Factors Driving Today's Health Care Staffing Shortages
What are the primary factors driving today’s health care staffing shortages? Why are we seeing health care staffing shortages despite revolutionary improvements in preventative care, greater life expectancy, ever more specialists and advances in technology?
An Aging Population
The healthiest segment of the population can be described as working adults, those between 25 and 55. However, the fastest growing population in the United States is the cohort over 60 years of age. This is due to the aging of the Baby Boomers, a demographic bulge in the age profile of the United States. Sometimes call the Gray Tsunami, this population is reaching an age at which the body starts to wear out and break down.
And unlike prior generations, they demand the latest and greatest technology to repair their bodies, visit doctors for every minor inconvenience instead of accepting problems as the natural symptoms of aging and rely on medical interventions to live as long as possible. With more people in their retirement years, the demand on the medical sector could only rise. The fact that those starting to hit retirement are those who consider health a right will only exacerbate today's health care staffing shortages.
The fact that many nurses are Baby Boomers and the young women who might have replaced them are doctors or medical administrators is one reason why there is a nursing shortage today.
Limits on Hours Medical Professionals Can Work
The Accreditation Council for Graduate Medical Education identified resident doctor fatigue as one cause of the uncomfortably high rate of medical errors in hospitals and roughly 98,000 deaths back in 2011. Physician and resident fatigue is an easily managed risk factor that could greatly improve patient safety.
Instead of medical residents working 30 hour shifts every three days, 79% of residency programs had set 16 hour limits for residents by the end of that year. An 80 hour work week limit has been recommended for all physicians; this rule has been adopted by many hospitals but has not yet become national law.
While doctors get more sleep and hopefully make better decisions on the hospital floor, the result is that we need more medical professionals to fill in for the staff who can no longer be expected to work 90 hours or more a week.
While it may seem counter-intuitive, the rise in the number of women in medicine is one of the reasons why there is a doctor shortage today. Many young women who have entered medicine have completed a decade of schooling and grueling residencies. Upon graduation, many young women are choosing to work part time while starting their families.
Work-life balance is an admirable goal, but the fact that many young doctors do not want to work as many hours as their predecessors exacerbates today's health care staffing shortages.
Marvels of Modern Medicine
It has been said that we can save people who never would have survived a century or even a decade ago. Unfortunately, one of the side effects of reducing the death rate is a higher disability rate. Instead of having a fifty year old man die of a heart attack, he spends a week in ICU, a month in cardiac rehabilitation and lives another two decades with modest lifestyle restrictions and close medical supervision.
The shift to lifetime medical maintenance such as the use of statin drugs, pacemakers and insulin pumps extends the life of those who might otherwise die. They can enjoy a relatively comfortable life span, but these medical advances increase the percentage of the population that requires ongoing medical monitoring and adds to today's health care staffing shortages.
24x7x365 Medical Care
More patients are unwilling to wait until Monday morning to see the family doctor or sit 10 hours in an Emergency Room for medical care. The result has been the rise of “doc-in-a-box” health care facilities. Often staffed by nearly retired doctors or nurse practitioners, patients gain access to a medical opinion, rapid testing for diseases like strep throat and instant forwarding of any prescribed medications to a pharmacy that is typically located in the same building as the “doc-in-a-box”.
Doctors in their fifties and sixties who would have worked full time until they retired can now work part time on weekends in these clinics and make almost as much money for a fraction of the stress. Younger doctors who want greater work-life balance than their predecessors are choosing to work a standard 40 hour work week or two or three long days in these medical facilities instead of working 60 to 80 hours a week. Obamacare, too, has pushed many to work part time or 40 hour weeks for hospitals instead of long hours in the office.
The end result is that many medical professionals are able to find a workplace and work schedule that suits their lives, often working less than they would in private practice. Fewer hours worked per person results in an overall healthcare shortage, since the supply of medical advice is limited compared to the increased demand.
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