If you ask US hospitals and health clinics how they're doing, they might tell you that they're coping with a crushing labor shortage spawned by workers quitting during the pandemic and never coming back.
Now, a pair of economists who've crunched the numbers say there's a problem: This perception isn't based in reality.
"The lasting impact of the Great Resignation is a myth," said Amitabh Chandra, PhD, director of Health Policy Research at Harvard Kennedy School of Government and co-author of a new report in NEJM Catalyst. "I don't see the long shadow of the pandemic at work. There are many more people working at hospitals and physician offices than in March 2020. It's just not consistent with the claim that 'our offices and hospitals have been hammered.'"
This matters, he told Medscape Medical News, because healthcare bosses who claim otherwise give the wrong impression to the government when they ask for financial help.
Chandra said that he developed the idea for the report after hearing stories about how labor shortages persisted in healthcare after the worst days of the pandemic.
Many doctors, nurses, and hospital executives believe that chronic vacancies remain because large numbers of workers quit during the pandemic and never returned, he said.
Politicians echo their views.
" We have nowhere near the kind of workforce, healthcare workforce, that we need," Vermont Senator Bernie Sanders told CNN earlier this year. "We don't have enough doctors. We don't have enough nurses."
The idea of a shortage "bothered me a lot because if it were true, then there would be real effects on the quality of care that people are receiving," Chandra said.
So he and co-author Louis-Jonas Heizlsperger, MSc, a graduate student at the University of California at Berkeley, decided to take a look at the data.
In February 2020, just weeks before much of the nation shut down, they found that "11.3 million workers were employed in these three sectors: 5.2 million in hospitals, 3.4 million in nursing and residential care facilities, and 2.7 million in physician offices," the report finds.
Then, the pandemic and the Great Resignation happened. But hospital and physician office employment was nearly full restored within 1 year, the researchers show.
Chandra and co-author Heizlsperger also found that wages for hospital and physician office employees have outpaced inflation.
"In contrast to the public narrative around quitting and resignations in health care, employment in hospitals is now slightly higher than what it was at the start of the pandemic and substantially higher in physician offices," they write. "Outside of nursing homes, the narrative of stagnant wages, vacancies, and low employment receives no empirical support."
The new report has limitations. Chandra said that the data don't allow him to analyze the numbers for specific occupation, such as physician or nurse.
The researchers concluded that policy makers "should be skeptical" of hospitals' requests for government financial assistance to ameliorate labor shortages without better facts about these alleged shortages.
Chandra cautioned that he's not saying that the idea of a labor shortage in medicine is itself a myth. There may be a shortage, he believes.
"You could argue that the demand for healthcare has far exceeded the past and far exceeds the labor market's ability to supply workers." But this would be due to rapid growth in the industry, he said, not because people quit nearly 4 years ago and never came back.
Another possibility is that there's only a perception that vacancies can't be filled.
"People feel there's a shortage because they're tired, they're burned out, they're exhausted. The well-being of doctors and nurses is quite poor," he said. "It could be that there's a lot of quitting, hiring, training and onboarding. That's a different problem than saying 'We don't have nurses.'"
So what can policymakers do with the information from the new report?
Chandra said that they could take note of one area within medicine that's definitely struggling: nursing homes and residential facilities.
That workforce has actually shrunk over the past 4 years, with employment down 6% since before the pandemic, the study shows. It doesn't examine whether that occurred because many potential patients died during the pandemic. Whatever the case, nursing homes "are not the ones at the helm doing the advocacy," Chandra said.
Advocating for nursing home workers "who care for most of the most vulnerable and frailest Americans" is quite different "talking congressmen and state legislators into aid packages that benefit hospitals and doctor's offices."
The report authors have no disclosures.
Randy Dotinga is a freelance medical writer and board member of the Association of Health Care Journalists.
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