Understand the various contributing factors of the shortages so you can make the adjustments needed to alleviate the problem.
The impacts of the pandemic over the last three years, and the lingering effects, continue to contribute to health care worker shortages. Moreover, these challenges are expected to continue throughout 2023 and for the foreseeable future. McKinsey predicts the shortage of nurses, for example, to reach a “dire” level as early as 2025, and the Bureau of Labor Statistics estimates that the U.S. will need more than 203,000 new nurses every year until 2026 to fill the current shortage.
The shortage is not just of nurses. We have been seeing shortages across various types of health care workers: nurses, certainly, but also physicians and allied health workers. It is important, therefore, to understand the various contributing factors of the shortages so that health care providers can make the kinds of adjustments needed to alleviate the problem.
A longstanding problem with many causes and effects
The first point to remember is that the current shortage of health care workers was not singularly caused by the pandemic, nor is it a new phenomenon. It has been occurring for decades and has many interlinking causes, though the pandemic and subsequent “Great Resignation” certainly did not help matters. One of the main causes is the aging population: both patients and health care workers. As the general population ages their need for medical care increases, but as aging doctors, nurses, and health care workers retire or leave the workforce, they are not being sufficiently replaced by new ones. This results in an increased demand for care but not enough care providers to support it.
There are many reasons that may result in the insufficient supply of new doctors and nurses. For physicians, a major contributing factor is that the education and training process is very expensive and time-consuming, making it largely inaccessible to a significant number of people who would otherwise be interested in this career path. Combined with this is the fact that there are not enough residency slots available for medical school graduates to keep up with the growing demand.
Another concern that predated the pandemic and made worse by the worker shortage is the increasing amount of administrative duties which have long been a target of frustration for physicians. These duties often threaten to divert time, energy, and resources from where doctors would prefer to devote those things: patient care. In fact, the burden of administrative work is one the main drivers of physician burnout, taking up to 25% of their work time.
Whether it’s doctors, nurses, or other allied health care workers, when the retiring or burned-out ones leave the industry and are not sufficiently replaced, this leads to a self-perpetuating cycle in which the remaining people have to work harder to make up for the difference. This causes them to burn out as well and the unfortunate cycle continues.
These shortages of physicians, nurses, and allied health workers often lead to less-than-ideal experiences for the patients, such as longer wait times to get appointments. This in turn may sometimes cause those patients to seek care elsewhere, negatively impacting practitioners’ and hospitals’ bottom line.
From understanding causes to creating solutions
Correctly understanding the array of causes underlying the health care worker shortage is important because it makes it possible to address the root causes of the problem with actionable solutions.
First and foremost is the need to get more doctors, nurses, and allied health workers into the system. That means creating more schools and programs to train them and reenvisioning how medical training takes place in order to make it more accessible and affordable. Since the timeline of training physicians can take up to a decade, this needs to be done as soon as possible to prevent the kind of severe shortage that experts are predicting. The same principle applies to nurses, medical assistants, and other allied health workers. With these professions as well, we need to find ways to make the training more affordable and accessible.
While individual providers and health care workers may have limited influence on implementing a systemic solution on this scale, it is nevertheless important to recognize that this must necessarily be part of the solution. At the very least, individual providers can become part of the growing chorus of voices asking for federal, state, and local policymakers to work cooperatively with higher education institutions and hospitals to make education and training more accessible to prevent a worst-case scenario just a few short years down the road.
Easing burnout and improving job satisfaction
Something that’s more within the direct control of providers is to make greater use of non-physician providers such as nurse practitioners, physician assistants, medical assistants, technicians, social workers and administrative staff so that they may operate at “top of license” and minimize much of the administrative burden contributing to physician burnout. This creation of “care teams” may require reviewing and revising workflow within the physician’s practice.Doing this often leads to a more efficient and smooth process that enhances patient, physician, and staff satisfaction.
Better leveraging of technology, such as the way many providers utilized telemedicine during the pandemic, can be another solution. New advances in technology such as artificial intelligence should soon provide physicians with more options to do their work more efficiently and mitigate the effects of burnout and shortages. Wearable technology reaching critical mass should also lift some of the burden so that doctors don’t have to be physically present to monitor data points. Instead, the devices would automatically capture and send them.
Addressing the nurse and allied health care worker shortage
Along with alleviating some of the burden on physicians, there are also measures that can be taken to address the concomitant shortage of nurses and other allied health workers.
Flexible scheduling is a definite must as burnout is one of the biggest causes of turnover for nurses, just as it is for doctors. Allow nurses to have the kinds of schedules that adapt to their needs and make the process of scheduling as simple and straightforward as possible so that it doesn’t become yet another source of stress.
There should also be better training and onboarding programs that take account of the many challenges that new nurses and allied health workers face. Complementary to a good training and onboarding program are opportunities for ongoing professional development as these not only help health care workers become the best they can be, but they further add to the sense that their employers are investing in them. A health care worker who feels mentored and supported, and therefore confident and satisfied, is a worker who is more likely to stay when the going gets tough.
Next, reducing overtime would help interrupt, or at least slow down, the self-fulfilling negative cycle of burnout leading to turnover which then further exacerbates burnout.
Finally, for many nurses and allied health care workers, higher wages and better benefits may be the bottom line that ultimately determines whether they stay or go. At a time when many nurses’ salaries are seeing a significant uptick, and alternative nursing careers such as travel nursing can be both more lucrative and flexible, to not offer satisfactory pay would only exacerbate any internal catalog of complaints that health care workers might be having.
Given that the shortages of doctors, nurses, and other allied health care workers has been a decades-old problem made only worse by the pandemic, it’s clear that without proactive measures the problem would at best remain a problem and, at worst, become more severe. While no single one of the solutions suggested herein might reverse the shortages single-handedly, in concert they are almost certain to make a sizable difference. Health care providers owe it to their patients, and themselves, to implement as many of them as they can.
Professor Karen Schechter is Director and Assistant Professor in the Online Healthcare Management and Health Administration Programs at Maryville University.