Office of Rural Health & Primary Care
Health Workforce Analysis Program
Greater Minnesota Health Professional Demand Survey 2007
Highlights
At the beginning of 2007, hospitals and clinics in Greater Minnesota reported especially robust
demand for nurse practitioners and physician assistants. Demand for primary care physicians also
remained strong.
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•
•
•
•
Primary care accounted for more than half of all physician vacancies and recruiting activity
in Greater Minnesota.
Overall, the physician vacancy rate was 9 percent. Demand for internal medicine
specialties was a bit stronger than for primary care and other specialties.
Demand for primary care physicians was a bit stronger than in the two previous years for
primary care physicians appeared to be stronger than in 2005.
Demand for physician assistants was stronger than for physicians. The 15.9 percent
vacancy rate was up from 6.3 percent two years earlier.
The reported vacancy rate for nurse practitioners was 12.9 percent, compared to 6.3 percent
two years earlier.
Background
The annual Minnesota Health Professional Demand Survey gathers information that can be used to
assess the demand for physicians, physician assistants and advanced practice nurses in Minnesota.
The questionnaire was mailed in June 2007 to administrators of hospitals, clinics and community
mental health centers in the 80 counties outside the seven-county Twin Cities area. Responses
were received from 91 employers, for a response rate of 52 percent, compared to a 49 percent
response rate in 2006. See the methodology for more information.
The survey asked about numbers of:
•
•
•
Practitioners currently employed
Vacant positions
Practitioners being recruited.
The survey also asked about recruiting during 2006, including reasons for vacancies and how long
it took to fill vacancies.
P.O. Box 64882
St. Paul, MN 55164-0882
(651) 201-3838
http://www.health.state.mn.us
December 2007
Greater Minnesota Health Professional Demand Survey 2007
Vacancy rates were derived by dividing the number of vacant positions by the sum of the full-time
equivalent (FTE) number of vacancies and the number of FTEs currently employed. Many
respondents reported actively recruiting for more positions than they reported vacant. Recruitment
rates were calculated by dividing the number of FTE positions being recruited by the sum of FTEs
currently employed.
Surveys conducted in 2005 and before included Twin Cities area employers, but response rates
were too low to provide reliable data. Earlier surveys also included questions about mental health
professionals, but these were dropped from the 2006 survey because the sample missed too many
employers of mental health providers.
Physicians
The 91 Greater Minnesota respondents reported employing 2,903 full-time-equivalent physicians
at the end of 2006. One large employer accounted for 43 percent of these. The Office of Rural
Health and Primary Care estimates that approximately 5,500 physicians were practicing in the 80
Greater Minnesota counties in 2005.
The survey respondents said they had 168 vacancies, but were recruiting 284 physicians at the
time. The largest Greater Minnesota employer did not provide vacancy or recruitment data. For
this reason, all physician vacancy and recruitment data reported below excludes this one large
employer. Thus, while the total level of demand for physicians outside the Twin Cities is
understated, the data reported here is more representative of the situation found in most regions
outside the Twin Cities.
Primary care accounted for 56 percent of both reported vacancies and positions being recruited, up
a bit from the two previous years.
Physician Recruitment, 2007
Other
specialties, 19%
Surgical
specialties, 11%
Medical
specialties, 14%
Primary care,
56%
Greater Minnesota Health Professional Demand Survey 2007
Greater Minnesota Physician vacancies and recruiting (excluding largest employer)
January 1, 2005
January 1, 2006
January 1, 2007
Vacancies Percent Vacancies Percent Vacancies Percent
of total
of total
of total
Respondents
89
48%
34
52%
95
56%
Primary
care
22
12%
6
9%
20
12%
Medical
specialties
28
15%
8
12%
16
10%
Surgical
specialties
46
25%
18
27%
37
22%
Other
specialties
TOTAL
185
100%
66
100%
168
100%
January 1, 2005
Recruiting Percent
of total
January 1, 2006
Recruiting Percent
of total
Respondents
75
35% 68 50%
Primary
care
34
16% 13 10%
Medical
specialties
47
22% 24 18%
Surgical
specialties
60
28% 30 22%
Other
specialties
TOTAL
216
100%
135
May not add to 100 percent due to rounding
100%
January 1, 2007
Recruiting Percent
of total
159
56%
40
14%
31
11%
54
19%
284
100%
The overall physician vacancy rate was 9.1 percent. Although primary care specialties accounted
for more than half of all vacancies, the 9.4 percent vacancy rate for primary care was similar to
rates for other broad categories of specialists – slightly lower than for internal medicine specialties,
but slightly higher than for surgical and other specialties.
