QUESTIONS AND ANSWERS ABOUT HEALTH CARE WORKFORCE SHORTAGE

1. There have been workforce shortages in the past and they always seem to take care of themselves. Is this shortage any different?

This shortage appears to be different. First, the workforce shortage is more pervasive across multiple sectors of the healthcare system.  It does not affect just nursing, just radiology, or any one particular area. Several underlying causes make this situation different. Declining enrollment in health education programs due to demographic changes, an aging workforce, competition amongst healthcare employers, increased burdens from complex regulations and paperwork imposed on the industry, coupled with dramatically increased demand, are causing this situation. In the case of the physician shortage, dramatically rising medical liability risk exposure and insurance premiums are causing physicians to retire, change locations, or drop high-risk services.  These factors have not converged simultaneously before, therefore creating a far greater and more long-term problem than has existed in the past.  Further, as this shortage spreads beyond America’s borders, relying on foreign-trained workers will become less likely, especially with rising concerns over visas further exacerbating the problem and dire economic circumstances affecting the whole world.

2. How does the shortage in the healthcare workforce affect patient care?

The impact on healthcare delivery has been felt with more and more hospitals reporting increased waiting times for emergency room treatment and surgery due to staff shortages.  Additionally, the Institute of Medicine (IOM) has linked staffing shortages to some medical errors.

The physician shortage is particularly severe in high-risk specialties such as surgical and obstetrical care.  In fact, nearly half of America’s counties lack an obstetrician. This means patients must sometimes travel long distances to receive needed care. Nurses are working longer hours and must accommodate a greater number of patients in order to make up for the lack of qualified nursing personnel.  Thus, addressing healthcare workforce shortages is a key aspect in the delivery of high-quality medical care. 
 
3. With the increased use of medical technology, won’t many of these positions be eliminated, lessening the need for additional medical personnel?

Although positions within the workforce may vary from sector to sector over time, healthcare is a service industry that, despite developments in medical technology, is a 24/7 industry that still relies on people.  Millions of people are employed in the healthcare industry, and that number continues to grow.  The Bureau of Labor Statistics projects that healthcare will generate three million new wage and salary jobs between 2006 and 2016, more than any other industry.

With a decrease in faculty to train the workforce, falling numbers of students, and increased demand for services, the workforce shortage problem is projected to worsen. For example, the Department of Health and Human Services has estimated that three million nurses will be necessary to care for our nation's aging population in 2020, which is one million more than the projected supply.  Mechanization and innovation will likely help to alleviate workforce pressures, but they won’t solve the problem altogether.

4. Aren’t these staffing issues really internal ones to be dealt with by hospital administrators as part of their human resources function?

Many hospitals and other sectors within the healthcare industry are taking creative steps to address the problem.  However, with not only a national but an international shortage of qualified healthcare personnel, only so much can be done at the local level.  Without adequate staff, administrators are faced with closing programs, pharmacies, sections of the hospital, or labs to ensure safety. Developments in medical technology may be slowed in the process, due to lack of staff. Such shortages can ultimately affect patient quality and access to care. It is not simply an internal business issue for a healthcare organization to address on its own, but an external issue the industry needs to address, as a whole.

5. In a tight congressional budget environment, what can be done to help address the workforce shortage problem?

In addition to public funding to address shortages, attention must be paid to the impact of issues like health information technology, medical liability, regulatory burdens, and the costs associated with each that affect staffing and recruitment capabilities.  Studies show that organizations that have effectively implemented electronic medical records and other technologies see a marked decrease in staff turnover. Similar retention results occur when teamwork and communication training has been implemented.  Adequate reimbursements for hospitals, clinics, doctors, laboratories, and other providers are a vital part in helping to solve healthcare workforce shortages.