Health care at a crossroads: Addressing workforce demand with innovation and inclusion

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Physicians and other health care leaders face a persistent challenge in recruiting and retaining qualified support staff. Whether in giant health systems or independent doctor’s practices, competition for talent has intensified in recent years, exacerbated by the health care industry's workforce shortages and the COVID-19 pandemic. In addition, many health care professionals left the field due to burnout and others are reaching retirement age. After losing 100,000 registered nurses during the COVID-19 pandemic, the workforce is expected to lose nearly 900,000 nurses by 2027, according to research from the National Council of State Boards of Nursing. The U.S. Bureau of Labor Statistics reports that total employment in health care between 2022 and 2032 is projected to grow much faster than the average for all occupations over the same period. This workforce gap must be filled to continue to meet the health care needs of an aging population.

Contributing factors: health care workforce gap

Marlo Robinson, DNP, JD, RN

Two major contributors to the health care workforce gap are the lack of exposure to career options in health care and employee burnout in health care workers. Research from YouScience shows that 43% more students have an aptitude for careers in health science than interest, highlighting significant untapped potential! We, as a country and industry, need to expose students who have the aptitudes for these in-demand careers to opportunities in health care.

But it’s not just about getting more individuals to enter the health care field; there is also work to do on retaining health care workers. According to research published by The Journal of Nursing Regulation, stress, and high workloads have contributed to nurse burnout and many new nurses leaving the profession. Out of the nurses in the sample, high proportions reported feeling emotionally drained (50.8%) or burned out (45.1%) a few times a week or every day. Less experienced nurses reported higher levels of burnout. Increasing the number of nurses in the field can help to spread out workloads and better support new nurses to improve early career retention.

Beyond nursing: lesser-known, in-demand health care professions

While much attention is paid to nursing shortages, less attention has been paid to addressing critical demand in other areas of health care that impact physicians and nurses, straining resources.

Positions in medical assisting, respiratory care, and surgical technology, for example, are in particularly high demand. These lesser-known skilled trades in health care are experiencing strong, growing demand. According to the Bureau of Labor Statistics (BLS), total employment for medical assistants is expected to grow by 14% between 2022 and 2032. In certain states, projected growth is even higher. For example, in California, medical assistant jobs are expected to grow by 20% between 2020 and 2030, while Florida and Texas will see projected job growth of 30% and 29% respectively during that same period.

Nationally, total employment in respiratory therapy is expected to grow by 13% from 2022 to 2032. However, in California, respiratory therapy jobs are projected to grow by 25% from 2020 to 2030. During the same period, Florida and Texas respiratory therapy jobs have a projected growth of 32% and 33%.

Demand for surgical technologists, professionals who assist surgeons and nurses in ambulatory surgical centers as well as in hospitals, is expected to grow by 5% between 2022 and 2032 according to BLS data. In California, projected job growth from 2020 to 2030 is 10%, while surgical technology jobs are projected to grow by 18% in both Florida and Texas during the same time.

These lesser-known skilled positions in health care offer in-demand jobs and shorter pathways to the workforce. Students can prepare for respiratory therapy and surgical technology careers through an associate degree. Medical assisting programs offer a short diploma pathway, or an associate degree option. For many students, finding programs that will directly prepare them with skills for their careers is priority. If we educate students on their full range of options beyond four-year bachelor’s degrees, we can help more high school students go on to meaningful, in-demand careers. These skilled health care professions can also allow mid-career professionals to upskill or switch fields without having to go back for a four-year degree. Educating more people about the full range of health care careers can open possibilities for young graduates and mid-career workers who are looking to change or advance their careers.

Nurses in high demand: exploring solutions to a growing crisis

According to The U.S. Chamber of Commerce, there will be 193,100 projected job openings for registered nurses (RNs) on average per year until 2032 including growth and net replacements. Only 177,400 new nurses are expected to enter the workforce between 2022 and 2032. In the United States, there are an average of just nine RNs for every 1,000 people. Nurse shortages contribute to inadequate staffing, higher patient mortality rates, and higher nurse burnout.

