Staffing exec: Rural states could benefit from providers seeking jobs away from major metros

There’s not nearly enough data yet to predict what healthcare ramifications will occur months or even years from now as a result of the COVID-19 (coronavirus) pandemic.

A healthcare staffing executive in Rogers, however, says he does see a data trend that may signal a significant shift is in the offing. It could be a boon to healthcare sectors in mostly rural states — like Arkansas and its approximately 3 million residents.

Joe Goddard is the founding owner and managing partner of Cardinal Healthcare Group Inc., a national company that recruits healthcare providers for clients.

Cardinal employs 20 people throughout the country, and Goddard’s career spans nearly 30 years. From the company’s database of about 600,000 providers, Cardinal communicates regularly with thousands of practitioners throughout the country, both employed and self-employed, as well as upcoming medical school graduates.

The company specializes in recruiting physicians, nurses and mid-level practitioners. Whether it is finding a surgeon for a plastic surgery practice in California, a dermatologist for an office in Alabama or an orthopedic specialist for a healthcare system in Tennessee, Cardinal contracts with healthcare systems and practices in all 50 states.

Goddard said the company generally launches its procurement campaigns for jobs on Fridays.

“Saturdays are when we get the best reach and best response,” he said.

He said since mid-March, a trend has emerged and not with subtlety. An unprecedented number of providers have responded to Cardinal’s campaigns to find doctors, Goddard said.

“Twenty-seven years I have been doing this,” Goddard said. “On Saturday, March 21, we had more candidates contact us than any other Saturday in company history. By 10 times. We broke that record on March 28 and set another record on April 4.”

Goddard said the numbers indicate a “mass exodus” of healthcare providers who are seeking new opportunities away from major metro areas of the U.S. and into smaller, less urban areas. He said so-called “hot spots” in the U.S. where the COVID-19 pandemic is raging are prompting the migration trends.

“I can watch the news and see where the hot spots are, and then sure enough on Saturdays, our candidate inflows will match that almost perfectly,” Goddard said. “The vast majority are from the New York City metro and northern New Jersey, then from Atlanta, [Washington] D.C. and New Orleans. They are specifically seeking [jobs in] small and mid-size metros and physician-owned independent practices.”

To further explain the uptick in healthcare providers’ interest in prioritizing quality of life and community size in where they live and work, Goddard set up an employment campaign for roughly 12,000 upcoming physician graduates from the classes of 2020 and 2021. It encompassed five specialties and recruited for a job in a small town in the Midwest.

The urban draw for new providers is often hard to ignore, Goddard said. They tend to favor going directly from medical schools to big-city jobs, where lucrative salaries can help quickly wipe out debt from medical school.

Goddard said the response to the procurement campaign suggested otherwise.

“We have a typical [percentage] that we use as a rule of thumb for the number of candidates who will be interested in a job,” Goddard explained. “Again, the number who responded to that campaign was 10 times that number. Even the graduates for the next two summers are shifting gears. They aren’t looking to go to New York or Atlanta. They aren’t looking to go to Dallas or Miami or Los Angeles. [Children’s Hospital Los Angeles] is one of our clients, and I’ve heard the same from them.

“Doctors that are looking for jobs and are considering career changes across America are looking to smaller towns.”

There is another dynamic Goddard said could help small- to mid-sized metros become somewhat of a boomtown for healthcare providers: retirement.

“We are seeing a very unordinary high number of physicians taking retirement — like now,” he said. “They are unexpectedly shutting the doors forever and moving their retirement date up a year or more.

“This will affect all areas of healthcare, but it will hurt the areas of high outmigration even worse.”

Goddard said when a physician responds to a procurement campaign to say they are retiring, many times the stock market is referenced.

“It’s been on such a great run for 10-plus years, they’re taking their money and running,” he said. “Many have indicated they are ‘moving home’ to be near family and perhaps will work part time while retired.”

‘UNPRECEDENTED MIGRATION’
A study released in July 2019 by the American Medical Association (AMA) showed that for the first time in the U.S., physicians working for hospitals or healthcare systems outnumbered self-employed providers.

The AMA’s annual Physician Practice Benchmark Survey, which polled 3,500 doctors, showed that 47% of all physicians in 2018 were employed, compared with 46% of doctors who were self-employed that year.

The number of employed physicians rose 6% since 2012, while the number of self-employed doctors fell 7% over the same period, according to the survey.

Goddard said the trend of doctors forgoing their independence for the comfort of a steady paycheck had hindered healthcare delivery for years in non-urban, smaller areas of the country.

Because of coronavirus, that trend may be changing direction. Goddard said the real-time staffing data he sees has the potential to accelerate the swing and transform healthcare staffing in the U.S fundamentally.

Some areas of the country may benefit, while others will suffer.

“There is an unprecedented migration of [healthcare] providers out of certain large metros, and that is going to benefit Arkansas,” he said. “We’re mostly a rural state, a small-town state. I think there’s going to be a better candidate pool of healthcare providers that want to come here and other mostly rural states.”

Fayetteville healthcare executive Jason Wilson said he hadn’t seen much evidence of an increase in physician calls looking to relocate over the past month. Wilson is CEO of Medical Associates of Northwest Arkansas (MANA), a physician-owned independent practice based in Fayetteville.

Wilson said he would be “very happy” about any trend that could potentially broaden the provider candidate pool in Arkansas.

“Our feeling is that most physicians are hunkered down right now just trying to get through this [pandemic], and then physicians may re-evaluate after this is over,” he said. “As you know, we are hampered in physician recruiting due to the low reimbursement we receive from Medicare, Medicaid and commercial payers in Arkansas compared to surrounding states.”

MANA has 100 providers and 23 locations and has averaged hiring about 10 providers a year the past several years, Wilson said.

“Physicians typically finish their training in June, so July and August is a typical start time for new doctors out of training,” he said. “But we have start dates throughout the year for doctors relocating their practices.”