Graham Center Policy One-Pager

High Demand, Low Supply: Health Centers and the Recruitment of Family Physicians

 

Am Fam Physician. 2018 Aug 1;98(3):146.

Expansion of the Health Centers Program has been associated with persistent workforce challenges for this critical component of the primary care safety net. In a national survey, 69% of health centers had a family physician (FP) vacancy. Those with FP vacancies reported spending an average of 11.4 months recruiting for an FP, one of the longest recruiting periods for a clinical position.

After years of bipartisan support for expansion, the Health Centers Program collectively delivers care to more than 27 million patients in more than 10,000 predominately low-income communities—substantial growth from the 10 million served in 2000.1 A 2006 health center survey revealed that 13.3% of FP positions were vacant, which was third highest among physician positions and fourth overall.2 More than a decade later, the National Association of Community Health Centers resurveyed health centers on their clinical workforce vacancies and their recruitment and retention experiences. Of the 1,278 health centers surveyed, 499 (39%) responded. Respondents were representative of health centers nationally based on characteristics such as size, patient insurance mix, and geography.3

Results of this assessment show that clinical vacancies are still common at health centers—95% report having at least one. Vacancies for FPs are the most common, with at least one at 69% of the health centers (Figure 1).3 In addition, 51% of health centers indicate that filling an FP vacancy is their highest priority. Two-thirds of centers rate FP vacancies as very difficult to fill, and those with FP vacancies spend an average of 11.4 months recruiting for FPs, one of the longest periods reported for any clinical vacancy.3

Although health centers employ a multidisciplinary health professional workforce to meet the diverse needs of their patients, nearly one-half (46%) of all health center physicians are FPs,4 and survey findings suggest that FP supply is not meeting demand. This highlights a need for policy makers to support federal programs that create incentives and provide community-based primary care training opportunities for medical students and residents to ensure an adequate supply of FPs to staff health centers and provide care to underserved populations.

 Enlarge     Print

FIGURE 1.

Top 10 clinical vacancies reported by health centers.

LCSW = licensed clinical social worker; LPN = licensed practical nurse; LVN = licensed vocational nurse.

Other: Psychiatrist (18%), dental hygienist (16%), other licensed mental health/substance abuse staff (16%), physician assistant (16%), psychologist (9%), nonlicensed mental health/substance abuse staff (8%), pharmacist (7%), certified nurse midwife (6%), vision services staff (6%).

Information from reference 3.


FIGURE 1.

Top 10 clinical vacancies reported by health centers.

LCSW = licensed clinical social worker; LPN = licensed practical nurse; LVN = licensed vocational nurse.

Other: Psychiatrist (18%), dental hygienist (16%), other licensed mental health/substance abuse staff (16%), physician assistant (16%), psychologist (9%), nonlicensed mental health/substance abuse staff (8%), pharmacist (7%), certified nurse midwife (6%), vision services staff (6%).

Information from reference 3.

Author disclosure: No relevant financial affiliations.

References

show all references

1. NACHC, 2017. Includes patients of federally-funded and non-federally funded health centers, and expected patient growth for 2017. Bureau of Primary Health Care, HRSA, DHHS. 2000 and 2016 Uniform Data Systems....

2. Rosenblatt RA, et al. Shortages of medical personnel at community health centers. JAMA. 2006;295(9):1042–1049.

3. National Association of Community Health Centers. Staffing the safety net. March 2016. http://bit.ly/nachcworkforce. Accessed September 1, 2017.

4. Bureau of Primary Health Care, HRSA, DHHS. 2016 Uniform Data System.

The information and opinions in this article do not necessarily reflect the views or the policy of the AAFP.

This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.

A collection of Graham Center Policy One-Pagers published in AFP is available at https://www.aafp.org/afp/graham. Policy One-Pagers are available from the Graham Center at https://www.graham-center.org.

 

 

Copyright © 2018 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions

CME Quiz

More in AFP


Editor's Collections


Related Content


More in Pubmed

MOST RECENT ISSUE


Oct 15, 2018

Access the latest issue of American Family Physician

Read the Issue


Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article