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We sit down with Patrick Hunt, a physician executive, to explore one of the most pressing challenges in U.S. health care—the growing physician shortage. With projections indicating a shortfall of up to 86,000 doctors by 2036, Patrick shares his insights on how workforce management technology can help mitigate this crisis. We discuss how these innovations optimize staffing, improve physician well-being, and maintain quality care, especially in underserved communities.
Patrick Hunt is a physician executive.
He discusses the KevinMD article, “Prescribing data and efficiency: Harnessing technology to alleviate the physician shortage in the U.S.”
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Patrick Hunt. He’s a physician executive. Today’s KevinMD article is “Prescribing Data and Efficiency: Harnessing Technology to Alleviate the Physician Shortage in the U.S.” Patrick, welcome to the show.
Patrick Hunt: Thanks, Kevin. Appreciate it. Happy to be here.
Kevin Pho: So let’s start by briefly sharing your story and journey.
Patrick Hunt: Yeah, so I’m a emergency physician, trained at Chapel Hill, did my residency at Palmetto Health Richland—or it was Richland, I guess, at the time—and I joined a private group. I went back to Duke to get my MBA in’ 06-’07, or’ 05-’06, I think now. Came out of that and took over sort of managing our private group. Did that for another 13, 14 years. And then we rolled into our larger medical group. I took over as chair and then moved to an executive chair over all of emergency medicine. And as of about six weeks ago, I took the acute care CMO role. So I’ve got radiology, pathology, anesthesia, hospitalist, and emergency medicine, so about 1,100 physicians in that role.
That’s my clinical side. I’ve always had sort of an IT background. I started a software company back in ’07 called Shift Admin with a partner and grew that for about 13 years and then sold that to QGenda back in 2020. And so I serve as the chief medical officer for that company and am working as a chief medical officer for a small ambient AI company called Clio Health as well.
Kevin Pho: All right, so we’re going to talk about one of those intersections today: “Prescribing Data and Efficiency: Harnessing Technology to Alleviate the Physician Shortage in the U.S.” Tell us the events that led you to write this article in the first place, and then, for those who didn’t get a chance to read it, tell us about the article itself.
Patrick Hunt: Yeah, I think at a very high level, I mean, it’s not a surprise to anybody who hasn’t been living under a rock that we’re at risk of having a pretty significant provider shortage coming up in the next number of years just based on the volume of the population that’s coming into that age group that’s going to need a lot of health care and the number of people that we have available to provide that service. So, from the standpoint of my software side, we’re looking at tools to really be able to operationalize the efficiencies that software can provide to help in a small way to alleviate that problem.
When I look at it from two different lenses on my clinical side, I realize, why does it take so long to get a provider from when we say, “Yes, we’d like to hire this provider,” until they’re seeing their first patient? A lot of that can be solved with software and allows us to utilize the resources that are very limited in the most efficient way possible. That’s kind of what we talked about in the article.
Kevin Pho: All right, so tell me more. Tell me in more detail how software can help alleviate some of those delays.
Patrick Hunt: Yeah, so I think the idea is that visibility into the process—particularly on the credentialing side—is key. The credentialing side needs visibility into how long it takes and all the tasks that are required to go from, “Hey, I’d like to change jobs,” to “I’m seeing my first patient.” You know, we may have 60 or 70 different touch points through the process in a large organization, and without visibility, it’s very easy for that process to get bogged down.
So, finding ways to have all the affiliated and important parties be able to see what’s going on at any given time, to know, “Hey, we’ve got a roadblock here,” or “We’ve slowed down on this part.” Also, doing it in a fashion that’s automated and helps flag, “Hey, this position or this part of your process has not been done in a few days. We need to check on that and get moving.” So, that piece on the credentialing side is important. Making that operationally efficient is so important.
