Evaluation of the Encore Physicians Program

Community health centers (CHCs) serve as crucial health care access points for those with low incomes or who lack insurance. However, CHCs face persistent provider shortages and burnout that predate, and have been exacerbated by, the COVID-19 pandemic.

The Encore Physicians Program — a partnership between Kaiser Permanente, the Encore Fellowship Program and CHCs — recruits retired physicians to fill staffing needs at CHCs while providing the physicians with a meaningful work opportunity in their retirement. Starting with a pilot in early 2018, the Encore Physicians Program continues to grow and has now hosted over a dozen physicians in five health center systems throughout the Bay Area. In 2021 it began an expansion to the South Bay and San Francisco.

From 2018 – 2021, the California Health Care Foundation partnered with Engage R+D to evaluate the program. The brief (available for download below) summarizes the program’s key components, key impacts, and considerations for scaling or replicating the model in other settings. The accompanying slide deck provides a more in-depth look at the evaluation’s findings.

Key Findings

• Overall, there was wide interest from retired physicians, though not all were a good fit for health centers’ needs.
  • There was continued interest in the program from retired physicians over time, many of whom heard about the program through The Permanente Medical Group newsletter and through personal connections.
  • About half of physician applicants found placements at health centers, including during the pandemic.
  • The main reason physicians were not placed in the program is that their specialty was not needed, indicating a potential mismatch between health centers’ needs and interested physicians. A few were not placed because they were not a good fit with health centers’ mission and values.
  • While there was some concern that physicians would not be located where health centers needed them, in general there was a supply of interested physicians located within commuting distance of interested clinics.
• Overall, retired physicians and health centers have been very satisfied with the program.
  • Health centers reported high satisfaction with the matching process, Encore physicians’ quality of care, and support from the Encore Physicians Program.
  • Encore physicians reported that they appreciated the part-time schedules, that the program gave them a sense of purpose, and that the matching process was smooth.
  • Health centers are overcoming challenges such as working with Encore physicians’ part-time schedules to ensure high-quality care.
  • Encore physicians reported that the onboarding and credentialing process at health centers can be time-consuming and that it is important to find a clinic that is a good fit for their skills and time.
• Physicians helped expand workforce capacity and access to care while benefiting from their participation.
  • The ability of the Encore Physicians Program to place both primary care physicians and specialists enhances its potential to address workforce issues.
  • Some specialists — such as ob/gyns, cardiologists, podiatrists, and orthopedists — are sometimes a good fit for health centers and can fill gaps in specialized care.
  • Across the board, health centers reported receiving positive feedback from patients about Encore physicians.
  • Encore physicians reported that the placements helped give them a sense of purpose in their retirement.
• While program participation slowed at the start of the pandemic, interest in the program remained strong at the end of 2020.
  • In spring 2020, at the start of the pandemic in the US, health centers experienced a decrease in patient visits and other changes that led to lost revenues and staff furloughs. Later in 2020, the transition to telehealth improved patient access to care and health center revenues, which renewed, at least in part, the need for Encore physicians.
  • Physician interest in the program remained strong, with Encore physicians returning to their placements throughout summer 2020 and more physicians applying toward the end of the year.
  • The Encore Physicians Program made some adaptations during the pandemic, with many physicians working virtually. This shift to telehealth may provide opportunities to adapt the program.