**I = Interviewer
**R = Robert Hickey
Welcome to the D&Y Innovators exchange. A podcast series focusing on medical staff development leaders whose dedication, work ethic and unique industry approaches have enhanced and inspired their medical staffs to provide the highest levels of clinical service and quality patient outcomes to the communities they serve
With us today is Mr. Robert Hickey, a tenured position recruitment leader with a Kaiser Permanente Mid-Atlantic division to discuss the anticipated physician shortage and its potential impact on healthcare.
I: If we take the Kaiser hat off for a second, it might be a little painful, Bob, to peel that off the head… and just look at again with all your success within the physician recruitment marketplace – are there trends you’re seeing across the country within recruitment? (That have really impacted some of the contemporaries that you have I have talked to in terms of what you’re hearing from your constituents across the country, maybe not just specific to Kaiser)
Are there any trends you’re picking up on?
R: Yeah, there’s one. And this is very alarming as a trend. It’s the number of physicians is not gonna be enough to cover the population. That’s problem number 1.
The number of people going for primary care, internal medicine from the time that they start their training they’re pushing them very hard to go into a specialty there. So again, those internal medicines they could do the geriatric and where elder care and primary care…they’re not there.
There’s just not enough physicians.
In Dermatology, you have to be in the top 10 in your class to get into Dermatology.
As people get older they’re going to have more Dermatology issues.
I: Exactly.
R: So that’s a huge problem.
There’s not enough med schools, not enough residency programs across the US to feed that. And in certain areas, it’s even a bigger challenge. I live in an area that’s a very nice suburb of Baltimore. I found out that we’re very underserved medically. We have about 60% of the physicians we should have for that population.
I: Really?
R: And I thought we were doing pretty well…
The other thing too is that we’re finding for primary care physicians, family medicine in Hartford county the average age is 58. Ok, well, that’s another 5, 7…
I: Exactly, a massive percentage of that market is going into retirement.
R: Right. So when you take a look at the other thing too, is the cost of education, cost of med school, I think is keeping people out. When you can come out with a degree in engineering or business and things like that and do amazingly well…
I: Yeah, get your MBA, your JB, and we talked a little early about the legacy physics, and these are individuals who grew up in a household where they had a view of what it would be like to be a doctor and the financial means potentially existed where they could see themselves as a physician, and their parents are telling them “don’t go into medicine” get your MBA, get your JB, go into anything except medicine.
R: That’s an excellent point, and that’s exactly what I’m finding out when talking to candidates “if you had to do it over again would you do it?” And each are candidates that are like right out of residency even up to the oldest one I hired was 62. And most of them said oh absolutely.
“Would you recommend your kid?”
Absolutely not.
With rare exceptions…
Again, some of them have the same approach – they want to consider specialty care. If you really have the passion for it, do it. And that’s what most of them are saying to their son or daughter, if you really have the passion for it, do it. But if not, please consider something else.
Again, 350k in debt coming out, everybody thinks doctors make a ton of money. Well, a large part of it is they are coming out of a hole. So, the average kid is not graduating with that kind of debt. The average med student is.
I: Yeah. Well, there’s also in addition to the student loan debt, many of them have family, they’re going into their first job, and just a lot of factors that make it very stressful very early on in their healthcare career.
Bob, just sort of to put a synopsis on your answer… are you going on record and saying there’s a physician shortage? Is that what you’re saying?
R: Big time.
And the cool thing is that we’re still getting more than our fair share – which I’m really happy with!
I: Ok, so that’s a perfect segway into my next question. Given the shortage that we’re seeing across the country and again when you look at the average retirement age for physicians being in the early to mid ’60s and again to your point about PC – we’re very rapidly approaching a period where we could lose conceptually 25-35% of a specialty marketplace to retirement. What are some of the – and you’ve already outlined so many of the programs you have here – is there another one that jumps out that you think really allows you guys to circumvent and work around the shortage that is impacting everyone else to such a disastrous degree?
R: If we get the recipe for the special sauce I’m not giving it away.
But the reality is what we’re trying to do is meet physicians where their needs are better than our competition. We’ve tried to be a little bit ahead as far as trends for that.
I can’t say that we have everything, one of the things we talked about offline is that a lot of physicians wanna work less than full time. Full time with us is 40 hours of face to face with the patients. But even with that a lot of the physicians do that and end up doing work outside of that.
So, a lot of them want to consider .8 or .9. In some environments, they don’t allow that, but we do. That’s been a huge plus. We don’t ding people as far as their benefits and doing that, which is another big plus.
One of the other things that is really alarming as a whole culture is most people were not prepared for retirement. Our company has amazing retirement benefits, which has been a huge plus. This is not as important to the new resident or fellow coming out cause they’re broke and are looking at the salary. Somebody that’s worked for themselves for 10-15-20 years and now looking at it saying okay I didn’t have the money to put into a 401k like I would have liked to, I didn’t have a defined benefit plan, I will be retiring but at the same time, I’m not going to be able to retire in the position I’d like to be in.
And when I first got here (which was amazing) is the economy was not doing well, we had many people who had just retired and you could tell they really wanted to be retired. Psychologically they were ready to be retired, but they wanted to come back.
It’s hard to say no to somebody in that caliber, but at the same time the heart is not in it, it’s just purely financial as to why they want to come back.
You’ve been listening to the D&Y Innovator’s Exchange featuring physician recruitment leader Robert Hickey with the Kaiser Permanente Mid-Atlantic division.
Join us next time when we discuss successful recruiting strategies with Mr. Hickey.