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?

Yes, this shortage is different. First of all, the workforce shortage is pervasive across multiple sectors of the health care system.  It does not affect just nursing, just radiology, or any one particular area. There are several underlying causes that make this shortage different. Declining enrollment in health education programs due to demographic changes, an aging workforce, competition amongst health care employers, increased burdens from complex regulations and paperwork imposed on the industry, coupled with dramatically increased demand, are causing this shortage. In the case of the physician shortage, dramatically rising medical liability premiums are causing physicians to retire, change locations, or eliminate high-risk services. All of these factors have never converged simultaneously before, therefore creating a far greater and more long-term problem than has existed in the past. Furthermore, 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.

2. How does the shortage in the health care workforce impact patient care?

The impact on health care 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 that 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 health care workforce shortages is a critical 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?

No.  Although positions within the workforce may vary from sector to sector over time health care is a service industry that, despite developments in medical technology is a 24/7 industry which still relies on people.  Millions of people are employed in the health care industry, and that number continues to grow because the backbone of the health care delivery system is the workforce. The Bureau of Labor Statistics projects that health care will generate 3 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 only projected to get worse, not better. For example, the Department of Health and Human Services has estimated that 3 million nurses will be necessary to care for our nation's aging population in 2020 – one million more than the projected supply.

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 health care industry are taking creative steps to address the problem.  However, with not only a national but an international shortage of qualified health care personnel, there is only so much that can be done on the local level. Without adequate staff, administrators are faced with closing programs, pharmacies, areas 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 impact patient quality and access to care.  It is not simply an internal business issue for a health care organization to address on its own, but an external issue the industry needs to address, as well.

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 which have effectively implemented electronic medical records and other technologies see a marked decrease in staff turnover.  Adequate reimbursements for hospitals, clinics, doctors, laboratories, and other providers are a vital part in helping to solve health care workforce shortages.