Lawmakers stress urgency of healthcare worker shortage

https://www.healthcaredive.com/news/lawmakers-fixes-healthcare-workforce-shortages/642994/

Addressing the education pipeline is one thing that legislators could focus on to improve nurse and physician shortages, medical school and health system leaders said.

As the healthcare industry continues to face pandemic-driven workforce challenges, lawmakers are exploring ways to boost the number of clinicians practicing in the U.S.

“A shortage of healthcare personnel was a problem before the pandemic and now it has gotten worse,” Chairman Sen. Bernie Sanders I-Vt., said during a Thursday Senate HELP committee hearing. “Health care jobs have gotten more challenging and, in some cases, more dangerous,” he said.

The country faces a shortage of up to 124,000 physicians by 2034, including 48,000 primary care physicians, according to the Association of American Medical Colleges.

Hospitals are currently facing shortages of registered nurses as burnout and other factors drive them to other roles. 

For example, 47-hospital system Ochsner Health in New Orleans has about 1,200 open nursing positions, Chief Academic Officer Leonardo Seoane said at Thursday’s hearing.

The workforce shortaged led Ochsner to close about 100 beds across its system during the past six months, leading to it use already-constrained emergency departments as holding bays for patients, he said.

Like other systems, labor costs have also been a concern due to a continued reliance on temporary staff to fill gaps. Ochsner’s non-agency labor costs grew just under 60% since 2019, while its costs for contract staff grew nearly 900%, he said.

“Our country is perilously short of nurses, and those we do have are often not working in the settings that could provide the most value,” Sarah Szanton, dean of Johns Hopkins School of Nursing said.

“This was true before the pandemic and has become more acute,” she said.

While many nurses left permanent roles for higher-paying contract positions during the pandemic, others have turned to jobs at outpatient clinics, coinciding with a shift toward non-hospital based care.

Registered nurse employment is nearly 5% above where it was in 2019, with nearly all that growth occurring outside of hospitals, Douglas Staiger, a professor of economics at Dartmouth College, found in his research and said at the hearing.

One major concern: Driving current and projected shortages in hospitals that lawmakers can address is the educational pipeline, medical school and health system leaders said.

Educational programs for nurses and physicians face site shortages and educators who are often allured by other higher-paying jobs in the industry.

Nursing educators in Vermont earn about $65,000 a year — about half of what nurses with similar degrees working in hospitals earn, Sanders said during the hearing. He asked members to consider expanding the Nurse Corps and nurse faculty loan repayments, among other programs.

Supporting partnerships between universities and hospitals to create more training opportunities is another way Congress can help, along with addressing high costs of tuition, James Herbert, president of University of New England, said during the hearing.

“Scholarship and loan repayment programs are critical to make healthcare education more accessible for those who would otherwise find it out of reach,” Herbert said.

That includes expanding and improving Medicare-funded physician residencies, he said.

Creating a more diverse workforce that looks more like the population it serves is another important task, and one lawmakers can address by supporting historically black colleges and universities.

Federal funding could help improve classrooms and other infrastructure at HBCUs “that have been egregiously are underfunded for decades,” in addition to expanding Medicare-funded residencies for hospitals that train a large number of graduates for HBCU medical schools, said James Hildreth Sr., president and CEO at Meharry Medical College in Nashville.

The American Hospital Association submitted a statement to the HELP subcommittee and said it also supports increasing the number of residency slots eligible for Medicare funds and rejecting cuts to curb long-term physician shortages.

Other AHA supported policies to address current and long-term workforce shortages include better funding for nursing schools and supporting expedited visas for foreign-trained nurses.

AHA also asked lawmakers to look into travel nurse staffing agencies, reviving requests it made last year alleging that staffing companies engaged in price gouging during the pandemic.

Last year some state lawmakers considered capping the rate hospitals can pay agencies for temporary nursing staff, though none ended up passing legislation to do so.

Physician residents and fellows unionize at two major California health systems

Seeking stronger workplace protections, physician residents and fellows at both Stanford Health Care and the University of Southern California’s (USC) Keck School of Medicine have voted to join the Committee of Interns and Residents, a chapter of the Service Employees International Union (SEIU).

Despite being frontline healthcare workers, most Stanford residents were excluded from the first round of the health system’s COVID vaccine rollout in December 2020. The system ultimately revised its plan to include residents, but the delay damaged Stanford’s relationship with residents, adding momentum to the unionization movement. Meanwhile, Keck’s residents unanimously voted in favor of joining the union, aiming for higher compensation and greater workplace representation.

The Gist: While nurses and other healthcare workers in California, as in many other parts of the country, have been increasingly banding together for higher pay and better working conditions, physician residents and fellows contemplating unionization is a newer trend. 

Physicians-in-training have historically accepted long work hours and low pay as a rite of passage, and have shied away from organizing. But pandemic working conditions, the growing trend of physician employment, and generational shifts in the physician workforce have changed the profession in a multitude of ways. 

Health systems and training programs must actively engage in understanding and supporting the needs of younger doctors, who will soon comprise a majority of the physician workforce.

Michigan Medicine accused of exploiting 1,300 resident physicians in labor dispute

https://www.beckershospitalreview.com/hr/michigan-medicine-accused-of-exploiting-1-300-resident-physicians-in-labor-dispute.html?utm_medium=email

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The union that represents 1,300 resident physicians at Ann Arbor-based Michigan Medicine said the health system is exploiting its members as both sides negotiate a new contract, according to Michigan Radio.

The University of Michigan House Officers Association and Michigan Medicine are trying to reach an agreement before the current contract expires in late June. But compensation remains a key sticking point.

Ruth Bickett-Hickok, MD, a second-year anesthesiology resident, told reporters May 18 she’s been treating COVID-19 patients and seeks a cost-of-living raise, according to Michigan Radio.

“Frankly I’m here because, for lack of a better term, Michigan [Medicine] residents right now are being exploited for their labor. Especially during this crisis,” said Dr. Bickett-Hickok, who is on the union board. She also cited her debt load for undergraduate and medical school in her reasoning for seeking a cost-of-living raise.

Overall, the union says it wants fair wages that recognize the risks physician residents have been willing to take on during the pandemic.

In a statement provided to Becker’s Hospital Review, Michigan Medicine spokesperson Mary Masson said the health system “recognizes the important role of the [union] members” and amid the pandemic “has honored the compensation package previously proposed to the HOA, which includes salary increases.”

Ms. Masson said Michigan Medicine is undergoing a $400 million expense reduction plan with furloughs and layoffs affecting about 1,400 full-time employees. Physician residents’ salaries range from $58,500 to $82,900 annually based on experience. Ms. Masson said to provide even higher salary increases, Michigan Medicine would have to eliminate additional jobs.

The union proposes that the health system use part of the university’s endowment funds to help cover the new labor deal.