As the physician shortage mounts, many leaders have found the number of physicians in leadership positions has also dipped.
Nari Heshmati, MD, who was recently named Fort Myers, Fla.-based Lee Health's Physician Group's chief physician executive, joined Becker's to discuss this decline and what can be done to mitigate it.
Questions: Why are fewerphysicians taking leadership roles?
Dr. Nashi Heshmati: I talk to my colleagues about this a lot. Unfortunately, between the COVID-19 pandemic and the different stresses in healthcare, we had a lot of seasoned leaders around the country who have decided to retire. They've done so at a pace that's far greater than we've been able to recruit new ones. We need people to get in, establish themselves, while also being a good clinical leader. But then, there's the added layer of learning healthcare leadership and understanding how these complex systems run. When you consider integrated delivery systems that may cross more than one state, or hospitals and outpatient groups together, that often requires additional training. I went back and got my MBA, as did a lot of my cohort. It's going to take years to build that leadership bench, which is quite shallow right now. Just like there's a shortage of physicians, there's a significant shortage of physician leaders. Without good leadership, it's going to be really hard to navigate the challenges of the healthcare system.
Q: Why is it important to have physicians in leadership positions?
NH: Physicians look at it from a care model standpoint. They got into healthcare to take care of patients, and that’s the lens they use in a leadership role. It's not just about spreadsheets and numbers; they want to ensure that if they or their family need healthcare, it will be provided. If we don't have physician and clinician leaders, there will be a gap, and the care model may not develop ideally. The concern right now is that there are so few physician leaders around the country that the scope of work they have to oversee makes it difficult for them to innovate. We need a larger cohort focused on innovating and developing the next healthcare model. Healthcare is unique in that everyone will go through the system multiple times.
Q: What is needed to abate this shortage?
NH: To mitigate the shortage, we need to stop the bottlenecks in developing physicians and clinicians. It's a challenge to go from state to state due to licensing processes, and while we've expanded medical school spots, we still don't have enough residency spots, particularly in primary care. Those shortages will persist unless we address these bottlenecks. We also need to figure out how to reduce the financial burden on medical school graduates, who may come out with $300,000 to $500,000 in debt, limiting their ability to work in high-need areas. Additionally, we need to fix the reimbursement and care delivery models. Right now, the system incentivizes more and more care instead of high-value care, and even in areas where high-value care is pursued, the rules change rapidly, making it difficult for systems to adapt.