Why it matters: Amid increasing concerns about burnout in health care and workforce shortages, the poll of more than 900 workers between Sept. 2–8 shows there is still a lot of optimism about the health care profession even as workers deal with stressful working conditions.
A common theme among the responses was the message that “working in healthcare is hard and it’s something that should only be done if you are completely committed to it.”
Responses ranged from one worker who said “it’s a great career,” to another who said young people should avoid the field “unless you have a death wish.”
The poll also found men were more likely than women to be optimistic about the future of the health care industry.
Trinity Health is the latest—and now the largest—U.S. provider organization to roll out a COVID-19 vaccination requirement for all of its employees.
Announced Thursday and effective immediately, the nonprofit, Catholic healthcare system said the policy will extend across its entire workforce of more than 117,000 employees, including clinical staff, remote employees, contractors and “those conducting business in its healthcare facilities.”
Trinity said it will approve exemptions for religious or health reasons that are formally requested and documented. Others who don’t meet the criteria for exemption and fail to provide proof of vaccination “will face termination of employment,” according to the announcement.
Trinity said an estimated 75% of its employees have already received at least one dose of a COVID-19 vaccine, and it hopes the new policy will bring that number closer to 100%.
“Safety is one of our core values. We feel it is important that we take every step available to us to stop the spread and protect those around us—especially the most vulnerable in our communities who cannot be vaccinated including young children and the more than 10 million people who are immunocompromised,” Trinity Health President and CEO Mike Slubowski said in a statement.
“Over the last year, Trinity Health has counted our own colleagues and patients in the too-high coronavirus death toll. Now that we have a proven way to prevent COVID-19 deaths, we are not hesitating to do our part,” he said.
Livonia, Michigan-based Trinity operates 91 hospitals and 113 continuing care locations serving more than 30 million people across 22 states. The system reports $19.4 billion in annual operating revenues and is on track to top that number having recently reported $15.1 billion in operating revenues for the nine-month period between July 2020 and March 2021.
Trinity said that most of its locations will be requiring employees to submit their proof of vaccination by Sept. 21. Should it be determined that COVID-19 vaccine boosters will be necessary down the line, the hospital said that it would similarly require employees to submit proof of their receipt “as needed.”
“The science has shown us that the COVID-19 vaccine is the single most effective tool in slowing, and even stopping, the spread of the virus,” Dan Roth, M.D., Trinity Health executive vice president and chief clinical officer, said in a statement. “As a Catholic Health Ministry—even if we work remotely or do not regularly encounter patients—we view ourselves as caregivers, and it’s important that we do everything we can to end the pandemic and save lives.”
But perhaps the best known of the bunch has been Houston Methodist, which drew a line in the sand on June 8 and has since cut loose 153 employees who did not comply with the vaccine mandate.
That policy led to protests from the dissenting employees as well as a lawsuit that argued the system was “forcing its employees to be human ‘guinea pigs’ as a condition for continued employment.” The case was dismissed by a U.S. district judge and quickly appealed by the employees.
Other organizations such as Mass General Brigham have signaled support for a mandatory COVID-19 vaccination policy but said that they would not enforce the requirement until a COVID-19 vaccine receives formal approval from the FDA.
Earlier this year, the U.S. Equal Employment Opportunity Commission paved the way for employer-mandated COVID-19 vaccine policies with guidance permitting the requirements “so long as employers comply with the reasonable accommodation provisions of the [Americans with Disabilities Act] and Title VII of the Civil Rights Act of 1964 and other [Equal Employment Opportunity] considerations.”
That’s the question business leaders are facing after Colorado lawmakers passed a bill requiring companies to post salary ranges for open or remote work positions in the state. California, Connecticut, Maryland, and Washington already have laws on the books mandating companies provide pay ranges to candidates who specifically ask for them or during an offer. The Colorado law takes it one step further by making companies proactively disclose the minimum and maximum salary as part of the job posting.
Though Colorado is the first state to make salary ranges available to any applicant, it won’t be the last, says Benjamin Frost, a solutions architect in Korn Ferry’s Products business. “The wind is clearly blowing in the direction of this becoming commonplace,” he says. Investors and employees want more transparency from companies, particularly around diversity, equity, and inclusion. Moreover, supporters argue providing salary ranges up front can help companies better match candidates to positions, making the hiring process more efficient.
