Staffing of physician practices and medical groups has largely returned to pre-pandemic levels but medical care providers remain busier than ever thanks to a surge of patient visits.
Total clinic staff per provider, which includes both physicians and advanced practice clinicians, is now at a median of 2.15 total clinic full-time equivalent employees, which is essentially the same as the 2.13 FTEs per provider in 2020, according to the American Medical Group Association’s 2024 Medical Clinic Staffing Survey.
Though staffing has improved, it’s not enough to meet increasing demand for healthcare services, which is threatening patient access to care. Many patients, particularly older Americans, put off getting routine healthcare, outpatient services and surgeries during the pandemic but are now suddenly seeking treatment.
Many of these medical groups affiliated with health systems are seeing a major increase in wait times for patients.
“Within system-affiliated groups, wait times for established patients (third next available) have risen from 1.1 days in 2022 to 4.4 days in 2024,” AMGA’s analysis shows. “Schedule fill rates have increased almost 5% for system-affiliated groups over the same period.”
The AMGA study is a snapshot into the labor problems in healthcare, which was hit hard by an economic trend of workers quitting their jobs though studies show healthcare, education and hospitality industries were hit the hardest. The survey by the group’s AMGA Consulting unit is based on responses from 38 medical groups reporting staffing for 7,697 clinics and representing 31,415 providers.
“While groups continue to add clinical staff to support provider needs, increases to productivity coupled with challenges with patient access overshadow any gains in staffing support,” AMGA said in a statement accompanying its staffing report, which said total clinic staff included “both front- and back-office clinical staff along with ancillary and other direct patient care staff.”
To be sure, AMGA compensation and productivity analysts say increases in production by physicians “overshadow any gains in support staffing.” They say there are decreasing numbers of clinical staff per 10,000 weighted relative value units (wRVUs), which are a standardized way to measure the value of physician services.
Medical groups reported a more than 5% increase overall in median productivity and a 3% increase in median visits compared to a year ago. Meanwhile, staffing levels “only increased 1.3% on a per-provider basis over the same timeframe,” AMGA said in its analysis.
“It is important to note that productivity-adjusted staffing is artificially deflated due to the Centers for Medicare and Medicaid Services (CMS) changes in wRVU values over the last couple of years,” Mike Coppola, AMGA Consulting’s vice president and chief operating officer. “Medical groups continue to face staffing challenges in the overall economic environment.
To remedy staffing issues in order to keep their practices and medical groups treating patients, medical groups are looking to advanced practice clinicians, which include physician assistants, nurse practitioners, certified registered nurse anesthetists and certified nurse midwives to fill in any gaps in medical care service.
In 2020, advanced practice clinicians accounted 39.6% of the provider workforce in primary care but that has grown to 48.1% in AMGA’s 2024 analysis. “Almost 8.5% of the provider workforce is comprised of (advanced practice clinicians) today,” AMGA’s analysis said.
“As organizations continue to refine care models through the use of APCs, there has been continued increase in the percentage of APCs to total providers across all specialties over the last several years,” Coppola said. “Organizations continue to navigate the varying state regulations on the scope of practice for APCs, while attempting to address overall physician shortages.”
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