Congress returns from its July 4 break today and its focus will be on the President: will he resign or tough it out through the election in 120 days. But not everyone is paying attention to this DC drama.
In fact, most are disgusted with the performance of the political system and looking for something better. Per Gallup, trust and confidence in the U.S. Congress is at an all-time low.
The same is true of the healthcare system:
69% think it’s fundamentally flawed and in need of systemic change vs. 7% who think otherwise (Keckley Poll). And 60% think it puts its profits above all else, laying the blame at all its major players—hospitals, insurers, physician, drug companies and their army of advisors and suppliers.
These feelings are strongly shared by its workforce, especially the caregivers and support personnel who service patient in hospital, clinic and long-term care facilities. Their ranks are growing, but their morale is sinking.
Career satisfaction among clinical professionals (nurses, physicians, dentists, counselors) is at all time low and burnout is at an all-time high.
Last Friday, the Bureau of Labor issued its June 2024 Jobs report. To no one’s surprise, job growth was steady (+206,000 for the month) –slightly ahead of its 3-month average (177,000) despite a stubborn inflation rate that’s hovered around 3.3% for 15 months. Healthcare providers accounted for 49,000 of those jobs–the biggest non-government industry employer.
But buried in the detail is a troubling finding: for hospital employment (NAICS 6221.3): productivity was up 5.9%, unit labor costs for the month were down 1.1% and hourly wages grew 4.8%–higher than other healthcare sectors.
For the 4.7 million rank and file directly employed in U.S. hospitals, these productivity gains are interpreted as harder work for less pay. Their wages have not kept pace with their performance improvements while executive pay seems unbridled.
Next weekend, the American Hospital Association will host its annual Leadership Summit in San Diego: 8 themes are its focus:
Building a More Flexible and Sustainable Workforce is among them. That’s appropriate and it’s urgent.
An optimistic view is that emergent technologies and AI will de-lever hospitals from their unmanageable labor cost spiral. Chief Human Resource Officers doubt it. Energizing and incentivizing technology-enabled self-care, expanding scope of practice opportunities for mid-level professionals and moving services out of hospitals are acknowledged keys, but guilds that protect licensing and professional training push back.
By contrast, the application of artificial intelligence to routine administrative tasks is more promising: reducing indirect costs (overhead) that accounts for a third of total spending is the biggest near-term opportunity and a welcome focus to payers and consumers.
Thus, most organizations advance workforce changes cautiously. That’s the first problem.
The second problem is this:
lack of a national healthcare workforce modernization strategy to secure, prepare and equip the health system to effectively perform. Section V of the Affordable Care Act (March 2010) authorized a national workforce commission to modernize the caregiver workforce. Due to funding, it was never implemented. It’s needed today more than ever. The roles of incentives, technologies, AI, data and clinical performance measurement were not considered in the workforce’ ACA charter: Today, they’re vital.
Transformational changes in how the healthcare workforce is composed, evaluated and funded needs fresh thinking and boldness. It must include input from new players and disavow sacred cows. It includes each organization’s stewardship and a national spotlight on modernization.
It’s easier to talk about healthcare’s workforce issues but It’s harder to fix them. That’s why incrementalism is the rule and transformational change just noise.
PS: In doing research for this report, I found wide variance in definitions and counts for the workforce. It may be as high as 24 million, and that does not include millions of unpaid caregivers. All the more reason to urgently address its modernization.
HENRY KOTULA 