Ameliorating Healthcare Staff Shortages with eConsults

Physician and medical staff shortages are happening across all facets of the U.S. healthcare system. Article after article discusses this challenge and offers multiple possible solutions — most of them involving additional financial or human resources.

The problem has become even more pervasive during the COVID-19 pandemic. (Keep reading for some shocking statistics on that topic.) And while not traditionally thought of as a solution, eConsults pack a powerful punch and can directly help address healthcare staff shortages.

If you’ve been reading along over the past few months, you know that this blog has covered various ways that asynchronous, provider-to-provider eConsults reduce barriers and improve access to care. So far, we’ve addressed how to improve eConsult quality to personalize care and support clinical information sharing, and even how eConsults help overcome SDoH barriers. As an expert who has spent years teaching organizations and their physicians how to effectively leverage eConsults, I believe that eConsults are an outside-the-box way to help prevent these shortages from blocking access to care.

Healthcare staff shortages have a variety of causes, and I’ll dive deeper into each of these:

• Burnout
• Job-hopping to increase salary
• Physician clustering
• Limited residency spots

Burnout Among Doctors, Nurses and Administrative Staff

If you need proof that the U.S. healthcare system is under increased human strained, take a look at this U.S. News and World Report article on healthcare burnout, which states that burnout cost the health care system about $4.6 billion a year before COVID-19. Now, the percentage of physicians reporting depression has risen from 40% to somewhere between 60 and 75%. About 20% of all health care workers have quit during the pandemic and 80% believe that shortages are affecting their work.

EConsults address burnout by helping practices run on a smaller staff. That’s because many practices that use eConsults handle more patient care through asynchronous conversations between two providers — avoiding a patient visit (and all the overhead tasks that go with it) altogether. Practices can then prioritize those patients who truly need the limited appointments available.

Sure, the burnout issue is a beast and eConsults alone are not going to solve it. But eConsults can dramatically reduce the workload of doctors, nurses and administrative staff treating referred patients.

Healthcare Workers Seeking Higher Paying Jobs

COVID has created an environment conducive to employees switching jobs for higher pay and career advancement. By some estimates, more than a quarter of workers plan to switch jobs post-COVID. Healthcare is not immune to this trend. A Fortune article from earlier this year explains that hospitals are even competing with Walmart to retain talent in roles where the store offers a higher hourly wage.

Implementing eConsults won’t translate to higher wages, but research shows that people are willing to overlook salary growth for a better work-life balance. Business Insider reports that nearly 70% of people would choose work-life balance over a pay increase when selecting a new job. EConsults can help create that balance as they save time, improve efficiency, and streamline workflows.

I’ve heard from many specialty offices that before implementing eConsults, the volume of incoming referrals was unmanageable due to the lack of an adequate number of support staff. Incoming referrals would sit for days before staff addressed them.

As eConsults are digital, they help reduce administrative clutter. In many cases, they eliminate the need for referrals altogether. Moreover, the staff saves time spent to turn over rooms between patients and sanitize them to COVID standards. For providers, eConsults offer a way to coordinate care quickly and efficiently for their patients, eliminating labor-intensive visits and follow up processes. In most cases, a provider who sends an eConsult gets a response from the consulting provider within two business days, thus allowing them to close the care loop themselves and improving care for that patient with less stress on the support staff or the physicians involved in providing care.

Physician Clustering in Metropolitan Areas

Access to specialty care has long been an issue in rural areas because of physician clustering in major cities. Providers are hesitant to work in rural communities as larger academic medical centers (which tend to be in metropolitan areas) offer more complex and challenging cases. Additionally, many rural health centers or smaller hospitals have a hard time attracting providers away from cities that offer more exciting social lives and more options.

One example is rural South Carolina, where I worked with a health center whose patient traveled four hours across town by bus to see a specialist at the nearest academic medical center. The state, which has 1.4 million rural residents, recently joined a list of four U.S. states with critical staff shortages in more than one-third of its hospitals.

EConsults tackle physician shortages by quickly and conveniently connecting providers in rural areas with specialists in metropolitan areas. That way, patients receive the best advice from physicians even when the consulting doctor is outside their local area.

Limited Medical Residency Spots Exacerbate Physician Shortages

Demand for healthcare keeps growing. Meanwhile, for those interested in becoming doctors, there are not enough spots in physician residency programs to complete their training after medical school. In this case, people want to help increase access to care, but they can’t.

The Association of American Medical Colleges reported back in 2019 that medical student enrollment had increased by more than 50%. Yet, the organization still expected a physician shortage of 122,000 by the year 2032 due to the fact that medical residency spots (which Congress controls) were only increasing 1% per year.

Recently, the Biden administration promised to add 1,000 new residency slots over five years. Still, more work is needed, and the results of this change will impact access to care slowly.

EConsults are a crucial service when patients cannot find a doctor due to a lack of trained providers in the market. Primary care providers can instead leverage the knowledge of specialists digitally to provide better patient care, while allowing specialists to provide care to vulnerable populations without increasing their patient loads. In other words, a patient benefits from high-quality specialist advice and care even if unable to schedule a specialist appointment.

COVID has worsened a pre-existing shortage of healthcare workers that will be an ongoing challenge for the industry. EConsults are a solution to that can address staff shortages, both due to the pandemic and into the foreseeable future.

While they will not solve all the problems, eConsults do provide a fast and secure option for sharing specialist-informed advice and care guidance. With provider-to-provider eConsults, patients receive the best advice from the best specialists, with the least amount of burden on support staff and providers.