Hospitals say lack of certainty over universal health care hurts recruiting


MONTPELIER -- Sen. Kevin Mullin is floating the idea of a statewide symposium to help hospitals and health systems refine their recruitment pitch to clinicians regarding Vermont's planned universal health care program.

The Rutland Republican said last week that universal health care would greatly expand access to health coverage and result in increased demand for services.

Vermont's hospitals, especially those serving rural populations, already struggle to recruit medical professionals, and Mullin said he wants to make sure they're ready for a spike in utilization.

Human resources executives from three Vermont hospitals testified that they aren't always able to answer questions from potential employees who want to know how the state's health care reforms will impact the jobs they're considering.

"How can we sell 2017?" asked Jennifer Archambault, vice president of human resources at Copley Hospital in Morrisville, referring to the anticipated date of Vermont's transition to a universal health care system.

"What will that mean as we're having real conversations with people who are interested (in coming to work in Vermont)?" Archambault wanted to know.

In turn, Archambault and the others said they don't have a clear picture of how their staffing will need to increase or change under a universal health care system.

"I don't really know enough about the upcoming changes to really start to proactively work on recruitment," said Robert Patterson, vice president of human resources at Central Vermont Medical Center in Berlin.

Vermont is working on how to answer those questions, but Mullin expressed concern that the state isn't actively sharing that information with the human resources departments at hospitals.

"We haven't really focused on what the state's efforts are yet, but it sounds like the people in the trenches aren't aware of efforts to make sure we have the proper work force ready for 2017," he said.

The state has a workgroup focused on ensuring Vermont has the necessary health care work force to make the transition to a universal system.

It is one of seven workgroups that are part of the state's Health Care Innovation Project, which was launched last year with a $45 million federal grant.

The work force group is charged with gathering data to assess what additional needs a universal health care system will create and how the state's providers can meet that demand.

Mullin suggested a conference that would gather recruiters and human resource executives from all 14 Vermont hospitals, and give the state the opportunity to outline how utilization is likely to change and how hospitals can best answer questions from clinicians considering jobs in Vermont.

The Senate Economic Development Committee will continue to gather testimony this week from stakeholder groups and those working on the innovation project.

Laura Gunn, vice president of human resources at Fletcher Allen Health Care in Burlington, said her hospital has roughly 7,300 employees, including 600 physicians and 300 residents, or physicians-in-training.

Fletcher Allen hired 790 people in 2013, and filled close to 350 positions internally, Gunn said.

She is actively looking to fill 150 positions, 40 to 50 of those are for physicians. It's most difficult to recruit specialists, such as neurologists, rheumatologists and certain surgical specialties, Gunn said.

Patterson, at Central Vermont Medical Center, echoed Gunn's comments.

"Specialists are a group that we need to recruit on a national level," Patterson said, "Sometimes you can get lucky on a regional level, never on a local level."

He said they have an easier time recruiting primary care physicians.

Archambault said the challenges are magnified for the state's critical access hospitals, which serve Vermont's rural communities.

"In our case, you have to drill down even further because not only do they have want to live in Vermont, they have to want to live in an area where a number of different services and activities could be upward of an hour away," she said.

Even when they do find an interested candidate, if that person has a spouse or significant other, it can be hard to find work or volunteer opportunities for them, Archambault said.

She works with the local chamber of commerce, the Department of Labor and even cold calls recruiters at businesses in the field of an interested doctors spouse to try to make the placement work, Archambault said.

Attrition due to the state's aging health care work force is also a problem for hospitals, the human resources executives said.

"As we look at an aging work force, the number of entrants isn't keeping pace," Archambault said. "There's not the same level of competence and educated people coming into the work force in health care,"

It's not just new physicians that are hard to recruit, she said, Copley has difficulty finding critical care nurses as well as physical and occupational therapists.

Given those challenges, it's important for the human resources departments at hospitals, who are on the front lines of shaping the health care work force, to know the state's latest estimates on how reform will impact their organizations.

"We need some sort of idea of what that will mean to us on a really operational level," Archambault said.


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