On the scheduling side, you know, that’s sort of where I grew up. There’s another entire piece that involves building optimal schedules so that you utilize your resources as efficiently as you can and don’t wear them down. I mean, everyone who works in health care and has shift schedules knows this is sometimes just a painful process. And unfortunately, particularly in hospital medicine, emergency medicine, and so forth, you have to have somebody there 24/7—got to be available. So we have to figure out the best way to build those schedules in the most efficient and balanced way so that providers are still able to do the things that they want to do and we’re able to get the shift coverage that we need. It’s, you know, when we look at it, it’s basically a math problem. And it’s a massive, massive math problem. In our group, on the emergency medicine side, we have 30-plus physicians for one facility with 13 shifts and a lot of different requests and parameters. That number of possible combinations for that schedule is well into the trillions.
So, doing it efficiently is incredibly important.
Kevin Pho: So, let’s talk about those individually. First, you talk about the credentialing side. You said there are 70-plus different touch points, and what you’re mentioning is some transparency in terms of the status as one becomes credentialed. For those who aren’t familiar with that world, how long does it normally take for a physician to be credentialed in a large system? And then tell us about some of those touch points. What are some of the roadblocks that make it take so long?
Patrick Hunt: Yeah, so you start off and go through the initial offers and contracting piece. Then you’ve got the recruiters, the interview process, and you say, “OK, I’m interested.” That moves to legal. And depending on your organization and where I am now, we can have a situation where there’s got to be seven signers for a contract to get all the way through the process. So each one of those is a piece of it. And that’s just getting the contract side.
Once you get that, you say, “OK, you’re coming in.” Then you have all the credentialing paperwork. Depending on the organization and how many different med staffs you might have at places you’re working at, you may have multiple different documents and multiple different med staffs that you’ve got to get paperwork filled out. You go through that process and then have the actual privileging and payer enrollment side of things. So, you fill that part out with all of the different insurance companies that require particular payment and verification for you to get paid or for your facility to get paid for that.
And then, beyond that, you think, “Hey, I’ve made it.” And then you realize, “Oh no, actually I have to get my health form and do my background screening. I’ve got to make sure my vaccinations are up.” It just keeps going and going and going. It’s easy with that many steps for things to fall through the cracks. And sometimes, if it falls through the cracks, it might sit there for an extended period of time.
We’ve seen it where it’ll take 120 days to get somebody credentialed. Optimally, if you do it with software, you can get those times down to 30 to 60 days because you’ve sped the process up. And that gives you 30 to 60 days more to be able to utilize that provider to take care of patients.
Kevin Pho: And in terms of what the standard is, do the majority of major institutions use technology-based solutions like the one you’re describing?
Patrick Hunt: Yeah, so most of them, the vast majority, are using technology. At the same time, particularly in the credentialing space, we went from a paper world to the phase one versions of software that a lot of organizations still use, and they’re very clunky. They don’t have the kind of efficiencies that we’re talking about. They don’t have dashboards and things that make it easy for all the interested parties to see where things are going.
They’re almost like comparing old DOS systems to current levels of computers.
Kevin Pho: All right. Now, the next piece you talked about is how technology can facilitate scheduling. Are we talking specifically in the emergency department? Are we talking about outpatient facilities? Talk more about how technology can facilitate that scheduling and best utilize the workforce that we have now.
Patrick Hunt: Yeah, I think it’s all of the above. It’s any shift-based scheduling, any task-based scheduling, whether it be anesthesia, radiology, hospital medicine, emergency medicine— all of those sorts of specialties have unique challenges to how they do their workflow and what their schedule setup is.
Some of them, like anesthesia, come in and they work until the work is done. Emergency medicine and hospital medicine are very shift-based—you work from this time to this time, and then you’re done. The outpatient world, we certainly do as well, and that’s, again, scheduling for cardiology or neurology or so forth. It’s about looking at what resources we have available in terms of providers and even looking at room utilization. We look at some room management stuff. OK, we have this facility, it’s got these rooms, we can optimally schedule this physician for this particular day in this particular location to get the most out of our current setup at our facility.
The complexity of the math problem that we’re solving is immense.
Kevin Pho: And is that not happening regularly? Are people still using pen and paper? Do most organizations not use some type of algorithmic or technological approach like you’re describing?
Patrick Hunt: Yeah, there is a very broad spectrum. There are people still using paper—not many anymore. There’s a lot of people that are using Excel. That being said, there’s a very, very large contingent using software, ours being one of the biggest ones in that space.
