Can We Avoid The Impending Healthcare Workforce Labor Shortage?

“I’ll propose in a moment what I believe are some achievable, common-sense solutions to the labor-shortage problem. But first, it helps to quickly understand why policymakers and industry leaders believe a crisis will come.

It boils down to three elements. First, the number of older Americans is growing and will continue to grow – peaking in 2030 at roughly 56 million adults – and the impact on our health system will be enormous. A typical senior’s health is arguably more complicated than at any point in history, with many managing two or more chronic illnesses, and thanks to treatment advances they’ll also live longer with those advanced illnesses than they might have in past eras. This cohort will simply require more care from our finite pool of healthcare providers, and the ripple effects will be felt throughout the system.

Meanwhile, the stresses of the pandemic pushed many younger workers to turn their backs on their healthcare careers, and many of the industry’s sizeable older cohort are looking to retire at the earliest possible moment.

This would all be manageable if not for healthcare’s third major headwind: there aren’t enough new workers joining the industry. [..]

My conviction is that our shortage is not a supply problem, in other words. It’s a demand problem. We need to drive less healthcare consumption in the U.S., and we can do that in a few key ways.

It starts by acknowledging the staggering amount of wasteful, useless healthcare that’s delivered to patients because we fail to intervene early on their medical conditions.

Far too often, our failure to intervene early on a patient’s medical condition becomes an expensive and labor-intensive complication. Diabetes becomes dialysis and retinal disease. Hypertension becomes heart disease stroke. And so on and so forth.

Let’s have the courage, time, and reimbursement to arm primary-care doctors and nurse practitioners with data-driven guidance on thorny medical questions to intervene early and obviate the need for costly specialty care rather than glorify our technical sophistication managing what are fundamentally avoidable complications.

A second way to diminish healthcare industry demand: increase the effectiveness of existing workers. This starts with reimagining the healthcare team. [..]

We need to engineer truly inter-professional teams who rely on robust supervision models and tech-enabled, data-driven escalation protocols, and whose collective capacity is greater than the sum of their individual capacity (1+1=3). We need to support professionals in practicing with each other rather than merely alongside each other. We need to rethink who does what – and in what situations – in other words.

Take pharmacists, for example. They are a highly-trained and potentially powerful group of clinicians who can do more to help manage the burden of chronic disease than they’re permitted to do by the current set of arcane laws and regulations. By giving them greater decision-making authority in the care team, with all appropriate supervision and safeguards in place, we can keep patients healthier.

[..] we also need to find ways to make healthcare jobs less demanding. Or at least less mind-bendingly frustrating.

Healthcare workers are drowning in an ocean of low-value (or no-value) tasks. Practitioners spend on average 35 percent of their day documenting, and by some estimates they make more than 50 calls per day, many of which are administrative in nature. Think insurance-related skirmishes, referral hassles and the like. Think, also, about poorly designed quality reporting that improves little.

We’re crushing our healthcare workforce beneath the burden of documentation and administrative tasks that are only tangentially related to clinical care. And we are occupying many valuable members of the healthcare workforce with non-value added tasks.

It’s time to start calling it what it is: a threat to quality patient care. AI will help—but it’s not the full answer. We need a national multi-sector movement to reduce unnecessary administrative work and a nation of healthcare leaders to acknowledge their complicity in the mazes of non value-added work we’ve created—and a full-throttled commitment to navigate us out of it.”

Full editorial, SH Jain, Forbes, 2023.4.24