Industry Experts Discuss What Needs to Change in the Coming Years

By Ron Shinkman

Healthcare is one of the few sectors of labor in the United States where the workforce is fairly assured of stable and steady employment. Everyone needs healthcare services at some point – particularly given the aging of the U.S. population. New developments in medical technology, drugs and treatments continue at a strong pace. The sector itself must change in order to accommodate the current labor climate, experts say.

The healthcare sector has long had to manage persistent labor shortages. Medical schools and nursing schools are limited in how many graduates they can produce on an annual basis, as are programs for allied professions such as surgical and imaging technicians. 

Combine this chronic shortage of newly minted professionals and skilled workers with worker burnout from the COVID-19 pandemic and the lowest unemployment rate in 55 years, and the issue becomes more concerning.

Eric Dickerson, managing director and senior practice leader for Kaye Bassman, a recruiting firm based in Plano, Texas, observed that the healthcare labor is among the tightest he has ever seen. Although the nationwide labor participation rate is about 63% among all adults, it is 83.5% among those in the prime working ages of 25 to 54. Given the myriad business sectors across the United States, that means the healthcare sector is competing for just a small sliver of the U.S. labor market.

“That means you’re struggling to find additional workers while the demand is growing for your hospital or healthcare system. You have to really address that and not necessarily do things the same way all the time,” Dickerson said during a HealthExecWire webinar, “Healthcare’s Ongoing Workforce Challenges: Recruitment/Retention Strategies.”

What does a different approach actually mean? 

According to Dickerson, while money is important, it is not be the be all and end all. He suggested providers and other healthcare companies focus more on their values and the way they are imparted to its workforce. He noted that in recent decades many healthcare organizations had become overly focused on the bottom line, and workers began to believe they were easily replaceable, making it difficult to retain them over the long-term.

“People are interested when they see a future in your organization, and when they see an opportunity to grow and have career growth and opportunity,” Dickerson said. “That’s when they want to stay in an organization.”

Dickerson also cited workforce polling data indicating workers want more flexibility in their jobs, including opportunities to work remotely.

Of course, that has also created friction points in the labor marketplace. According to Matthew Fontana, a Philadelphia-based partner in the law firm of Faegre Drinker, workers have become more empowered in recent years to join labor unions. In fact, the biggest healthcare work stoppage in history occurred last fall, when some 85,000 unionized employees of Kaiser Permanente walked off the job.

According to Fontana, union representation petitions in the healthcare sector rose 57% between October 2022 and March 2023. Bargaining demands have also increased, with unionized nurses typically asking for 7% annual pay increases in recent negotiations. He noted that the increased reliance on unions in recent years has been in response to hospital and healthcare system management not responding to workplace issues in a timely or responsive manner.

But Fontana observed that most unionization efforts are coming in response to rank-and-file workers’ interactions with lower-level managers. “You really want to think of management interaction [that properly matches up] with employees,” he said. Fontana added that some healthcare employers have already taken that into consideration, with supervisors receiving additional training to defuse such potential situations, along providing additional focus on boosting compensation and retention.

Meanwhile, the healthcare system needs to also focus on creating new pipelines to recruit new workers. 

“How can we think outside the box?” asked Elizabeth DuBois, chief operating officer and principal with COPE Health Solutions, a Los Angeles-based consulting firm.

New approaches are crucial, given DuBois has noted that some healthcare systems have approached COPE needing to hire as many as 400 registered nurses – an impossible demand given the current labor climate.

In response, COPE developed a scholar program intended to attract the interest of a range of potential future healthcare workers, whether high school or college students or even adults looking to make a career change.

“If all of a sudden you have a huge shortage, let's say in the (medical/surgical) unit, you can increase your scholar support over there,” DuBois said. “This is a system you can do within your organization.” She added that grants from community support organizations are also available to fund such initiatives.

In addition to such outreach, COPE has also developed fellowships to help train and acculturate individuals for advanced practice providers such as physician assistants and nurse practitioners. Other programs have also been developed to train crucial non-clinical workers such as care navigators, community health workers and promotores.

Since COPE began such programs around 2000, some 55,000 individuals have participated. About 87% have remained in healthcare, often with the organization that gave them their first employment opportunity, according to DuBois.

Whether rejiggering the traditional approaches to healthcare recruitment and retention will pay dividends remains to be seen. These are long-game approaches. But then again, healthcare entities have always had to recruit, hire and retain competent and able employees. Barring an economic catastrophe on part with the Great Depression of the 1930s, that will likely never change.

“Healthcare is a unique business that attracts individuals with great hearts and caring personalities,” Dickerson said. “But the balancing of that with the business of caring for [patients] is absolutely critical. You have to make sure everyone is being taken care of.”