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Healthcare workforce shortages: plan now for the long-term

Aug 08, 2021

Even before the pandemic, for years we were already seeing shortages in healthcare depending on specialty or discipline. Physician shortages usually get the most attention, but that’s just the start. 

Shortages also exist for:

  • Medical assistants
  • Nurses
  • Nurse practitioners
  • Physician assistants
  • Dentists
  • Dental assistants
  • Dental hygienists

These shortages are most acute in underserved or rural areas. Factor in the pandemic, and the problem is compounded.

There’s nothing new to say there is burnout. The long hours. The stress of working in the pandemic’s highly-contagious environment. Coupled with worry about providers returning to their families and not wanting to get them infected, creating an entirely new definition of work-life balance. Burnout has been very intense for clinical providers.

Additionally, early retirements are rising, and more people are leaving the clinical environment at a faster pace. The future is tight and organizations need to get more creative. Let’s examine some options for healthcare organizations to address workforce shortages and staffing needs.

Short-term option for healthcare shortages

For immediate help, the fastest solution can be:

Contracting with locums. Building a network of locum physicians can help fill immediate needs. These physicians temporarily fill the position of an absent or newly-retired physician for an agreed-upon time. Maintaining a continuously-updated list can fill staffing shortages and extend search times for full-time physicians.

Unfortunately, there is not a short-term magic fix. The option above can buy time and keep continuity of service in place. But long-term, organizations need to focus on what is most important: building through relationships.

Long-term planning to avoid healthcare shortages

Become a rotation site. Partnering with a clinical program in a medical school or health professional school can provide you with residents or post-graduates to see patients. Although there are rules not to overload these learners with too many visits. And there are rules for Medicare and Medicaid regarding supervision of learners. Learners are not there to turn out patient visits, they are there to learn. Becoming a clinical rotation site exposes learners to you in hopes that they will come back to you or stay with you when they complete their training.

Make workforce a priority

We hear the phrase “employer of choice” a lot. But this means a lot of different things to different people. To some it means compensation and benefits. To others it means employees feeling empowered and having a say.

For example, if we create a program to help grow a clinical workforce, but it’s tried in a toxic environment, all we’re doing is wasting time and money. Organizations can address this by making workforce a priority and creating a culture that supports workforce development.

Becoming an employer of choice should be a constant driving factor, with an emphasis on how to grow the clinical workforce and focus on which programs are best to develop.

Focus on grow your own

For some healthcare organizations, especially in underserved and rural areas, the biggest emphasis may be on “grow your own” programs. At Wipfli, we help create grow your own programs. Recruitment takes place at the local level, and prospects return to school to learn and train to become primary care providers within their communities. These can be viable options for federally qualified health centers (FQHC) and rural health clinics (RHC).

But grow your own can’t be done in a vacuum, or if it’s missing other employer of choice aspects. The grow your own framework isn’t for everybody. You have to have some bandwidth to do this, along with a commitment to education. So much so that it’s in your mission statement. There must be a commitment to scholarly activity and intellectual curiosity.

Plus, you need volumes. In the world of clinical education, patients equal educational material. But, as mentioned above, there are minimums and other requirements on how many patients can be seen. When starting a grow your own program, it’s a mistake to think you have all these residents in your clinic who can see all these patients.

Starting a residency program: what you need to know

Looking through the lens of grow your own, let’s examine steps an organization would take to start a residency program.

Step 1: Feasibility study. As a first step, the feasibility study should examine:

  • if the academic criteria are met for a residency program.
  • high-level financial picture for examining graduate medical education (GME) and clinical / hospital finance to show an organization what to expect if they choose to proceed.
  • covering the language of GME for organizations to adopt and incorporate into day-to-day operations.

Step 2: Accreditation. Taking the physician side as an example, to have a residency program at your healthcare entity you must first be credited as a sponsored institution by ACGME. This whole process involves governance training, policy and procedure development, and application development and approval.

Step 3: Application process for the specialty. Developing a specialty application is very in-depth and involves an incredible amount of work. Be prepared to develop the curriculum, the goals and objections, and the evaluation tools all before submitting the application. 

After submitting the specialty application, a site visit will be conducted, and the organization waits to get approved.  

If you need healthcare workforce planning help

Wipfli specializes in GME services and developing programs, along with strategic workforce plans. We can advise you on ways to secure state and federal funding. Your strategic objectives will be examined from a data-driven perspective, and we do the analytics on strategic workforce plans.

When we take you on as a client, we will write your applications. We understand that most people have never gone through this process, and we see a lot of errors that are commonly made. The unfortunate truth is, it takes a lot of work to fix these errors and it is very expensive. To prevent that, we’ll write your application, because we want it done right the first time to get you accredited. In fact, we’re with you all the way through your site visit.

Beyond the application process, we can assist you with grant writing, evaluations of existing programs, building education consortiums and writing your curriculum.

Our team of experts can help you in whatever stage you are in, whether it’s GME or workforce development. Contact Wipfli to let us know how we can help you.

Author(s)

Kiki C. Nocella
Director
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