Susan Salka

The Future of Health Care – Staffing shortage crisis

May 02, 2016
The shortage of nurses, physicians and other health care practitioners is beginning to receive much more attention in the national discussion about health care. While some regions have more severe shortages, this is clearly a nationwide crisis. Demand for both permanent and temporary health care practitioners has grown significantly, reaching acute proportions in some specialties. One example on the physicians’ side is the severe shortage of psychiatrists, a specialty in which nearly 60 percent are 55 or older, so a wave of retirements in the near future will make this shortage even worse. For nursing, there are greater shortages in critical care such as neonatal, intensive care unit (ICU) and operating room, but the problem exists across the board.

The situation will soon go from bad to worse, and there are many factors causing the shortfall. Demand for health care services is rising quickly. The U.S. population is growing inexorably older, and older people use three to four times more health care than the general population. Also driving utilization is the improving economy and declining unemployment rate. This means more people have jobs that provide insurance, or have the money to pay for copays and deductibles. And we have 20 million more Americans who have become insured due to the Affordable Care Act — which only went into effect a little over two years ago.

This rising demand for health care services means rising demand for health care practitioners who provide those services. At the same time, a “silver tsunami” of clinicians hitting retirement age will significantly impact the number of experienced nurses. The 2015 Survey of Registered Nurses by AMN Healthcare found that 62 percent of nurses over 54 say they are now considering retirement, and most of them say they will retire within three years. While the number of new enrollees under the Affordable Care Act will eventually level off, the aging of our health care workforce and of our patient population will continue for decades.

There have been increases in the number of graduates among many health care professions, but there have not been enough to make up for rising demand. In particular, there are not enough residency positions to make an appreciable dent in the physician shortage.

The workforce challenges facing the health care industry are very real. But there are solutions: Workforce optimization will be increasingly vital to health care providers. Since shortages will worsen, health care providers — hospitals, health systems and other health care services — will need to optimize their permanent and temporary staff. Optimization solutions include:

• Predictive analytics to accurately forecast future patient demand and staffing needs.
• Expert resource management to help providers better optimize their workforce.
• Managed services programs (MSP) to provide a single point of contact for managing outside staffing vendors.
• Recruitment process outsourcing (RPO) for expert recruitment teams to join health care providers in tackling their staffing challenges.
• Customized education and training programs that provide transition to practice for entry-level nurses.

Health care providers must maintain their focus on excellence in patient care. Trying to cope with the highly competitive environment for talent could infringe on that mission. The workforce will be front and center in the future of the health care industry. Success in the three objectives of health care reform — improving patient experience, containing costs and expanding care to populations — can only be achieved through the actions of nurses, physicians, allied professionals, leadership and support staff. Clearly, workforce experts will play a vitally important role in the future of our nation’s health care system.

Susan Salka is president and CEO of AMN Healthcare, a leader and innovator in workforce solutions and health care staffing.