Solving the Healthcare Human Capital Crisis

In Executive Leadership, Healthcare, Human Capital Trends, Published articles or white papers on September 21, 2010 at 5:47 pm

Healthcare has seen its fair share of shortages. The lack of primary and specialty care doctors, nurses and physicians assistants has been well documented for some time. Albeit not with quite the same level of concern – some may even call it panic – engendered by the predicted shortage of healthcare professionals that will accompany the influx of aging baby boomers, the newly insured and an ever-increasing immigrant population into the nation’s healthcare system.

The U.S. Bureau of Labor Statistics anticipates that staffing shortages will affect a large majority of healthcare providers between now and 2018, due in large part to the factors mentioned above. Employment of physical therapists will see an increase of 30%, while occupational therapists will see an increase of 26%. Physicians and surgeons, and nurses will see a growth of 22%. These numbers will be compounded by the anticipated retirement of the nearly 40% of doctors who are currently 55 or older, and the nearly 33% of the nursing workforce who are 50 or older, according to a recent article in The Washington Post. Peter Buerhaus, a nurse, healthcare economist and professor at Vanderbilt University, related in the article that the near-future shortage of nurses could reach 300,000, while a dearth of 100,000 doctors may be felt over the next 10 years.

"Without a doubt in my mind, we are not prepared to handle the growing aging population that will utilize tremendous resources in the next 20 to 30 years," says Angela Little, a nurse who has worked in several major hospital systems throughout the Southeast. "This is compounded by the fact that patients are living longer as well. In addition, we are faced with a growing immigrant population who also use resources we are simply not budgeted for. We will certainly need a greater number of healthcare professionals to handle this load."

No one is ignoring the numbers or denying the problem. In fact, it is hard to go a day without coming across an article or blog that sounds the clarion call for change and preparation.

Education and Training a Vital Piece of the Puzzle
Some providers, particularly those in primary care, are developing and implementing innovative ways with which to deal with the problem. Programs have included more care provided over than phone rather than face-to-face, appointments "shared" by up to 14 patients at a time, and nurse practitioners who hold advanced degrees that provide primary care in nurse-managed centers.

Education of the future workforce also weighs heavy on the minds of providers. Little recommends that providers "start planting the seeds of interest in healthcare early in high school with healthcare mentors, fairs and greater exposure to the industry; utilize bachelor’s and graduate-trained nursing professionals in a broader capacity in community and family practices; and in turn provide and foster that education."

Evergreen Hospital in Kirkland, Washington, actively seeks to train young physicians, allied health professionals and nursing students in and around its hospital and medical clinics, according to Dr. Mitch Weinberg, Vice President of Medical Affairs at Evergreen. "Providing this type of training affords us an opportunity to fulfill our mission and responsibility to train the professionals of the future, and also exposes these students to the wonderful career opportunities at our institution. In essence, it is both on-the-job training as well as on-the-job interview."

IT Staffing will also Take a Hit
Coupled with the anticipated caregiver shortage is a corresponding lack of healthcare information technology (HIT) professionals – those who will help healthcare providers achieve federally mandated Meaningful Use requirements via the implementation of electronic medical records (EMRs) and broader health information exchanges (HIEs) over the next several years. According to the National Coordinator of Health IT, providers will need an additional 50,000 IT workers to satisfy Meaningful Use criteria over the next five years. That represents a 50% increase in the size of the current estimated healthcare IT workforce.

Recruiters are already feeling the pinch when it comes to finding HIT professionals in the United States. There are simply not enough people to fill the number of positions needed to get providers to full Meaningful Use compliance on time.

International Recruitment: An Underutilized Solution
Where will these professionals – be they stationed at the bedside or in front of a computer – come from?

International recruitment may be the answer.

