Med Journal Jan 2022 Final 2 | Page 8

Cover Story by Casey L . Penn

The Challenges of COVID-Induced Staffing Shortages Commiserations & Coping Mechanisms

Medical staffing challenges are creating a real challenge nationwide and here in Arkansas .

“ The physical , economic , and emotional toll of the COVID-19 pandemic has kept staffing issues top of mind for most medical practices . Amid worker quarantines , resignations and vaccine refusals , last week ’ s MGMA Stat poll found that nearly three in four medical practices rank staffing as their biggest challenge heading into 2022 .”
This is from a Sept . 29 , 2021 , Medical Group Management Association * article by Chris Harrop . The poll he mentioned found that “ 73 % of medical practices reported ‘ staffing ’ as the biggest pandemic challenge heading into 2022 , followed by ‘ uncertainty ’ ( 15 %) and ‘ cost / revenue ’ ( 10 %). Another 3 % responded ‘ other ,’ with answers that included ‘ Keeping up with evolving federal and state requirements , the ongoing impacts of physician and staff burnout , and patient attitudes about in-person visits .’”
In speaking to the managers of two Arkansas family practice clinics located hours apart , many of the same challenges were heard .
Courtney Salmon is the practice administrator for Family Practice Associates in Benton . The clinic has eight full-time physicians and a patient population of around 24,000 . “ We were blessed early on in that people weren ’ t leaving ,” said Salmon , who noted that unfortunately , that changed in recent months . “ When we began to see staff leave , it led to increased workload and burnout for those left behind . Unfortunately , we saw a domino effect for a while .”
Salmon reflected on the changes her clinic has experienced . “ I think that the last year and a half has drained so many people emotionally , and they have started looking at what is better for their family ,” she said . “ More people
are getting out of health care . In the beginning , my staff did whatever it took to take care of our community . They were here to knock out this pandemic … to find out who had the virus and take care of them . But that was when we thought it would be a few months . When you put your all into it , and — because of the mental aspect of it — you care for many patients that didn ’ t have the most positive attitudes towards our staff , it drains you .”
A June 2021 MGMA Data report echoed her experiences and cited a recent Washington Post-Kaiser Family Foundation poll that found nearly three in 10 health care workers had considered leaving their professions and that pandemic stress had harmed their mental health .
In response to staff leaving , Salmon reported the clinic had to step back and ask , “ Okay , how do we retain the staff we have versus facing the challenges of recruiting ?”
Throughout the pandemic , recruiting has been difficult for clinics
changed in a big way . “ We ’ ve made some changes to our pay scale , but we can ’ t compete with what hospitals are paying right now , so we ’ ve just refocused our efforts on retention .”
Fortunately , Salmon has recently filled several positions . “ Three weeks ago , I was down three clinical employees and had three out on medical leave . Now , I only have two or three clinical positions open and one non-clinical .”
Even with recent hires working out well ,
Salmon remains on guard , a feeling shared by fellow clinic managers , especially in relation to nursing staff . She added , “ We ’ re up against the same thing as other clinics , so we ’ re all just stealing from each other . I hate to use that word , but we are . Those I got came from somewhere , and mine are going somewhere . Every time I hire one , I feel bad because I know what it ’ s like to lose one .”
Pete Atkinson , CEO of SAMA
Healthcare Services in El Dorado , understands well what Salmon has experienced . SAMA serves
like FPA – much more so than in past years . “ Normally , I could open
Pete Atkinson
close to 23,000 patients and has seven full-time physicians and
a position and have 30 to 100 applicants , depending on the role ,” explained Salmon . “ Now , we ’ re not getting the applicants , and the hardest thing for us has been the number of noshows to interviews . I ’ ve had more no shows than people show up . They will apply , schedule the interview , and then no-show the interview . We ’ ve even hired people , have them accept the offer , and then just not show up to their first day . Some of that , I think , is more recent because everybody ’ s hiring . The people that want a job are interviewing at more than one place and taking the best offer .”
At its worst staffing shortage , FPA was down to almost 50 % of its clinical staff . At the same time , the clinic ’ s reimbursement rate hadn ’ t
seven nurse practitioners . While he ’ s been fortunate to keep up his physician staff ( even gaining a physician during the pandemic ), staffing in other areas – particularly nursing – has been a challenge . Before the pandemic , he kept a stack of applications from those eager to join the popular , team-based approach clinic ; today , he struggles to get applicants regardless of openings .
“ When COVID hit our area , we had an influx in hospitalizations . We didn ’ t have enough nurses , so the hospital started using LPNs – something they had not done before ,” Atkinson recalled . “ They offered up to $ 6 more per hour than we could pay , and in the market , that forced us and other doctor ’ s offices to
152 • The Journal of the Arkansas Medical Society www . ArkMed . org