Talent Tuesday: Solving Hospitals’ Workforce Management Challenges

With Tech-enabled Virtual Care Partners

By Lyle Berkowitz, MD, CEO, KeyCare
LinkedIn: Lyle Berkowitz, MD
X: @KeyCareInc

Tales of a supposed “doctor shortage” have spread far and wide across the healthcare industry in recent years.

Consider a few examples of these dire headlines:

  • The nation will face an estimated shortage of 139,160 physicians by 2030, according to a 2020 article published in Human Resources for Health.
  • The U.S. could see an estimated shortage of between 37,800 and 124,000 physicians by 2034, said the American Association of Medical Colleges in 2021. They further specified this would include a shortage of 17,800 to 48,000 primary care physicians, as well as a shortage of 21,000 to 77,100 specialist physicians.
  • Most recently, the American Medical Association reiterated in a 2023 forecast that the country will to have a shortage of 77,000 specialists in the years to come.

But what if we’re looking at this so-called problem in the wrong way? What if we don’t have a shortage of physicians, but rather a shortage of using them efficiently?

In this alternative view, we have enough physicians, but we need to surround them with the right technologies and teams to ensure they can take care of a larger population at scale. Doctors are highly trained and highly compensated professionals, yet too often we devalue their time and expertise by requiring them to spend excessive amounts of time on routine care management activities – from chronic care refills to mild sinus infections and the like – instead of delegating such tasks to clinical partners that may be set up better to handle these items at scale.

This is especially true in primary care and cerebrally based specialties, where we ask office-based physicians to handle everything involved in a patient’s care, rather than dividing up that care across a team that has specialized technology around specific needs. Perhaps we can learn from our more procedure-based colleagues (e.g., surgeons, anesthesiologists, ophthalmologists, dentists) about using a team-based approach to share the care, with physicians handling the most complex patients and other providers (e.g., NPs, RNs, MAs) handling more routine care.

A better way: Outsourcing routine care to virtual partners

A re-visioned model of care would allow doctors to automate, virtualize, and delegate the numerous less-complex, routine tasks that do not need to be performed via in-person office visits. In this world, many of these activities are accomplished online by Virtualist providers and non-physician team members who are empowered to manage stable patients via evidence-based protocols and similar rules to help automate their care. By expanding access and delivering more consistent care, organizations can increase efficiencies and improve the quality of care.

Compared with traditional practice workflows, office-based physicians would actually see a smaller number of patients themselves (i.e., those with more complex care issues), while their patient panels would expand because they’d supervise a team that cares for a greater number of more stable patients. Rather than struggling to add more doctors in a competitive market, health systems could outsource routine care to a tech-empowered virtual care team and expand patient access in a scalable manner. This results in better financial performance for a health system and allows providers and the health system to focus on the more complex care that truly differentiates them in the market.

The importance of data sharing

It is important to note that health systems need to be cautious of the trojan horse phenomena if they direct patients to a third-party virtual care group that uses a separate electronic health record (EHR) platform. If clinical data and other workflows are not easily shared between the two parties, this model can lead to a fragmented, disconnected experience, creating frustration for clinicians and patients and compromising care quality, data reporting and population health management.

In contrast, a better approach is a partnership with a virtual care provider that utilizes the same EHR system, which thus supports the bi-directional sharing of clinical data, appointment scheduling, messaging, referrals and orders. This ensures that all care team members have access to the critical patient information and workflows they need to optimize care and outcomes.

The benefits of outsourcing routine care to a Virtual care partner

To understand how patients, physicians, and health systems all benefit from a model that outsources routine care to virtual partners, consider the example of a patient with a mild urgent care problem, such as a sinus infection. While not life-threatening, the patient is uncomfortable, and the condition should be addressed within a relatively short timeframe to prevent complications or inappropriate office or ER-based utilization.

In the traditional approach, the patient would call the doctor’s office for an appointment. If there are no immediate openings, the patient might decide to visit an external urgent care clinic, wait a couple of hours to be seen, and spend five minutes with a clinician. For the patient, this approach is frustrating, time-consuming and probably more expensive. And if they go to an external urgent care clinic, the health system misses a potential revenue opportunity, but more importantly risks losing the patient long-term as they start to use other facilities due to real and perceived access issues.

Alternatively, health systems want to make sure their patients always come to their front door for any type of care, from routine issues to complex situations. By partnering with a virtual care partner, they can start to ensure that access to their health system is as ubiquitous as any competition, and their quality is better due to the care coordination that ensues.

Furthermore, new technologies can make this experience faster, better and cheaper. Artificial intelligence can help with things like triage, abnormal variant detection, and note taking. Meanwhile, asynchronous telehealth visits can help provide more scalability and time-savings, while ensuring competitive offerings vs. other groups trying to create new front doors for patients.

This approach of partnering with a closely aligned virtual care partner thus positively addresses numerous workflow challenges and provides multiple benefits for doctors, staff and patients. Clinicians and staff are empowered to work at the top of their licenses, have better work-life balance, and less burnout. Meanwhile patients have improved access to care without having to travel to the doctor’s office for routine issues.

For healthcare systems seek to address physician shortages, the solution could very well be rethinking what problem you are trying to solve, and recognizing the power of working with the right virtual care partner to share the care in ways that meet the needs of both your physicians and their patients.