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How to start reversing the clinician shortage today

Timothy Lee, MPH
Policy
August 9, 2021
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The pandemic may have caused a nationwide labor shortage in the short term.

Employees resigning on the spot.

Businesses shortening operating hours.

Employers offering signing bonuses.

However, due to the ongoing urgency and lethality of COVID, very few leaders are currently thinking of how inevitable long-term trends like America’s aging demographics may accelerate the existing provider shortages soon.

By 2034, the U.S. Census is predicting the number of adults 65 years and over will surpass the number of children 18 and under. And with 2 out of every 5 physicians expected to retire in the next decade, coupled with current nursing shortages, the demand for health care services and providers will not only impact price and quality but also broader social reforms and economic policies.

Similar situations are occurring in Japan, Germany, and China. The supply of clinicians and other ancillary professionals cannot match the demand of their growing populations. As a result, health systems, which were already under severe financial and labor constraints, are now struggling to remain afloat with COVID.

And soon, America may too. But the gravity and severity will hinge on how well health care leaders today are preparing and incentivizing organizations for the future to address burnout rates, administrative burdens, and job satisfaction, which directly attributes to the clinician shortage. Thus, health care must first align on incentivizing value-based contracts to slow the turnover rate.

Clinicians burn out faster and exacerbate staffing shortages quicker when, instead of focusing on patient care, they must commit major time and energy to administrative tasks like charting, which has grown increasingly cumbersome. One study suggests physicians spend almost 17 minutes per encounter using EHRs; with 11 percent of that time occurring after-hours. This is especially true in a fee-for-service arrangement, where large swaths of documentation are needed to obtain reimbursements and clinicians are overworked.

Operating instead in a value-based contract arrangement, clinicians don’t need to generate large volumes of patients and associated documentation to receive payments. Clinicians can focus more on patient care with less paperwork. This can lighten the clinicians’ patient caseloads, reduce administrative burdens, and partially address the clinician shortage.

Secondly, health care leaders must leverage predictive analytics and automation to optimize staffing capabilities and eliminate highly manual and repetitive tasks.

EHRs that minimize pop-ups and require as few clicks as possible to chart records will not only free up time to provide higher-quality care but also perhaps enable other clinicians, like nurses and APPs, to practice at the top of their scope. Research shows higher retention levels are related to job satisfaction, which also influences better patient health outcomes and how likely nurses decide to retire early.

Furthermore, the physical and mental demands required of nurses today are taxing and will only continue to rise due to the increasing acuity of patients. Many nurses, like physicians, feel overworked and emotionally exhausted. The result only exacerbates the clinician shortage. Therefore, it is critical that health care leaders choose carefully which technologies best support providing high-quality patient care, optimizing workforce capabilities, and promoting a healthy safe work environment for employees.

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Unhealthy work environments are the last major factor that health care leaders need to consider. To counter the impacts of burnout and other factors on clinician shortages, organizations need to offer mental health wellness programs for care team members. More importantly, organizations need to foster a space that allows clinicians to seek help without feeling stigma. One survey reports that 73 percent of ER doctors expect stigma at work for seeking personal treatment during the pandemic. There must be an organizational shift to encourage clinicians that seeking help is normal. Clinicians don’t need to always feel as if they must be superhumans.

While certain factors contributing to the shortage aren’t amendable to change, health care leaders still must figure how to align payment incentives, invest in appropriate technologies, and foster a sustainable work culture. We have to realize that what’s most important for patient care and health outcomes is to ultimately help clinicians avoid leaving the profession. If we don’t, the clinician shortage will be far worse than one can imagine.

Timothy Lee is a health care strategist.

Image credit: Shutterstock.com

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How to start reversing the clinician shortage today
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