Date of Conferral
2-11-2026
Degree
Doctor of Healthcare Administration (D.H.A.)
School
Health Sciences
Advisor
Dr. Kourtney Nieves
Abstract
The increasing reliance on outsourcing of clinical roles in physician practices has raised concerns regarding continuity of care, staff morale, and organizational control over service quality. While outsourcing may offer temporary financial relief, outsourcing often introduces inefficiencies and declines in patient satisfaction. In this integrative review, I identified workforce planning strategies that reduce outsourcing reliance while enhancing organizational efficiency and patient care outcomes. Using the Johns Hopkins evidence appraisal tools, I analyzed sources published between 2022 and 2025 grounded in resource dependency and Herzberg’s two-factor theories. Five thematic areas emerged: organizational efficiency, patient satisfaction, cost management, staff morale and engagement, and strategic risk. These themes highlight the need for internal workforce development and strategic human resource investments to reduce vendor dependency. Specifically, subthemes, such as predictive workforce analytics and cross-training, are essential for building internal resilience and reducing agency reliance. Additionally, integrating ambient AI and virtual scribes reduces administrative burden and clinician burnout, thereby preserving internal capacity. Implementing these strategies mitigates care fragmentation and aligns physician practices with value-based performance goals by enhancing relational continuity and patient satisfaction. Sustainable workforce planning improves care coordination and strengthens clinical performance. These findings have implications for leadership decision-making by prioritizing internal workforce stability, health workforce policy by reinforcing retention and continuity-focused staffing approaches, and clinical practice by showing stable care teams improve continuity and the ability to address social determinants of health.
Recommended Citation
Sontag, Heidi, "Optimizing Workforce Planning to Reduce Outsourcing of Clinical Roles in Physician Practices" (2026). Walden Dissertations and Doctoral Studies. 19160.
https://scholarworks.waldenu.edu/dissertations/19160
