Arbor Associates, Inc. has developed a market-based approach to medical staff planning. This technique will identify the number, location and type of physicians required to meet the needs of the residents of a hospital’s service area. The need for primary care and specialty physicians is expressed in terms of the ability of the communities to generate sufficient office visit volume to support their practices.
Successful recruitment and retention of primary care physicians to meet the needs of one or more communities depends on the ability of these communities to support their practices. This ability is best measured in terms of the office visit volume which each community can be expected to generate. Such a market-based approach to medical staff planning must also take into account the influence of the practices of existing physicians. Based on the location of all existing primary care physician offices, irrespective of hospital affiliation, a series of primary care service areas (PCSA) will be developed surrounding the hospital. These PCSAs will be designed to maximize patient convenience by minimizing travel time from home to the office location. For each PCSA, the model will define the geographic boundaries, the population, the number of primary care office visits and the number of full-time equivalent (FTE) primary care physicians which could be supported in the current year. Similar information will be produced for five years in the future. Projects will take possible reduction in FTE or retirement into account. In addition, for strategic planning purposes, the model will identify any potential new service areas not currently served by a primary care physician, specifying its geographic extent, population, and office visit demand.
The estimation of the number and variety of specialists which can be supported by the service area population is derived by similar market-based means. The approach is based on the assumption that specialists generally receive patients through referrals from primary care physicians.
Age/sex-specific office visit rates for each type of specialist are applied to the combined population served by the referring primary care physicians on the staff of the hospital. Alternative scenarios of medical staff composition will be prepared which reflect the strategic placement opportunities for primary care physicians identified in the first part of the study. The results will identify the number and type of physician specialists who can be supported by different degrees of aggressiveness in physician recruitment. Figures will be developed for the current population and for the population projected for five years in the future. In areas where significant increases in the elderly population (who require higher amounts of health care) are anticipated, the age-specific adjustments of this technique are particularly important.
Once complete, the Strategic Medical Staff Plan is intended as a guide for the current and future number, location, and type of physicians whose practices best meet the needs of the population. It can also be used as supportive material for recruitment efforts and as a strategic plan for expansion and/or protection of market share.