Is There a Doctor In the House? Part II
In part 1 of this series, we took a look at a serious problem facing healthcare – clinician shortage. In this blog, I will take a look at some potential solutions. These solutions include, but are not limited to, the following: improving education, removing barriers to access, promoting efficient care delivery, and improving the practice environment.
First, improving education. Many problems are endemic to professional training, and the terms and conditions of training and education should remain the responsibility of the professions. Educational financing should reflect a better balance between primary care and specialty practices, increasing graduates of all health professions and providing financial incentives for faculty. Health professionals should incorporate interprofessional education to increase efficiency and productivity, promote coordination of care, and hold training exercises in teamwork. Congress should also reevaluate the current Graduate Medical Education program. It is imperative to ensure available residency slots for the projected medical student enrollment.
Second, removing barriers to access. Scope-of-practice rules can contribute to the cost and inefficiency of the health care system, creating another barrier to patient access to care. In a national survey of physicians and nurse practitioners, a majority of respondents indicated that having more nurse practitioners would improve timeliness of care and access. While physicians are concerned with quality of care and, of course, a reduction in their market share, no evidence suggests that using APRNs negatively affects patients or physicians. Nursing, the largest segment of the health care workforce, should be “full partners” with other health professionals in the improvement of the health care system.
Third, promoting efficient care delivery.Human capital is the backbone of the health care industry. Providing health care is labor intensive, and recruiting and retaining a sufficient workforce are essential. Strengthening the workforce supply should be coupled with innovation in role and task allocation. Efficiency and productivity will expand the workers’ capacity to deliver high-quality patient care. To increase care coordination and improve work flow, professionals should pursue team-based collaboration. This means health professionals should define the necessary tasks of their own professions and be ready and able to delegate tasks outside of their profession to other personnel. Workforce shortages compel health care leaders to invent new ways to use limited personnel efficiently to meet increased demands.
Finally, improving the practice environment. Increasing retention will require greater incentives. Incentives should include a mix of public policies, such as reducing liability through tort reform, Medicare payment reform, and reduced federal tax rates. In the private sector, health care businesses will need to use the most effective methods of attracting, hiring, and retaining workers. Retaining talent will require extensive human resource planning and incentivizing through benefits, education and career advancement, profit sharing, and workforce protections. Active interventions to prevent work overloads and strategies for stress management will reduce attrition and costly replacements and ensure adequate supply. Workers need to be protected physically, emotionally, and psychologically to ensure a healthy workforce.
As we can see, there are many options that can begin to help alleviate clinician shortage. I encourage you to see what your own state is doing to help.