But some companies, already under increasing wage pressure brought on by the hiring boom, apparently don’t see it that way: some recent job listings have specifically excluded candidates who live in Colorado from certain open positions. Frost says the move is less about Colorado’s talent pool and more about losing negotiating power with talent overall. “Excluding Colorado workers seems like a decent price to pay for not needing to disclose salary ranges at the moment,” he says. By contrast, he says, if and when a state like New York or California takes the step toward proactive disclosure, it will be a much bigger deal: “It is about talent pools and where companies can and can’t afford to close off access.”
Human resources leaders also argue that proactively providing pay ranges will actually make the recruiting process less, rather than more, efficient. For one, designating a salary range is tricky business. “You don’t want to limit the talent you get to look at,” says Andy De Marco, Korn Ferry’s vice president of human resources for the Americas. At the time, the range can be so broad that it could become arbitrary. A span of $100,000, for instance, expands the candidate pool and skills spectrum so much that it could slow down recruiting and, by extension, operations.
Excluding applicants from Colorado for now might give companies more time to clean up their pay practices, says Tom McMullen, a Korn Ferry senior client partner and a leader in the firm’s Total Rewards practice. He notes that posting pay ranges could expose internal inequities leaders aren’t yet prepared to deal with. For instance, suppose a company posts a range of $80,000 to $100,000 for a role, but an existing employee is still earning the minimum number after five years with the firm. “How upset will that employee be after seeing this posted range?” asks McMullen.
To be sure, optics are a huge part of the disclosure calculus for leaders. McMullen says companies are running out of time to institute fairer pay practices on their own before regulators push them to do so. “Employees will give their leaders credit for making these changes proactively,” he says.
Health system executives continue to tell us that the top issue now keeping them up at night is workforce engagement.
Exhausted from the COVID experience, facing renewed cost pressures, and in the midst of a once-in-a-generation rethink of work-life balance among employees, health systems are having increasing difficulty filling vacant positions, and holding on to key staff—particularly clinical talent. One flashpoint that has emerged recently, according to leaders we work with, is the growing divide between those working a “hybrid” schedule—part at home, part in the office—and those who must show up in person for work because of their roles. Largely this split has administrative staff on one side and clinical workers on the other, leading doctors, nurses, and other clinicians to complain that they have to come into work (and have throughout the pandemic), while their administrative colleagues can continue to “Zoom in”. There’s growing resentment among those who don’t have the flexibility to take a kid to baseball practice at 3 o’clock, or let the cable guy in at noon without scheduling time off, making the sense of burnout and malaise even more intense. Add to that the resurgence in COVID admissions in some markets, and the “help wanted” situation in the broader economy, and the health system workforce crisis looks worse and worse. Beyond raising wages, which is likely inevitable for most organizations, there is a need to rethink job design and work patterns, to allow a tired, frustrated, and—thanks to the in-person/WFH divide—envious workforce the chance to recover from an incredibly difficult year.
Many U.S. hospitals are turning to layoffs to cut costs as they recover from the financial hit of the COVID-19 pandemic.
Here are seven hospitals or health systems that recently announced layoffs or job cuts:
1. Mishawaka, Ind.-based Franciscan Health will lay off 83 employees of its 100-year-old hospital in Hammond, Ind., according to a notice filed with the state. The layoff notice comes as the health system works to shrink the 226-bed Franciscan Health Hammond Hospital to an eight-bed acute care facility with an emergency department and primary care practice. The layoffs are slated to begin Aug. 21 and will be permanent, the health system said.
2. HealthAlliance of the Hudson Valley, a three-hospital system in the Westchester Medical Center Health Network, laid off an undisclosed number of workers June 14. Westchester Medical Center Health Network in Valhalla, N.Y., said it laid off HealthAlliance hospital employees in Kingston, N.Y., to eliminate redundancies as it begins to consolidate inpatient services to one location.
3. As part of a financial restructuring plan, Sacramento, Calif.-based Sutter Healthwill issue another round of layoffs this year. The health system said in early June it plans to lay off 400 employees. These newly announced layoffs are in addition to 277 information technology jobs that were cut April 2. Sutter said most of the new layoffs affect employees in administrative positions in benefits, human resources, data services and accounting. The layoff notice said many of these employees were working remotely or in the field.
4. A little over a month after filing a notice to complete about 651 layoffs this year, Ascension Technologies, the IT subsidiary of St. Louis-based Ascension,eliminated 92 remote IT jobs in Indiana, according to a June 3 report. Most of the laid-off employees are based in Indianapolis and Evansville, Ind., the Indiana Department of Workforce Development said June 2
5. Lawrence (Mass.) General Hospital plans to lay off 56 employees and is warning of more cuts unless it receives government aid quickly, according to a May 25 report. The layoffs will affect employees working in administration and patient care. The layoffs affect about 2.5 percent of the 186-bed hospital’s workforce. Lawrence General attributed the layoffs to the COVID-19 pandemic weakening its financial profile.
