As the winter season approaches, with its snowy days and freezing temperatures, the snowbirds fly south, causing staffing headaches for area hospitals and healthcare organizations who must accommodate for the influx of these seasonal residents. With origins in the northern regions, a snowbird is not of the feathered sort you typically spot flying south for the winter. Snowbirds are retirees who escape the winter season by migrating to warmer climates in the southern states for the months of October to April. During the snowbird season, southern states experience a flood of seasonal residents. For example, in Florida during the 2012 season the U.S. Bureau of Census estimated 9,240 snowbirds in Jupiter, 6,310 in Palm Beach, and 143,837 in Palm Beach County. Such a drastic increase of seasonal residents has a number of effects on the surrounding community and economy, including increased patient volumes for area hospitals, clinics, and practices. Healthcare organizations in the destination southern states typically see 30 percent more patients during these months, according to Willa Copelin, a medical assistant at Jupiter Medical Center. In conjunction with the snowbirds, the flu can also increase patient volume between 25-30 percent, depending on the severity of the illness in any given season. Considerations such as these make it extremely important for healthcare organizations to have a plan in place to ensure they can continue to provide quality care to their communities. A seasonal staffing plan could include extending hours, juggling the schedules of full time physicians, and bringing in per diem or locum tenens physicians, physician assistants, and nurse practitioners to supplement full time providers. Snowbirds Require More Healthcare Services Snowbirds are typically 65 years or older, and they often arrive to their part-time residences with a number of healthcare concerns. By age 65, around two-thirds of all seniors have at least one chronic disease and see on average seven physicians throughout the year. Twenty percent of that population range has five or more chronic diseases, sees 14 or more physicians, and averages 40 doctor visits each year. The seasonal increase in older, sicker patients means that hospitals and healthcare organizations in southern states will be faced with more complex cases, placing further strain on already overextended healthcare providers. Seasonal Census Increases Lead to Physician Burnout Appropriate staff levels will guarantee adequate patient to provider ratios, which is important for the emotional and mental state of healthcare providers. Hospitals that are short-staffed often require existing providers to pick up additional shifts. However, 81 percent of physicians already feel they are at the limits of their practice, not even taking into account seasonal census increases. Maintaining a work-life balance reduces stress levels, increases focus and concentration levels, results in higher job satisfaction, stabilizes physician turnover, and results in greater patient satisfaction overall. Without preparing for increased patient volume, physician burnout becomes a concern during the snowbird season. Physician burnout is described as a “pervasive healthcare problem characterized by a loss of emotional, mental, and physical energy due to continued job related stress.” One of the effects of physician burnout is “depersonalization,” or rather, “the tendency to see your work negatively, without value, or meaningless.” Such depersonalization has widespread results, including increased medical errors, lower patient satisfaction with medical care and patient compliance with treatments, and increased rates of physician substance abuse, depression, and turnover. How to staff for Seasonal Surges Understanding the seasonal trends in a given region will allow healthcare administrators to plan ahead for staffing challenges, prevent physician burnout, and meet patients’ needs head-on. Obinna Egbo, MD, the Phoenix regional medical director with IPC The Hospitalist Company Inc., told Today’s Hospitalist that during seasonal upswings, they had “between three and five doctors every day, each responsible for between 18 and 20 patients…but only two or three doctors worked on the weekends, each carrying between 35 and 40 patients.” With the so called “ sweet spot” of patient to hospitalist ratio at 15-1, adding temporary staff during the summer months allows physicians to more effectively provide care to patients, without feeling stressed, overextended, and burnt-out. However, in a nation already in the throes of a physician shortage, meeting these needs may not be a simple feat. It is illogical and unnecessary to staff full-time employees (FTE) year around in preparation for the snowbird season. Turning to organizations skilled in delivering part-time, qualified providers on an as-needed basis is a great solution to maintaining patient care and allowing FTE providers time to recharge. While there is no way to accurately predict how much a state’s census will fluctuate season to season, healthcare organizations can look to past seasons to help formulate a staffing plan. Locum tenens is an excellent option for healthcare organizations with seasonal staffing needs as it allows them to increase staffing levels without asking existing staff to pick up additional shifts. It is even possible for healthcare organizations to utilize the snowbird season to their advantage, as snowbirds themselves could be willing to pick up extra shifts during their stay. Catherine Polera, DO, MPH, chief clinical officer for the Division of Emergency Medicine at Sheridan Healthcare, states,
“Usually, we increase our coverage by day or by hour as trends dictate. Many times, our own doctors will pick up extra shifts, but we also employ part-time doctors, who may also be snowbirds themselves. I’ve been talking to more of those doctors who are getting really sick of cold weather and looking at ways to change their lifestyle. Some emergency medicine doctors have work that allows them to be almost semi-retired and contract part-time in warmer climates. Also, many more doctors are calling me, saying they wouldn’t mind taking shifts in the winter, or downsizing their shifts and coming to Florida.”
Many top healthcare organizations have established relationships with locum tenens companies so they can quickly bring on additional physicians, physician assistants, and nurse practitioners when unforeseen staffing needs arise. Such preparation reduces patient wait times, alleviates overextending current staff, and reduces the risk of medical errors. For more information on how locum tenens can assist your organization this winter, please visit Barton Associates’ Hospital, Practices, and Companies section.
