Thoughts on the Healthcare Worker Crisis…
By Mario
Over the past few years, a significant portion our work has focused on the health sector, including projects that center on upskilling and reskilling young people into middle and high-skill healthcare jobs. Our theory of action has been that if we can create systems that strengthen pathways for students to develop skills that align with in-demand, high-quality middle skills jobs, without taking on significant student debt, that we can create high-value outcomes for employers and employees.
It’s through that lens that I read with particular interest a Politico story, Hospitals struggle with staff shortages as federal Covid funds run out. The story argued that hospitals throughout the country are facing staff shortages because of, “long-standing problems, worker burnout, and staff turnover [that] have grown worse as Covid-19 waves have hit health care workers again and again.” Noting the difficulties created by the unpredictable variant surges, the story also noted that the pandemic led older healthcare workers to retire early, while also creating a market for traveling medical professionals willing to take their skills on the road for a higher premium. As federal Covid relief funds run out, the ability to pay these premiums is coming to an end. Consequently, rural communities will face a disproportionate share of the fallout from the situation as medical professionals increasingly return to their home bases in urban cities and critical access hospitals face more difficulty attracting traveling staff.
The strategic question underpinning this story is: how do we build and develop a sustainable healthcare workforce across America, particularly outside of our big cities? The answer is multifactorial and like any labor force issue, starts with offering strong wages, providing access to good schools, safe communities, and all of the other community-characteristics that make for a high quality of life. More tactically, though, I think about this question as a physician, considering all of the “who pieces” that make a hospital work (or not). No hospital operates with nurses and physicians alone. Delivering good healthcare requires a strong base of janitorial staff, lab workers, technicians, and others who form the less often seen but just as critical middle- and high-skills workforce that our healthcare ecosystem needs. These are roles that are rarely discussed but are just as difficult to staff and are experiencing the same workforce shortages as those on the provider side.
As a result, I think the more interesting question is how do we create opportunities for skills acquisition for a healthcare labor market that is more dynamic and offers less security than in pre-Covid days? My fear is that if we continue to address healthcare workforce issues with the same debt-heavy learning approaches we’ve used to train healthcare workers –across the entirety of the skills continuum– we’re doomed to cycle through similarly bad outcomes during future crises (if we are able to muddle through the current healthcare labor crisis).
We have to change the employer-employee relationship in healthcare. That means 1) providing employees at all skills-levels with high-quality training in pathways with proven career ladders; and 2) fundamentally altering healthcare finance so that there are tighter linkages between service, quality, and performance throughout the care continuum (e.g., through worker cooperatives).
The transition to an endemic state of Covid offers us the opportunity build a healthcare labor system that recognizes the importance of all of our healthcare workers and dignifies them by building opportunities for advancement. Doing so won’t be easy, but a failure to do so will not only leave us less prepared for the next health emergency, it will continue to widen the gap in healthcare delivery for communities across America.