"I see no reason why international nurses can not be utilized in our country as long as they can meet our standards of practice, function seamlessly in the role they are hired into, and do not compromise patient care or safety due to a lack of education or clinical expertise," says Little, who has worked with nurses from Russia, the Philippines, Mexico and Germany. "I would hold them to the same rules and regulations of any ‘homegrown’ healthcare professional."

Like Little, healthcare providers are quickly coming to the realization that, in the face of such daunting shortage predictions, international recruitment will be a necessary means of filling the staffing gaps the U.S. simply does not have the infrastructure to fill at this time. Lack of educational capacity including adequate clinical training sites in this country has resulted in international graduates now accounting for nearly 30% of all primary care doctors, according to a recent article in the New York Times – this being a segment that has received its fair share of coverage in recent months due to the enormous staffing shortfalls it will soon face and the lack of US medical students wanting to fill this type of position for economic reasons.

"The underlying issue in the United States is that we do not have the educational capacity to meet these needs," says Shari Sandifer, a nurse and CEO of Avant Healthcare Professionals. "In my experience over the past 13 years of recruiting healthcare professionals internationally, there are numerous countries that want to educate healthcare professionals for the United States. I am completely aware and supportive of the need to recruit ethically, especially through my work as a board member on the Alliance for Ethical International Recruitment Practices."

The education factor, or lack thereof, also plays a part when it comes to healthcare IT professionals. Sandifer adds that although the government is stepping up to the plate in terms of offering educational grants and programs – like the ARRA Health IT Workforce Development Program – to begin or strengthen healthcare IT training programs, the lack of education infrastructure is simply not adequate enough to meet the anticipated need of HIT professionals. "Similarly to how international recruitment can help fill the gap in the provider area, it can help with IT professionals," Sandifer explains. "This country has a long history of utilizing IT professionals from overseas."

Overcoming International Recruitment Concerns
Avant Healthcare Professionals, a Joint Commission-certified healthcare staffing firm, is working to educate the healthcare industry on the importance of having an international healthcare strategy in place, and to overcome the more general apprehensions that are sometimes associated with recruiting foreign-born healthcare professionals, such as the notion that recruiting internationally takes away US jobs at a time when unemployment rates are still high and the immigration debate shows no signs of letting up.

Many people – some might even say most – feel that if healthcare jobs are available they should be given to US citizens. "As demand increases for healthcare professionals, healthcare institutions should first recruit domestically, then turn their focus internationally," says Sandifer. It’s important that people remember that the positions providers are recruiting for are specialized and typically take a Master’s degree or higher and years of clinical experience. "We already rely heavily on international medical graduates," Sandifer adds.

"The aging healthcare workforce, the constraints on the educational infrastructure and the growing number of Americans over 65 all point to increasing demand and limited supply" she explains. "How can foreign workers take US jobs when we simply do not have the US-educated workforce?"

Speaking to concerns of successfully transitioning foreign medical personnel into a hospital or practice’s particular working environment, Sandifer explains that Avant has developed programs around the practice differences and regulatory requirements unique to the US healthcare system. "All of our international healthcare professionals go through these programs upon arrival in the US," she says. "In addition, the cultural and social transitioning support Avant provides is ongoing for at least the first year and a half a healthcare professional is in the US. The receiving institutions also receive support from Avant to prepare them to transition and retain these healthcare professionals.

"Avant’s success is due to the alignment of expectations and goals for our international healthcare employees and the client healthcare facility. International recruitment and placement is our core competence and allows our clients to focus on delivery of healthcare rather than on learning how to recruit."

Providers will Succeed with a Progressive Plan
Predicted healthcare personnel shortages can be solved in a timely manner, as long as progressive organizations understand that investing in a multifaceted talent acquisition and management approach including education, training, recruitment – domestic and international – and retention strategies must be developed.

About the Author
Jennifer Dennard is a writer and social media marketer based in Atlanta. A graduate of the University of Georgia, she enjoys bringing a fresh perspective to the healthcare industry, and keeping up with social media marketing trends.


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