So I think we have made really good progress in the scheduling space, using technology to help us. And now it’s just a matter of refining that. The software also gets better and better as we move along and continues to improve in the same way that the AI technology continues to improve. It’s just going to get better and better over time.
Kevin Pho: Now, can you tell us a case study, maybe a before and after picture, where a hospital system— and it could be hypothetical—what their situation was before implementing some of these technological solutions and then their situation after, and how that optimized their workforce and perhaps alleviated some of their provider shortages?
Patrick Hunt: Yeah, I’ll give you just a couple of little anecdotal ones. One is a group that was on a templated schedule. So they were like, “OK, you work this 12-week block,” and they just set lines. So they had everything set, and then every 12 weeks, you just step down a line, step down a line.
It’s nice because you sort of know, “This is my schedule,” and you could work it out and figure out what you were going to be doing six months out. The problem was if you have any kind of event or any flexibility that you need, you don’t have that. I know when that group was going live, there were several folks that were a little hesitant, saying, “Oh, we’re going to move off of our template. We loved our template.” It’s just change management to some extent, but within a few months, we heard back that some of the folks that were older and maybe the big sort of naysayers in the tech were like, “Wow, this is awesome. I needed all these days off and normally I’d have to figure out all these trades, and it was just done.” It was like, you just requested those days off and they were done.
So provider satisfaction is a big piece of getting a good scheduling system in place.
On another example, on the hospital side, we implemented some software in place, and they had been at that point in time using an Excel spreadsheet. It was a busy multi-hospital system, and they were staffing and looking, and they were actually trying to recruit a couple of other positions in.
What we were able to do is look at their capacity, what they had and what they needed to cover, and using this algorithmic approach, we put together a system where they could see very quickly, “Oh, if we just actually scheduled more efficiently, we only need one provider.” The ROI on that is like, well, we just saved $300,000 because we don’t actually need another provider. We can just schedule these people more efficiently so that we get the best, most use out of what is the most valuable resource that they have. It’s true of any health care system—it’s the people that you have working there.
Kevin Pho: So what do we have to look forward to on the horizon in the next, say, year or so when it comes to these workforce management technologies?
Patrick Hunt: Yeah, so I think they will continue to get better and better in terms of ease of use as we kind of learn and solve problems. Instead of having to fill out the same piece of paperwork and sign your credentials form 12 times, it’s all just done seamlessly, and it moves through the system much, much quicker.
I think even further down the road, there’s potential that we can build systems where credentialing as we know it changes. You come through and get credentialed, and then you continue with just your continued professional practice evaluation stuff, and you don’t ever actually recredential—almost the way we do our board certification now. It used to be, take a test, and then you wait 10 years, and you’re like, “Oh man, I’ve got to go relearn all this stuff about the TCA cycle that I forgot.” OK, go back and learn it, which wasn’t very efficient.
Now we have this kind of continuous process, and I think we’re going to do the same thing with credentialing over time, where that becomes just a very seamless process. It’s just a continual process, and when there are issues that pop up, you address them and then just keep moving.
Kevin Pho: We’re talking to Patrick Hunt. He’s a physician executive. Today’s KevinMD article is “Prescribing Data and Efficiency: Harnessing Technology to Alleviate the Physician Shortage in the U.S.” Patrick, let’s end with some of your take-home messages that you want to leave with the KevinMD audience.
Patrick Hunt: Yeah, I think the things I would tell folks is, don’t be afraid of technology. At the stage we’re in now, it’s time to embrace technology. Health care as a general rule tends to lag behind industry in its adoption of technology for good reason in some places, just because we deal with a lot of very sensitive data and so forth. But the advantages that organizations and individual physicians can glean from utilizing technology efficiently are massive. So I really just encourage people to not be afraid to take a look at the latest and greatest.
Kevin Pho: Patrick, thanks again for sharing your perspective and insight. Thanks again for coming on the show.
Patrick Hunt: Thanks, Kevin. It’s great to be here. Appreciate it.
