New Report Shows Demand For Psychiatrists at an All-Time High... 'Silent Shortage' of Mental Health Specialists a Looming Crisis


IRVING, TX July 15, 2015 – Demand for psychiatrists is at an all-time high, according to an annual report tracking physician recruiting trends.

Prepared by Merritt Hawkins, the nation’s leading physician search firm and a company of AMN Healthcare (NYSE: AHS), the 2015 Review of Physician and Advanced Practitioner Recruiting Incentives tracks the 3,120 physician and advanced practitioner recruiting assignments the firm conducted from April 1, 2014 to March 31, 2015.  Now in its 22nd year, the report indicates that Merritt Hawkins was retained to conduct more searches for psychiatrists in the prior 12 months than in any other similar period in its 27-year history. Psychiatrists trailed only primary care doctors on the list of the firm’s 20 most in-demand medical specialties.

“Psychiatrists are aging out of practice at a time when demand for their services is spiking,” said Kurt Mosley, vice president of strategic alliances for Merritt Hawkins. “Finding a psychiatrist willing to practice in an inpatient setting is like looking for a needle in a haystack.”

The federal government has designated 3,968 whole or partial counties as Health Professional Shortage Areas (HPSAs) for mental health, Mosley said, defined as areas where there is less than one psychiatrist per 30,000 people. It would take 2,707 health professionals to remove these designations. In Texas alone, 185 of 254 counties have no general psychiatrist, according to a separate Merritt Hawkins report. Disparities by state are dramatic. While Massachusetts has 18 psychiatrists per 100,000 population, Idaho has only five. Approximately 48 percent of psychiatrists are likely to retire over the next five years, Mosley said, with few available to take their place.

“Mental health is a topic that the health system and patients themselves often avoid,” Mosley said. “For that reason, psychiatry can be considered the ‘silent shortage,’ even though shortages in psychiatry may be even more acute than they are in primary care.”

King v. Burwell and doctor demand

The recent Supreme Court decision in King v. Burwell will keep healthcare reform on its current trajectory, boosting demand for certain types of physicians, according to the Merritt Hawkins report. Emerging delivery models promoted by the Affordable Care Act (ACA), which was upheld by King v. Burwell, encourage the use of healthcare teams led by primary care physicians. These teams include physician assistants (PAs) and nurse practitioners (NPs) and may incorporate physicians who provide women’s health or who manage chronic diseases.  

The Merritt Hawkins report indicates that demand for primary doctors, PAs, NPs, obstetrician/gynecologists, and physicians who manage chronic illness, such as psychiatrists, pulmonologists, and cardiologists, all increased over the previous year. Implementation of population health management through integrated systems such as accountable care organizations (ACOs) is likely to keep demand strong for these types of clinicians, Mosley said.       

Physician Employment and Value-Based Incentives

The Merritt Hawkins report indicates that the prevalence of private, independent physician practices continues to decline. Only about five percent of Merritt Hawkins search assignments in the previous year featured an independent practice setting, while 95% featured employment by a hospital, medical group, urgent care center, Federally Quality Health Clinic (FQHC) or other employer.

The new report also suggests that the use of value-based physician incentives has stalled.   Of those clients offering physicians a production bonus last year, only 23% based the bonus in whole or in part on value-based metrics such as patient satisfaction, compared to 39% two years ago. Despite the national movement from volume to value based payments, Merritt Hawkins’ report indicates that physician compensation continues to be driven by volume based metrics such as relative value units (RVUs), patient visits, and net collections

An infographic previewing results of Merritt Hawkins’ 2015 Review of Physician and Advanced Practitioner Recruiting Incentives can be accessed at http://bit.ly/1IWf0qr and a complete report can obtained by calling Kurt Mosley at 469-524-1446.