How the nursing shortage will affect private physician practice

As a physician, it’s impossible not to have heard about the rising nursing shortage.

It’s old news at this point, and the less talked-about but no less serious physician shortage feels like it hits closer to home. What should have alarm bells ringing, however, is that the nursing shortage is going to impact the ability of private physician practices to staff nurses.

According to the U.S. Bureau of Labor Statistics (BLS), physician practices are the health care settings that employ the most nurse practitioners, and these settings come in second for registered nurses (RNs) and fourth for licensed practical/vocational nurses (LPNs/LVNs). Thus, private physicians should take note and plan.

What is driving the demand to outpace the supply?

Several factors contribute to the nurse shortage problem, not least of which are nurse burnout and nursing program capacity limitations.

However, there are two significant factors that are intrinsically linked: the aging baby boomer generation with the subsequent increased demand for health care services, and the Centers for Medicare & Medicaid Services (CMS) Minimum Staffing Standards Rule.

In 2019, the baby boomer generation was estimated at 71.6 million. Currently, the entire cohort is over 55 years of age, and their health care needs will continue to climb in complexity, severity and volume.

While this offers opportunities for the growth of private physician practices, particularly in gerontology, it also feeds the growth of long-term care facilities. Nursa’s research on differences in state readiness for aging populations found that states like Maine are projected to have more than a quarter of their population over age 65 by 2030, highlighting just how significant this demand wave will be.

These nursing homes are already competing for the inadequate nursing supply to join their rosters and provide patient care.

As the aging baby boomer population escalates health care demand and as federal regulations force compliance with minimum nurse staffing standards via the CMS Rule, nursing homes will be doubling down on nurse recruitment.

What the data say

According to national employment data published by the BLS, nursing care facilities already hire a significant portion of the nursing workforce, as follows:

• Registered nurses: 133,240
• Licensed practical/vocational nurses: 178,880

Furthermore, in a report published by the Health Resources and Services Administration, the demand for RNs and LPNs/LVNs in long-term care settings is expected to grow by 38% and 40%, respectively, from 2022 to 2037.

When will private practices begin to feel the strain?

Naturally, there are geographic factors that come into play. Some states have a more severe nursing shortage than others. Washington, Georgia, California, Oregon and Michigan are projected to be the worst off by the year 2035. Some physicians are already feeling the impact.

This doesn’t take into account regional discrepancies for health care access and diminished clinician supply in many rural areas.

Expect to see increased recruitment competition over the next year or two. Nurses know working in nursing homes isn’t “soft nursing,” but many of these facilities have been and will be examining their recruitment strategies and compensation packages to level up.

Although the CMS Rule is staunchly opposed by multiple organizations and interest groups, it’s unclear whether the current administration will take an interest.

What physicians can do to prepare

Even in the unlikely case that the staffing mandate is rescinded or overturned, the baby boomer generation is here to stay. It’s up to physicians to understand the implications and plan accordingly. Here’s how:

• Evaluate your compensation packages: Confirm your wage/salary offerings are competitive, consider sign-on or longevity bonuses, and look into additional perks such as transportation or childcare stipends.
• Offer flexible scheduling: While financial stability can’t be understated, a high salary isn’t the only thing nurses want. Flexible scheduling is more important to nurses than ever as they strive for better work-life balance amid serious burnout reports.
• Leverage cross-training: Take a good look at your medical assistants and any unlicensed assistive personnel on staff. Explore cross-training them or delegating tasks to them (within regulations and scope of practice).
• Make your practice part of the pipeline: Partner with local nursing programs (don’t forget technical schools and community colleges) and become an established part of the pipeline by offering clinical placements.
• Lean into technology: Consult with your nurses on what parts of their jobs they see could be supported by technology. For example, invest in software that will reduce their administrative tasks.

Plan today for tomorrow’s nurses

The nurse shortage isn’t a problem just for hospitals; it has ramifications for the entire health care industry, including private practice physicians.

Create a plan to retain the nursing staff you have. Use per diem staffing platforms to fill gaps instead of asking internal staff to work overtime, and check in with them about their level of job satisfaction. Form connections with local nursing programs, and consider cross-training. Evaluate your recruitment strategy, and look for ways to stay competitive or stand out.

Strategic planning today will help you navigate future challenges with nurse staffing.

Lori Fuqua is a writer with a background in social work and a passion for making complex health care topics accessible.