbug infections in recent years has much of the medical community deeply concerned. The National Institutes of Health reports that there are more than 2 million such cases annually which lead to 23,000 deaths in the U.S.  There are a growing number of these drug-resistant bacterial strains including MRSA, CRE, C. Diff, NDM-1, tuberculosis, and gonorrhea. MRSA is the most dangerous of these, causing almost 80,000 infections and 11,000 fatalities annually. The growing number of drug resistant contagions is largely attributable to the overuse of antibiotics in humans and livestock. Because bacteria can propagate and exchange drug resistance genes, once immunity to a particular antibiotic has developed, it can be rapidly transmitted to an entire bacterial population. Hospitals have become the new battleground in…

If you are considering serving in a locum tenens position, then one of the most important considerations is the compensation package.  Many of the locum tenens placements offered by medical staffing firms offer very competitive perks like transportation, housing, malpractice insurance and licensing assistance, as well as very lucrative financial rewards.  Before you sign the contract, however, you may wish to learn about how those terms were drawn up and if there are more generous contracts available elsewhere. One of the most important factors in determining how much compensation you receive is the geographical location in which you plan to serve.  It may be counter-intuitive but the most populous, urban areas are not the most lucrative.  Rural areas which have difficulty attracting medical professionals typically offer $1,500 more in annual…

The slow growth in U.S. health care expenditure of the past few years is poised to disappear as renewed vigor in the economy and a larger segment of the U.S. population with health coverage are driving greater health care utilization. The Office of the Actuary within the Centers for Medicare & Medicaid Services (CMS) reported that health care spending was up 5.5 percent in 2014 over the previous year. As a nation, we spent almost $3.03 trillion on medical care in 2014 or almost $9,523 per capita. This was the highest growth rate since 2008, the beginning of the recession. Analysts at CMS predicted that health care expenditure should rise to 6.0 percent for 2015 and hold steady through 2023.  By 2023, the annual national health care expenditure should reach…

Much of the health care system is in a state of flux with hospitals and practices of all sizes merging into larger organizations.  With profits dwindling, many hospitals and medical groups have devoted available financial resources to acquiring greater market share.  This drive to consolidate has squeezed out many of the smaller players in the industry, including many private practices. In a recent study of 20,000 physicians by the Physicians Foundation, only 35 percent considered themselves independent, compared to 49 percent in 2012 and 62 percent in 2008. The Lure of Locum Tenens As more doctors leave behind their private practices, they are taking on new provider roles. One role that has grown significantly in popularity and is reshaping the health care industry is that of the locum tenens physicians. …

Most physicians recognize that much of their time is devoted to caring for particular types of patients—the elderly or chronically ill. According to the National Institute for Health Care Management, almost 20% of all health care expenditures, or $275 billion, makes up only one percent of the population, while almost half of all expenditures were for only 5% of the American public. On the other hand, almost half of the nation accounted for only 3% of all U.S. health care costs. This type of high cost patient distribution is reflected in the government programs Medicare and Medicaid. In 2001, only 5% of Medicare patients accounted for 43% of program spending while 25% of members accounted for almost 85% of all expenditures. Almost a quarter of Medicaid members are elderly or…

In modern America, health care is undergoing radical changes due to shifting internal and external dynamics.  One of the least noticed—but possibly quite important—is the introduction of retail medicine which includes clinics hosted by corner store pharmacies, big box stores and groceries. These new forms of health care delivery are being primarily driven by consumers who want high quality care on their own terms which typically means short wait times and at reasonable cost. Convenient care clinics found in local pharmacies are usually staffed by physician assistants or nurse practitioners, medical professionals who have historically been supervised by a physician.  However, with much of the nation experiencing physician shortages, more states are granting greater autonomy to the advanced practice providers and are allowing them to make diagnoses, write prescriptions and…