University of Wisconsin-Madison, 1513 University Ave., Madison, WI, United States of America.
University of Wisconsin-Madison, Institute for Clinical and Translational Research and School of Nursing, 4116 Signe Skott Cooper Hall, 701 Highland Ave., Madison, WI 53705, United States of America.
J Subst Use Addict Treat. 2023 Apr;147:208975. doi: 10.1016/j.josat.2023.208975. Epub 2023 Feb 10.
Physicians are a critical clinical resource for patient care. Yet physician recruitment has been considerably understudied, particularly in substance use disorder (SUD) settings. This study proposes a conceptual model called the "Physician Recruitment Descriptive Factors Framework" to investigate the role of environmental, organizational, and individual factors in the use of physician recruitment strategies.
The study setting was 75 sites that provided outpatient SUD treatment services in Florida, Ohio, and Wisconsin from 2016 to 2019. Central to the analysis is the use of five targeted physician recruitment strategies. The study investigated whether financial conditions, location (urban v. non-urban), external implementation coaching, and recruiters' roles influenced use of the targeted physician recruitment strategies.
During the study period, a formal plan to recruit physicians was the most common strategy used (n = 67.6 %). The director or chief executive officer (CEO) was most likely to conduct physician recruitment (n = 58.7 %). During the study, use of four of the five recruitment strategies significantly declined (at p ≤ 0.01), while the perceived need for new prescribing capacity significantly declined (p ≤ 0.01), and prescribers per site increased from 1.54 to 3.21. Sixty-four percent of this increase in prescribers was due to more physician prescribers, while 36 % was due to the onset of the ability of advanced nurse practitioners and physician assistants to prescribe buprenorphine. In year 3 of the study, the strategies most closely aligned with the current number of prescribers were conducting weekly outreach to prescriber candidates (p = .018), having a dedicated prescriber recruiter (p = .011), and having a dedicated budget for prescriber recruiting (p = .002).
The study describes which physician recruitment strategies SUD treatment sites used and how the need to recruit physicians for specialty treatment SUD clinics declined as prescriber capacity increased. The proposed multi-level framework provides the scaffolding for future physician recruitment research and practice.
医生是患者护理的重要临床资源。然而，医生招聘的研究还相当不足，特别是在物质使用障碍 (SUD) 领域。本研究提出了一个名为“医生招聘描述性因素框架”的概念模型，以调查环境、组织和个人因素在使用医生招聘策略中的作用。
研究地点是 2016 年至 2019 年期间在佛罗里达州、俄亥俄州和威斯康星州提供门诊 SUD 治疗服务的 75 个场所。分析的核心是使用五种有针对性的医生招聘策略。该研究调查了财务状况、地点（城市与非城市）、外部实施指导以及招聘人员的角色是否影响了有针对性的医生招聘策略的使用。
在研究期间，制定正式的招聘医生计划是最常用的策略（n=67.6%）。主任或首席执行官（CEO）最有可能进行医生招聘（n=58.7%）。在研究期间，有五种招聘策略中的四种使用显著下降（p≤0.01），而对新处方能力的需求显著下降（p≤0.01），每个地点的处方医生数量从 1.54 增加到 3.21。增加的处方医生中，64%归因于更多的医生处方医生，而 36%归因于高级执业护士和医师助理开始能够开丁丙诺啡的处方。在研究的第 3 年，与当前处方医生数量最匹配的策略是每周向候选处方医生进行外展（p=0.018）、有专门的处方医生招聘人员（p=0.011）和有专门的处方医生招聘预算（p=0.002）。
本研究描述了 SUD 治疗场所使用的哪些医生招聘策略，以及随着处方医生能力的增加，对招聘医生治疗 SUD 诊所的需求如何下降。提出的多层次框架为未来的医生招聘研究和实践提供了框架。