Respondents reported recruiting for more positions than for which they reported vacancies. The
overall recruitment rate for physicians was 14.5 percent. The strongest recruiting activity was for
internal medicine specialties, at 18.9 percent. The recruitment rate for primary care was 14.9
percent.
Economic analysts often consider vacancy rates over six percent to be high. By this standard, the
vacancy rates reported here for physicians are high. However, differences in data collection make
it difficult to compare this data to traditional government measures of job vacancies in other
occupations.
Greater Minnesota Health Professional Demand Survey 2007
Estimated physician vacancy rates, Greater Minnesota (excluding largest employer)
12/31/04
12/31/05
12/31/06
7.5%
7.4%
9.4%
Primary care
11.1%
8.3%
10.7%
Medical specialties
7.4%
7.8%
8.5%
Surgical specialties
9.4%
12.1%
8.1%
Other specialties
8.2%
8.4%
9.1%
All physicians
Estimated Physician Vacancy Rates, 2007
8.1%
Other specialties
8.5%
Surgical specialties
10.7%
Medical specialties
9.4%
Primary care
0%
2%
4%
6%
8%
10%
12%
Estimated physician recruitment rates, Greater Minnesota (excluding largest employer)
12/31/04
12/31/05
12/31/06
6.4%
13.8%
14.9%
Primary care
16.2%
16.5%
18.9%
Medical specialties
12.0%
20.2%
15.4%
Surgical specialties
11.9%
18.6%
11.4%
Other specialties
9.5%
15.8%
14.5%
All physicians
Greater Minnesota Health Professional Demand Survey 2007
Estimated Physician Recruitment Rates, 2007
11.4%
Other specialties
15.4%
Surgical specialties
18.9%
Medical specialties
14.9%
Primary care
0%
5%
10%
15%
20%
Physician vacancy rates by specialty. Vacancy rates are reported below for individual specialties
for which respondents reported information on at least 50 positions (number currently practicing
plus reported vacancies). For specialties with data for fewer than 50 positions, a small change in
the number of vacancies would significantly change the vacancy rate. Reported vacancy rates for
specialties with fewer than 100 positions should be treated with care.
Psychiatry
Orthopedic surgery
Internal medicine (general)
Emergency Medicine (FP/IM & BC)
Hematology
OB/GYN
Family medicine
Cardiology
General surgery
Diagnostic radiology
Pediatrics
Anesthesiology
Greater Minnesota
(excluding largest employer)
Vacancy Rate
Positions*
Specialty
16.8 %
78
Other
13.1%
57
Surgical
12.6%
188
Primary Care
12.5%
107
Other
11.5%
50
Medical
10.3%
79
Primary Care
8.7%
659
Primary Care
6.0%
40
Medical
5.9%
94
Surgical
5.2%
50
Other
4.8%
69
Primary Care
1.2%
58
Other
* Employed FTEs plus vacancies. Data reported only for specialties with at least 50 reported positions.
Respondents said it typically took an average of 14.6 months to fill family practice vacancies and
15.7 months to fill internal medicine vacancies. At 19.6 months, psychiatry vacancies took even
longer to fill. Too few respondents answered to permit reliable estimates for other specialties.
Greater Minnesota Health Professional Demand Survey 2007
PHYSICIAN ASSISTANTS AND ADVANCE PRACTICE NURSES
The Demand Assessment survey also asked employers about vacancies and recruitment of
physician assistants and advance practice nurses.
Physician assistants
Thirty-six of 90, or 40 percent of respondents, reported employing physician assistants. These 36
employers reported employing a total of 231 FTE physician assistants at the beginning of 2007.
One large employer accounted for 42 percent of these positions. The other 35 employers had 134
FTE positions. The one large employer did not report vacancy or recruitment data. The vacancy
and recruitment data reported below excludes this one large employer.
Only nine employers reported physician assistant vacancies. They had 25 FTE vacancies, but were
recruiting for 31 FTE positions. Excluding the largest employer (which did not report vacancy
data), the vacancy rate was 15.9 percent and the recruitment rate 18.6 percent.
Respondents reported it took an average of 7.6 months to recruit a physician assistant.
