It’s no secret that the demand for healthcare services has increased over the past few years. Some of the critical drivers of this demand are necessary side effects of actual improvements in access to care and advances in medicine. Notably, because of Obamacare we now have 20 million more people covered by insurance. Advances in medicine are leading to improved treatments and outcomes –we are living longer, using the system more, and as a result costing more. Finally, there are more of us living to old age. Between 2010 and 2050, the U.S. population is projected to grow from 310 million to 439 million, an increase of 42 percent. The population is also expected to become much older, with nearly one in five U.S. residents being aged 65 and older by 2030. All combined, these demands are creating a serious strain on health care resources. So much so, employment in health care occupations is projected to grow 19% from 2014 to 2024 – much faster than the average for all occupations.
Is the healthcare profession ready to meet this demand? It’s not. The numbers are clear. Lots of professionals, both medical and technical, are needed to deliver care.
Education and training for careers in health vary depending on level skill. On the lower end, it can be from as little as 100 hours of training for home health aides to 2 years for Licensed Practical Nurses (LPNs). Large numbers of lower-skilled health care professionals can, therefore, be trained quickly in response to increased demand for their services. This is not the case for other higher-skilled professionals, such as Registered Nurses (RNs), Nurse Practitioners (NPs), and Physicians, who require anywhere from 4 to 16 years of college education, advanced degrees and hands-on training.
The high demand for professionals in the latter category has led to an inability of supply to meet demand. In the US, we are currently facing a physician shortage. By 2025, the shortage is estimated to grow to between 124,000 and 160,000 full-time physicians. Despite the 21% increase in medical school enrollments between 2002 and 2012, the number of residency slots, where these newly minted doctors need to get their mandatory hands-on training, has only increased 8 percent over the past 5 years. Clearly, we are not training physicians at the rates necessary to meet our increasingly growing shortfall. Add to this the large numbers of physicians who are heading into retirement. Statistics are worse for nurses, where we are expecting a shortfall of more than 1 million by 2020. Contributing to the shortage of nurses is a lack of faculty to train them. Most openings for nursing faculty require doctoral candidates.
As our training systems stand today, we will not be able to increase the supply of doctors and nurses to match the avalanche of demand. We need to go ‘back to school’ to redesign our training programs. At the same time, we need to rethink the way we deliver care. We need innovative coordinated delivery systems to meet the challenges of patient care.
Though government agencies and academic/hospital centers play a large role in training and delivery, pivotal change to disrupt the failing system will come from grassroots organizations and innovative medical groups. For example, foreign-trained doctors, who have the necessary skills, but are unable to get residency slots, represent a largely untapped highly skilled workforce. Essen Health Care developed training programs for these skilled workers to become scribes, medical assistants, nurses, and even nurse practitioners. Essen Health Care’s emphasis on workforce development initiatives for foreign doctors is an example of the type of “out-of-the-box” thinking that will aid in addressing shortages in the near term. We need more such innovation.