Community Clinics Seeing more Patients, but Hiring Staff is Difficult

Patients and providers at the Metro Community Providers Network walk-in clinic in Aurora, Colo., on Friday afternoon, June 20, 2014. The expansion of Medicaid and new funding from the Affordable Care Act has increased the number of patients visiting public health clinics, but the clinics are facing a shortage of doctors and other medical staff.

Joe Mahoney / Rocky Mountain PBS I-News

Patients and providers at the Metro Community Providers Network walk-in clinic in Aurora, Colo., on Friday afternoon, June 20, 2014. The expansion of Medicaid and new funding from the Affordable Care Act has increased the number of patients visiting public health clinics, but the clinics are facing a shortage of doctors and other medical staff.

The section of the safety-net clinic at Wadsworth and 29th Avenue in Wheat Ridge designed for mobility-challenged seniors and people with developmental disabilities is a testament to thoughtful planning. Huge windows let in natural light, there’s a place to leave bulky equipment during appointments, and double-wide bathroom doors make wheelchair access easy.

The stage is set to take on the wave of aging baby boomers in the area, including those newly insured by Medicaid.

Just one problem: There’s no doctor.

This wing of Jeffco Family Health Services Center has sat empty for a year, as the efforts of Metro Community Providers Network to recruit a qualified internist have come up blank.

“We haven’t gotten any resumes,” says MCPN’s Chief Executive Dave Myers. “Not even a nibble.”

The increased use of clinics like the MCPN's in North Aurora have led a need for more staff, but hiring is difficult. “We haven’t gotten any resumes,” says MCPN’s Chief Executive Dave Myers. “Not even a nibble.”

The increased use of clinics like the MCPN's in North Aurora have led a need for more staff, but hiring is difficult. “We haven’t gotten any resumes,” says MCPN’s Chief Executive Dave Myers. “Not even a nibble.”

The underused facility illustrates a major challenge of the healthcare reform era, as a doctor shortage hampers efforts to meet a new surge in demand for services. Some famous Colorado ski counties need to boost their roster of primary-care physicians by 30 percent to meet the needs of their population, according to a study earlier this year by the Colorado Health Institute, while parts of eastern Colorado will have to triple their number of doctors to meet the need.

But the problem isn’t limited to these regions. Urban areas of El Paso and Douglas counties are also running short—particularly of doctors willing to accept Medicaid.

MCPN, a network of 21 safety-net clinics in the metro area, has hired 10 full-time staff in the past year, says Myers.

But he estimates that it needs to hire another 40 doctors, nurses and other staff to meet growing demand.

MCPN’s clinics have historically served uninsured people, but its patient mix is changing. Around half of the network’s patients are now covered by Medicaid, up from 30 percent a year ago. Next year, the percentage of patients covered by Medicaid is expected to go up to 60 percent. The expansion of public insurance in the state has also attracted new patients.

Community health centers across the state tell similar stories, as people seek out their services at a growing rate. Sunrise Community Health, a network of clinics in northern Colorado, is expecting to serve 34,000 patients in 2014, up from 11,000 in 2000, according to CEO Mitzi Moran.

The expansion of Medicaid and new funding from the Affordable Care Act have proven a boon for these clinics in many ways. Along with its new facility in Wheat Ridge, MCPN has opened a walk-in clinic and has plans for another one. Other community health centers, too, are offering expanded hours and opening new sites.

But their growth has been limited, as the pipeline for doctors has slowed to a trickle.

The expansion of Medicaid and new funding from the Affordable Care Act have proven a boon for these clinics in many ways.

Joe Mahoney / Rocky Mountain PbS I-News

The expansion of Medicaid and new funding from the Affordable Care Act have proven a boon for these clinics in many ways.

Gigi Darricades is chief executive of Valley-Wide Health Systems, Inc., which operates in the San Luis and Arkansas valleys. She says providers’ salaries have gone up 10 percent as doctors and mid-levels – including nurses and physicians’ assistants – see competition for their services.

Recruitment is often toughest outside the metro area. Doctors or nurses may be willing to dedicate themselves to rural health, but their spouses need work, too. Darricades said Valley-Wide finds itself trying to help the husbands and wives of providers find jobs in order to attract and retain staff.

Myers and Moran also look for non-monetary ways to compensate employees. Loan repayment can be an attractive option for recent graduates. Moran says she stresses the mission of providing health care to underserved communities, and work-life balance.

Similarly, Myers says the after-hours providers at MCPN’s walk-in clinic in Aurora gets more time off, and appreciate the help of extra support staff.

Even these perks aren’t enough to unclog the hiring bottleneck.

“At a provider a month,” says Myers, “we’re looking at 40 months.”

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