Physician Assistant Employees, Vacancies and Recruiting
Greater Minnesota (excluding largest employer)
2004-05
2006-07
61
35
Respondents
employing PAs
234
134
Employees
22
25
Vacancies
6.3%
15.9%
Vacancy rate
31
31
Recruiting
8.7%
18.6%
Recruiting rate
Nurse practitioners
Fifty-nine, or about two-thirds of all respondents, reported employing a total of 322 nurse
practitioners at the beginning of 2007. Eighty percent of these had adult or family practice
specializations. One large employer accounted for almost all of the family practice nurse
practitioners, but this employer did not provide any vacancy or recruiting data.
Thirteen respondents, or less than one in six of the other respondents, reported vacancies. They
said they had 29 FTE vacancies. Seventeen respondents said they were recruiting a total of 44 FTE
nurse practitioners.
The overall vacancy rate for nurse practitioners was 12.9 percent. The number of positions under
recruitment equaled 18.3 percent of all positions. More than two thirds of nurse practitioner
vacancies were for family practice NPs. Vacancy and recruiting rates were about twice as high as
Greater Minnesota Health Professional Demand Survey 2007
estimates for 2004-05. The 2005-06 response rate was too low to calculate vacancy or
recruitment rates.
Respondents said it took an average of 5.4 months to recruit a family practice nurse practitioner.
Nurse Practitioners, 2006-07, Greater Minnesota (excluding largest employer)
Respondents Number of Respondents Vacancies
Positions
Specialty
with
Employees
with
Being
employees
vacancies
Recruited
6
25 1
1
1
Adult
43
117 11
20
36
Family
5
11 1
6
2
Geriatrics
11
12
0
0
0
OB/GYN
9
12 0
0
0
Pediatrics/neonatal
13
18
2
2
5
Pyschiatry
57*
195 13*
29
44
TOTAL
* Some employers reported a nurse practitioner employees and vacancies in more than one category.
Nurse Practitioner Employees, Vacancies and Recruiting, Greater Minnesota
(excluding largest employer)
2004-05
2006-07
188
92
Respondents
320
195
Employees
22
29
Vacancies
6.3%
12.9%
Vacancy rate
31
44
Recruiting
8.7%
18.3%
Recruiting rate
Certified registered nurse anesthetists
Thirteen respondents reported employing a total of 168 FTE certified registered nurse anesthetists,
but most of these were associated with one larger employer. Only two employers reported
vacancies and only one reported recruitment activity.
Certified nurse midwives
Nine employers reported a total of 57 certified nurse midwives at the beginning of 2007. They
reported no vacancies or recruitment activity.
Greater Minnesota Health Professional Demand Survey 2007
METHODOLOGY
The Minnesota Center for Rural Health (MCRH) at the Rural Health Resource Center administered
the survey for the Minnesota Department of Health’s Office of Rural and Primary Care.
MCRH mailed scannable surveys to 179 health facilities located in 80 Greater Minnesota counties
outside the seven-county Twin Cities area in June 2007. The seven Twin Cities counties excluded
from the survey are Anoka, Carver, Dakota, Hennepin, Ramsey, Scott and Washington.
Reminder postcards were mailed to the entire sample after one month. Follow-up phone calls were
made to large health systems and hospitals that had not responded. Large clinics or health systems
with multiple satellite clinics were asked to complete one survey for all of their sites. Clarification
of possible duplicate reporting by organizations was verified by phone or email contact with the
administrator or recruiter.
The survey mailing list includes hospitals, clinics, health systems, mental health centers, and
Veteran’s Administration (VA) hospitals and clinics. The RHRC developed the list from
information provided by the Minnesota Department of Health, the Minnesota Hospital Association,
the Indian Health Service and the Veterans Administration.
Responses were received from 91 facilities. Four facilities reported no employees in any of the
occupations covered by the survey.
Facility Type
Clinic
Hospital
Combined Hospital-Clinic
Health System
Mental Health Center
Veterans’ Affairs Facility
TOTAL
Surveys
Mailed
71
28
41
13
22
5
180
Responses
34
7
31
6
12
1 20%
91
Response
Rate
48%
25%
76%
46%
55%
51%
The overall response rate was 51 percent. It is not known what percentage of total Greater
Minnesota employment the 91 respondents comprise. Clinics and hospital-affiliated clinics
accounted for 78 percent of respondents.