Shortages in Healthcare: Where are all the caregivers?

The healthcare industry suffers from a seemingly intractable labor shortage. Despite historically high wages, flexible schedules and advancement opportunities, the industry struggles to remain fully staffed. Read insights from Chrystina Howard , Enterprise Risk Management leader for HUB’s Complex Risk practice, and Dr. Harris Pastides , president emeritus of the University of South Carolina and epidemiologist, as they examine the healthcare labor shortage and workable solutions.

Healthcare is one of the most complex and personal fields, intertwining science, empathy and ethics in a way that significantly impacts individual lives and communities. Heavily regulated and scrutinized, the industry grapples with a constantly evolving stream of needs, necessitating solutions that often must be developed at a moment’s notice.

Yet, at its core, healthcare cannot function without qualified staff to deliver care. Despite salaries for physicians reaching unprecedented heights, along with flexibility in mobility and advancement opportunities, healthcare organizations still face challenges in recruiting and retaining the workforce they desperately need. So, what exactly is the problem?

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Aging population overwhelms healthcare industry

One primary issue is the rapidly aging U.S. population — people are living longer and consuming more healthcare services. This demographic shift results in mounting demand for qualified personnel that far outpaces the influx of new professionals entering the workforce. While some healthcare roles offer competitive compensation, significant pay disparities persist, particularly among clinicians such as nurses. This creates a perception of undervaluation in these specialties and has been a major contributing factor to clinician staffing shortages. This discouragement can deter prospective entrants into clinical disciplines, particularly when general environmental and operational challenges create barriers to delivering quality care. When clinicians are mired in unnecessary complexities and redundancies, they can become disillusioned and leave the profession prematurely.

In an age where technology is often viewed as a solution to staffing shortages, the opposite reality is unfolding. Advanced technologies such as digital diagnostic devices and laser surgery equipment often divert technicians from other critical areas, exacerbating staffing issues rather than alleviating them.

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Burnout prompts early career departures ?

Moreover, the fallout from COVID-19 has intensified the problem. A striking number of healthcare workers report high levels of burnout. The American Medical Association notes that approximately 20% of physicians are contemplating leaving the field within five years, irrespective of their age or experience. Despite increasing applications to healthcare professional programs and expanded educational capacity, the alarming trend of professionals exiting their roles persists. This is particularly true in rural regions where lifestyle opportunities are limited, especially for those with young families.

Several contributors to burnout have been identified, including the lack of control over patient care due to prior authorization requirements, excessive time spent on electronic health records — often extending into personal time — and the oppressive atmosphere stemming from litigation risks. Additionally, declining reimbursement rates from Medicare and inflationary pressures exacerbate these challenges, leaving medical professionals feeling overwhelmed and undervalued. Notably, amid mounting pressures from hospitals and financial entities interested in acquiring medical practices, fewer and fewer doctors are opting for private practice, thus further consolidating the healthcare market.

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Bridging gaps to ease shortages

Despite various strategies being advanced to alleviate the workforce shortage, the crisis is expected to intensify. For instance, bridge programs aiming to address nursing shortages —created in reaction to immediate crises — may overlook the educational prerequisites necessary for delivering complex care within diverse environments. And an inadequately prepared clinical workforce lacking skills in interdisciplinary collaboration and patient advocacy may ultimately impede efforts to enhance patient care and outcomes.

Legislative actions are underway, such as the Resident Physician Shortage Reduction Act of 2023, aimed at lifting caps on residency programs. Some states have independently taken measures to increase residency slots, a critical bottleneck in recruiting physicians to underserved communities. Additionally, advocacy for reforming immigration policies to facilitate the retention of international medical graduates in the U.S. following their residency has gained traction. A longer-term strategy involves investing in educational programs to expand the pipeline of healthcare professionals. Initiatives to mitigate student debt, which averages around $200,000 for U.S. medical graduates, could also significantly impact the workforce landscape.

In addressing these pressing challenges, strategies that integrate education, policy reforms, community support and mental health resources for healthcare professionals can pave the way toward a more sustainable workforce. On an organizational level, thoughtful assessment and planning via an innovative enterprise risk management (ERM) strategy can help bridge gaps and foster an environment where healthcare workers feel valued, empowered and adequately equipped to meet the needs of their patients.

For more information on developing an ERM strategy for your healthcare organization, contact a HUB Complex Risk Specialist .