To Your Health...Maybe

There is a serious health care problem that threatening to reach crisis proportions. This problem is the shortage of health care employees. This will be a crisis that will only continue to get worse and worse over time. We must take steps now to correct it.

Over the past few years, the average age of health care workers has increased. As this average age continues to increase, we are finding that people are leaving the health care field through retirement, resignation, or death faster than young people are entering health care fields. The emerging crisis is that the number of health care workers is declining as the demand for their services is increasing at a significant rate. As the average American population increases due to the growing numbers of senior citizens, we are seeing the beginning stages of a major problem where not enough health care workers are available to serve people requiring health care services. The demographic reality is that the number of elderly is increasing, baby boomers are entering retirement ages, and there are not enough young people responding to the call to attend to the growing health care demands.

The problems are particularly noticeable in certain geographic areas, such as urban areas and in smaller communities. It is harder for city hospitals and smaller health care clinics to attract employees. Besides shortages in certain areas, there are shortages nearly everywhere in many health care occupations, including physicians, nurses, pharmacists, and dentists.

The U.S. Health and Human Services Department reports the number of graduating nurses has steadily declined since 1995. There are now about one-fourth fewer people entering the nursing profession than there were eight years ago. Nursing schools indicate they have physical room for more nursing students, yet a shortage of people who can teach nursing is causing them to reduce enrollments.

The National Conference of State Legislature reports that nurses are not remaining in their nursing careers as long as their predecessors. Ironically, many hospitals, in dealing with the shortages, are making their nursing employees work longer shifts. This solves short-term problems yet, in the long-term, causes nurses to burn out faster and serve fewer years in hospital employment.

The Joint Commission on Accreditation of Healthcare Organizations estimated last year that there were 126,000 nursing jobs in existence today that can not find a qualified applicant. The situation continues to worsen. We need more nurses, and will continue to need still larger numbers of nurses in future years.

The high costs of medical school tends to drive graduates to accept higher paying jobs, such as being specialists in private hospitals. Unfortunately, the number of doctors serving clinics in urban areas, in rural hospitals, and in working as general practitioners has failed to keep up with public need.

Fortunately, there are steps that can be taken to deal with this overall problem. Tax credits or school loan repayment assistance can be provided to people who enter needed health care professions or who agree to work in geographic areas where there are critical shortages. Since financial considerations are often the reasons why people decline to enter specific occupations, there is a public need to respond to these imbalances.

Many education institutions are finding difficulties in offering enough courses to students who are interested in health care. In the midst of a need for more people in health care, colleges are turning away people who wish to enter health care. We need to conduct more outreach to find people to teach the young about health care professions. We need to reach out to retired health care employees who, while not able to teach full time, could teach part-time, serve as mentors, or be available to tutor or answer questions from students. Further, we need to work with our community colleges and State System of Higher Education to see that more course offerings are made in health care fields and in allied medical professions.

We should restrict the amount of overtime that health care employees work. Some hospitals believe it should be a rite of passage that interns, nurses, and new employees work multiple shifts back to back. Unfortunately, and health care supervisors should be among the people most aware of this problem, employees who are awake continually for several shifts have diminished alertness. In an occupation where clear and quick thinking in necessary in medical situations that can be life and death situations, the public should not have to face tired and overworked health care employees. This diminishes the quality of health care. This wears out employees and helps drive them out of the health care field. There should be a limit on the number of total hours and consecutive hours that health care workers can be required to work.

Emergency rooms and trauma centers save lives. There should be more, not less, of such facilities. We need to provide greater assistance to emergency rooms and trauma centers. The distribution of funds needs to reflect this.

We need to radically reconsider our health care delivery system. Patients could access physicians using telemedicine. Symptoms can be seen by video through computers and medical questions can be sent through email. Some types of medications can be mailed or delivered to customers. While special care needs to be taken to prevent abuses, this should be a step in the future of health care. Much of this may only serve as temporary care until a physician can directly see the patient. Some of it is useful primarily in low priority health needs where the care can be provided at home. It definitely is much better than having no access to health care, which current and future shortages are creating.

There should be a better distribution of health care job chores. By freeing more time for health care employees to provide health care, part of the shortages of available care can be significantly diminished. While only licensed physicians should perform the duties of a doctor, there are some duties we currently leave only to doctors that could not only be performed by nurses or by non-physician clinicians. This can further improve health care, as nurses are often more aware of patient needs and thus better able to know what kinds of certain care are needed.

There are some nursing jobs that do not involve decisions on patient care that could be shifted to non-nurses. There should be a growth in clinicians that could both alleviate the overload burden facing nurses while providing employment opportunities to people unable to afford nursing education.

To make health care training more accessible and affordable, distance learning should be implemented more widely. Penn State already offers online courses. This allows students who can’t afford to attend college to study at home and learn careers. Greater use of this type education will create greater entry into the health care profession

Several state governments are collecting data and establishing commissions that will determine where health care shortages exist and find solutions that will resolve the problems these shortages create. Pennsylvania needs to be one of those states. The Health Care Cost Containment Council could be expanded to deal with health care shortages or a similar entity could be created. This is an important issue that needs to be addressed on a continual basis for many years. We need to begin acting now.