Featured Blog Post Re-examining the Healthcare Workforce Shortage

Healthcare workers are aging along with the rest of the U.S. population. For some time, statistics have indicated that this represents a looming problem: as older clinicians retire, there could be a dearth of new ones to take their place.

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Healthcare workers are aging along with the rest of the U.S. population. For some time, statistics have indicated that this represents a looming problem: as older clinicians retire, there could be a dearth of new ones to take their place. For example, a 2013 report states that by 2020 nearly half of registered nurses will reach retirement age; as of 2007, almost a quarter of physicians were 60 or over.[1]

However, as the chart shows, in The Economist Intelligence Unit survey of U.S. hospital executives conducted for this research project, respondents seem divided about the impact of workforce aging. Slightly over half (53%) expect it either not to present a challenge or be problematic in the long term (i.e. more than a decade from now).

The other half of respondents see workforce aging as a more immediate concern. Furthermore, overall – even in the long term – only a quarter of respondents believe talent shortages will be a leading difficulty arising from an older workforce.

Are hospital executives ignoring a big problem or is the conventional wisdom wrong? Perhaps neither. Recent studies present a mixed picture about the link between workforce aging and talent.

The U.S. Health Resources and Services Administration (HRSA) recently revised its projections for the supply and demand of U.S. nurses – the backbone of the hospital clinical workforce. In 2002 it forecast a shortage of 800,000 by 2020. In 2014, however, it projected, despite potential local shortages, an overall surplus of 340,000 registered nurses and 59,000 licensed practical nurses. This new optimism is largely due to a rapid increase in the number of people training for the nursing profession over the past decade.[2]

The outlook for physicians, however, is more complex. A number of research sources still show a large, imminent shortage. A 2015 study by IHS, a consultancy, for the Association of American Medical Colleges, predicted a shortfall of between 12,500 and 31,100 primary care physicians, and 28,200 to 63,700 specialists, by 2025.[3] Similarly, the HRSA projects a shortage of between 6,400 and 20,400 primary care physicians by 2020[4] – figures similar to interim projections for that year in the IHS research.

A 2014 Institute of Medicine (IOM) report, however, took an opposing view.[5] It challenged the underlying premise of many of the studies predicting a shortfall – that the role of doctors will not change. According to the report, “an expanded primary care role for physician assistants and advanced practice registered nurses, redesign of care delivery and other innovations in healthcare delivery, such as telehealth and electronic communication, may ultimately lessen the demand for physicians despite the aging of the population or coverage expansions.” Accordingly, the IOM sees no need to increase doctor training.

Some of the research showing a shortfall acknowledges this possibility: the wide range in the IHS numbers reflects uncertainty over the greater use of advanced practice nurses and physician assistants. The big difference between the two sides is disagreement over how far the use of non-doctor clinicians will go. Both are issuing a call to action: those foreseeing large shortages for more training; those expecting smaller shortfalls for new care models.

Raw numbers will not be a problem: the HRSA’s projected nursing surplus indicates that potentially over 300,000 medically trained individuals will be available for the change in how healthcare is provided by 2025. The EIU survey also indicates that some hospitals are moving to address potential shortages along the lines the IOM suggests. Among those respondents who said that aging workforces would never be a problem for their organisation because they have effective policies in place to address the issue, 46% said they would increase the use of e-health and other non-traditional service delivery methods in the next three years (versus 38% of the rest of the respondents). Similarly, 42% expect to change care pathways to, for example, replace doctors with specialist nurse where appropriate (against 34% for other respondents).

The only question is whether this degree of change is sufficiently widespread or rapid to prevent clinician shortages: one would certainly expect a much higher figure for increased use of nurses among those who say their policies protect them from the dangers of an aging workforce. It is possible to avoid, or greatly mitigate, these problems, but it will require substantial innovation around how care is delivered. If that does not occur, then survey respondents’ equanimity about workforce aging may look like complacency by 2025.

Footnotes

Page Citations

  1. Laurie Harrington and Maria Heidkamp, “The Aging Workforce: Challenges for the Health Care Industry Workforce,” NTAR Leadership Center Brief, March 2013.
  2. The Future of the Nursing Workforce: National- and State-Level Projections, 2012-2025, 2014.
  3. The Complexities of Physician Supply and Demand: Projections from 2013 to 2025, 2015.
  4. Projecting the Supply and Demand for Primary Care Practitioners Through 2020, 2012.
  5. Graduate Medical Education That Meets the Nation’s Health Needs, 2014.

Disclaimer

This article was written by The Economist Intelligence Unit and sponsored by Prudential. For more information call Prudential Retirement® at 800-353-2847 or visit  Healthcare.PrudentialRetirement.com.

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