Headlines present conflicting narratives about the healthcare workforce, with CEOs highlighting it as a top concern while researchers emphasize a rapidly growing healthcare labor supply above pre-pandemic levels.
To reconcile these disparities, several crucial considerations come to light:
1. Demand matters. Merely citing an increase in the labor supply overlooks the crucial factor of demand. Despite a reported surge in the workforce from 2008 to 2023, various market forces contribute to heightened demand: The Affordable Care Act, Medicaid expansion, rising early cancer rates, the opioid crisis, extended pandemic effects, mental health decline, increased gun violence, and an aging population. Despite supply growth, the increases in demand may still lead to workforce shortages.
2. Experience matters. The quantity of personnel is less impactful than having the right individuals. The loss of experienced clinicians threatens vital elements like mentorship, training and clinical expertise. Despite efforts to boost training capacity, the decrease in the average age of nurses underscores the challenge of replacing decades of experience with new entrants.
3. Location matters. A sufficient national workforce does not guarantee an optimal distribution. Evolving work expectations and lifestyle choices mean that organizations in appealing locations or with great cultures may maintain a stable workforce compared to others.
4. Condition matters. Pandemic-induced burnout and disengagement remain alarmingly high, underscoring the inadequacy of simply having enough personnel. Burnout correlates with increased reporting of medical errors, and employee disengagement is costly. The focus should extend beyond numbers to the well-being of the workforce.
5. Turnover matters. Despite national workforce growth, heightened turnover among organizations disrupts healthcare's ability to deliver high-quality care. Even if healthcare workers stay within the industry, there is a link between high turnover and diminished quality. The loss of institutional knowledge also complicates efforts to build and maintain healthy cultures.
A robust labor supply is just one facet of ensuring the healthcare workforce is well-equipped to meet escalating demands. Researchers should exercise caution in equating mere labor supply growth with a healthy and effective healthcare workforce. Having enough people is not the same as having the right people, in the right places, with the right experience and in a condition to provide high-quality care.
With over a decade of experience in healthcare management, leadership, and research, Dr. Katherine Meese is a scholar in the field of organizational behavior, well-being, and leadership. She is an Assistant Professor in the Department of Health Services Administration and the Director of Research at the UAB Medicine Office of Wellness, where she oversees the evaluation of evidence-based interventions to improve the well-being of healthcare workers. She has co-authored numerous peer-reviewed articles and three books including her most recent title, The Human Margin: Building the Foundations of Trust with Quint Studer.