How to bring cardiologists to rural America during a physician shortage
As the national physician shortage deepens, cardiology is feeling the strain. Things are especially grim when it comes to staffing in rural America. Recruitment challenges are growing and health systems are grappling with how to attract and retain cardiologists in remote locations. Michelle Wimberly, director of physician recruitment and retention at Cardiovascular Logistics (CVL), explained that the solution starts with building relationships and a committing to long-term engagement.
“We certainly are seeing a shortage of physicians around the country,” Wimberly said. “Medicine in general, we're seeing a shortage of physicians going into medicine as well as cardiology… so the competition is fierce.”
Wimberly brings more than 30 years of experience to her role, including a long tenure at the Cardiovascular Institute of the South. She says the traditional approach to recruitment—such as posting jobs online—is no longer enough.
“Posting an ad doesn't necessarily get you the right candidate,” she said. “We try things like building relationships ... by talking with program directors and coordinators at training programs who have direct link with those fellows coming out of training."
In rural physician recruitment, peer collaboration matters
One of the most significant hurdles is staffing rural clinics, where lifestyle and the risk of isolation can be deterrents.
“Physicians want to be able to work with other physicians closely,” Wimberly said. “In the smaller rural areas, there are not necessarily a good number of physicians to work with.”
CVL addresses this by maintaining physician networks even in rural locations, enabling mentorship and peer consultation.
Virtual collaboration and efficiency
COVID-19 accelerated the use of virtual care, and CVL was prepared. This helped make the transition a breeze.
“We were set up in our virtual care center created in 2016 to be able to conduct virtual visits, so it was an easy button for us,” Wimberly said.
Virtual consults support physicians in isolated areas by giving them access to peers for clinical decision-making, a key concern among early-career doctors.
What job candidates want
In today’s recruitment market, cardiologists have leverage.
“They want the work-life balance more than ever,” Wimberly said. “They're looking for big compensation. They're also looking for a big collegial atmosphere to work in.”
CVL has been able to retain a lot of its cardiologists using this strategy.
“Many have come straight out of fellowship and are still with us... A lot of practices can't say that.”
In an era where over 90% of cardiologists are employed by health systems or private equity-backed entities, she explained that private practices have an edge because they often can offer more autonomy and mentorship.
“In the hospital system, oftentimes they're not part of the decision-making,” Wimberly said.
But she admits that it is difficult today to survive as a truly independent practice.
“The call burden is there, the reimbursement rates are lower ... It's just very hard for physicians to survive if you're not in a group setting where you have lots of support and the backing of private equity.”
Physicians also want more efficiency and jobs that help them avoid burnout. This means cardiologists want to work at the top of their license and have support from nurse practitioners and RNs who can help enable physicians to do that. They also do not want to be involved in a lot of the non-physician tasks like prior authorizations and medication refills, which are a big cause of burnout, she added.
Staffing pipeline planning is crucial
With retirements and expanding patient volumes, having candidates in the pipeline is no longer optional.
“For many years we knew that there was a shortage of physicians. I think now we're starting to feel it,” Wimberly said. “Having those people in the pipeline ... is important for the growth of our practice.”
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]