"Today, one of the most pressing issues facing our health care system is the shortage of health care workers. From lab technicians,to nurses, to pharmacy technologists, to rural and urban physicians, the demand for our health care workers is increasing just as more and more of our workers reach retirement age and leave the workforce. We cannot afford to have our hospitals short-staffed or our health care professionals to be working triple shifts. We must address this shortage and ensure that all of our citizens have access to quality health care."
Jim Doyle,GovernorState of Wisconsin
At the heart of the United States' health care system, lies a fundamental component, crucial to the success of the system as a whole: the Workforce. Without this element, there would be no one to provide the services necessary for citizens to access health care in the first place; there would be a missing component to the "three-legged stool" encompassing the access to care, quality of care and cost of care. In current discussions on health care reform, we must carefully consider the huge role the health workforce plays in the grand scheme of things and its affect on the system as a whole in order to make proper changes.
The health care workforce-- or those who provide health care and administrative duties for the general population-- includes, but is not limited to: physicians, nurses, dentists, pharmacists, optometrists, psychologists, podiatrists, chiropractors, non-physician practitioners, health services administrators and allied health professionals. Currently, there are over 10 million people in the U.S. health care workforce. In fact, it consists of greater than three percent of the total labor force in the nation. This contributes to about 16% of the nations Gross Domestic Product. It is projected that this number will only continue to grow due to a growing population of immigrants as well as in increase in the aging population. (Shi & Signh p. 3, 120)....
Our country's focus on disease treatment rather than preventive care has led to the lopsided training of physicians. Our medical schools emphasize hospital-based training, which has produced more specialists and fewer generalists/primary care physicians. These physician specialists are not prepared to focus on the promotion of wellness and prevention.
Despite there being such a huge number of people already in the US health care workforce, our country is actually experiencing a shortage in healthcare workers; it is estimated that by the year 2020 our country will be experiencing a shortage of 200,000 physicians and 1 million nurses. In our larger metropolitan areas, these shortages may not be felt as strongly, but in rural and underserved areas they will definitely feel the shortage.
With the current goal to expand our national health care plan to cover the uninsured, we would need to expand our current levels of primary care physicians by 25% at a time when we are experiencing a shortage them. Currently, our shortage in nurses across the country could be as high as 400,000 leaving as many as 116,000 RN positions in hospitals and over 100,000 nursing positions in nursing homes vacant.
One aspect of our evolving health care workforce to take into account is the fact that by 2011 some of the first 78 million Babyboomers will be hitting the age of retirement--this could spell out disastrous effects on our health care workforce--many will either retire from health related fields and/or begin to need increased amounts of care due to increases in chronic conditions. It is without a doubt that planning for these types of shortages would have been a very difficult task for our country to have foreseen due to regional maldistribution of health professionals, overspecialization of physicians, and the current and expected demographics of the health workforce and the population they serve.
Center for American Progress: Closing the Health Care Gap
http://www.americanprogress.org/issues/2010/01/health_workforce.html
Sources:
American Hospital Association. (2009). Workforce. Retrieved February 15, 2009 from
http://www.aha.org/aha_app/issues/Workforce/index.jsp
Center for American Progress. (2010). Closing the Health Care Gap. Retrieved
February 15, 2010 from http://www.americanprogress.org/issues/2010/01/health_workforce.html
Health Care Workforce Development. (2009). Healthcare in the News. Retrieved
February 18, 2010 from http://www.dwd.state.wi.us/healthcar/e
Shi, L., & Singh, D. A. (2008). Delivering Health Care in America: A Systems
Approach (Fourth ed. ). Sudbury: Jones and Bartlett .
U.S. Department of Health and Human Services, Health Resources and Services
Administration. (2006). The United States Health Workforce Profile. Retrieved
February 15, 2010 from http://bhpr.hrsa.gov/healthworkforce/reports/#multiple
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The point about the focus on hospital-based care instead of preventative is very interesting to me. Preventative seems more logical in the long-term; however, as Americans we like to see results right away and therefore often prefer hospital-based even if given the choice. It would be interesting to look at the cost effectiveness (if any) of focusing more on preventative care in the future instead of hospital-based.
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