6. Boca Raton, Fla.-based Cancer Treatment Centers of America closed its hospital in Tulsa, Okla. About 400 employees will be affected by the closure. The hospital saw its last patient on May 27.
7. Boca Raton, Fla.-based Cancer Treatment Centers of America is selling its hospital in Philadelphia and will lay off the facility’s 365 employees, according to a closure notice filed with the state. The cancer care network said it anticipates the layoffs in Philadelphia will begin after May 30.
A topic that’s come up in almost every discussion we’ve had with health system executive teams and boards recently is workforce strategy. Beyond the immediate political debate about whether temporary unemployment benefits are exacerbating a shortage of workers, there’s a growing recognition that the healthcare workforce is approaching something that looks like a “perfect storm”.
The workforce is mentally and physically exhausted from the pandemic, which has taken a toll both professionally and personally. Many workers are rethinking their work-life balance equations in the wake of a difficult year, during which working conditions and family responsibilities shifted dramatically. That, along with broader economic inflation, is driving demands for higher wages and a more robust set of benefits.
Meanwhile, many health systems are shifting into cost-cutting mode, due to COVID-related shifts in demand patterns and continued downward pressure on reimbursement rates, forcing a renewed focus on workforce productivity.
These combined forces threaten to create a negative spiral, which could lead to even worse shortages and deteriorating workplace engagement. It’s striking how quickly the “hero” narrative has shifted to a “crisis” narrative, and we agree completely with one health system board member who told us recently that workforce strategy is now the number one issue on his agenda.
No easy answers here, but we’ll continue to report on innovative approaches to addressing these difficult challenges.
A group of 117 employees is suing Houston Methodist over its COVID-19 vaccination mandate for workers, ABC News reported May 29.
Houston Methodist, which comprises an academic medical center and six community hospitals, rolled out its mandatory vaccination policy March 31, setting an April 15 deadline for managers to receive at least one dose or get an exemption. More than 99 percent of the management team complied by the deadline. By June 7, all about 26,000 employees are required to be vaccinated. However, employees can receive medical or religious exemptions or a deferral if they are pregnant.
Now, 117 Houston Methodist employees have filed a lawsuit, claiming that the mandate is illegal.
The lawsuit, filed May 28 in Montgomery County District Court in Texas, alleges the hospital is “illegally requiring its employees to be injected with an experimental vaccine as a condition of employment,” according to ABC News. It specifically cites that the COVID-19 vaccines are authorized for emergency use by the FDA but have not been fully approved.
The employees allege that Houston Methodist is violating Texas public policy and the Nuremberg Code, a medical ethics code for human experimentation drafted in 1947 because of the Nuremberg trials at the end of World War II, according to the report.
The plaintiffs’ attorney, Jared Woodfill, told ABC News the health system’s mandate is meant “to promote its business and increase profits at the expense of other healthcare providers and their employees’ health. Defendants advertise to the public that they ‘require all employees and employed physicians to get a COVID-19 vaccine.’ More clearly, defendants’ employees are being forced to serve as human ‘guinea pigs’ to increase defendants’ profits.”
Houston Methodist said earlier this year that employees who do not comply with the vaccination mandate initially will have a discussion with their supervisor, then could face suspension followed by termination. The lawsuit seeks to prevent the health system from terminating unvaccinated workers.
Houston Methodist President and CEO Marc Boom, MD, shared a statement about the lawsuit with Becker’s. As of May 28, he said 99 percent of Houston Methodist’s employees have met the requirements for the vaccination mandate.
“We are extremely proud of our employees for doing the right thing and protecting our patients from this deadly virus,” Dr. Boom said. “As healthcare workers, it is our sacred obligation to do whatever we can to protect our patients, who are the most vulnerable in our community. It is our duty and our privilege.
“It is unfortunate that the few remaining employees who refuse to get vaccinated and put our patients first are responding in this way. It is legal for healthcare institutions to mandate vaccines, as we have done with the flu vaccine since 2009. The COVID-19 vaccines have proven through rigorous trials to be very safe and very effective and are not experimental. More than 165 million people in the U.S. alone have received vaccines against COVID-19,and this has resulted in the lowest numbers of infections in our country and in the Houston region in more than a year. We proudly stand by our employees and our mission to protect our patients.”