Strategic planning to address this shortage includes reimagining pathways into nursing and increasing the practical nursing (or vocational nursing, depending on the state) option as an efficient path into nursing. These programs can move graduates into the nursing profession quickly, alleviating labor shortages and creating brighter futures for graduates.

Licensed practical nurses (LPNs) and licensed vocational nurses (LVNs) can practice with a diploma and licensure. This provides a solution to both the nursing shortage and a gateway for more diverse individuals to enter the health care workforce.

Strategies for increasing diversity in health care

Improving diversity in the health care profession contributes to better patient outcomes for underrepresented populations. It’s encouraging to see the growing commitment to diversifying the workforce and keeping that momentum going is important. Black, Latinx, and Indigenous Americans are particularly underrepresented in health care. In 2022, the U.S. RN population was 80% white, 7.4% Asian; 6.3% Black/African American; 2.5% more than one race; 0.4% Native American or Alaska Native, 0.4% Native Hawaiian or other Pacific Islander, and 6.9% Hispanic. These numbers are not reflective of the U.S. patient population.

Currently, there are significant racial disparities in patient care. Health policy analyst KFF reported that infants born to women of color are at higher risk for mortality and that Black women have the highest maternal mortality rate. Additionally, in a recent survey, 18% of Black patients, 11% of Hispanic patients, and 10% of Asian patients reported being treated unfairly or disrespected by a health care provider because of their racial or ethnic background. Having providers that share a patient’s ethnicity, race, and language can increase patient trust and support better patient experiences and outcomes.

Sustained diversity in the health care workforce is vital for providing the best possible patient experiences and outcomes. For minority patient populations, a lack of diversity in the health care workforce is a factor that contributes to poorer health outcomes and higher mortality rates according to the National Center of Health Statistics.

Addressing barriers to entering health care careers will help improve diversity. Educational institutions can address this in several ways, starting with diversifying representation among faculty and staff. As reported by New America, research shows that minority students have far better outcomes when their instructor was of the same race or ethnicity. Providing proactive, student-centered support from faculty and student affairs throughout the educational journey also helps with persistence and academic success. From a curriculum perspective, providing culturally responsive education helps students better understand the health care challenges faced by communities and how cultural factors impact health outcomes. This enables students of varied cultures to deliver compassionate care that values the perspectives and preferences of the patients they serve.

How physicians can help

Physicians can step in to create a more diverse medical field by aligning the missions of medical institutions, from hospitals to private practices, with inclusion and equitable access to health care – providing inclusivity training, helping to remove barriers, and creating positive, welcoming workplace cultures – can help to improve diversity and strengthen the health care workforce.

Physicians can also advocate for increased diversity in health care by supporting policy that underscores representation and removes barriers. This amplifies efforts led by other health care professions, leading to more powerful outcomes. The National League for Nursing has identified improving diversity and inclusion as one of its priorities. Recommendations include strategies such as promoting policies and funding to recruit and retain a more diverse nursing workforce and promoting policies and evidence-based strategies to foster and sustain inclusivity and belonging in care.

A health care workforce built for the future

We have an incredible opportunity and responsibility to strengthen the health care workforce. By increasing the number of health care professionals entering the profession, improving diversity, and focusing on retaining our new health care workers, we can support better patient care. It’s also time to step up efforts to educate young people about the full range of career opportunities in health care. By exposing more students to health care careers, we can bring a new generation of untapped talent into the health care workforce.

Marlo Robinson, DNP, JD, RN, is the national dean of nursing for Concorde Career Colleges, a division of Universal Technical Institute Inc. At Concorde, she oversees 13 nursing programs nationwide. She was recently appointed as the National League for Nursing consultant to the National Student Nurses’ Association. She also is the founder and owner of Mother's Care Doula Services, which serves as a full-service birth, postpartum and childbirth education provider in South Florida.As a licensed attorney, she is an active member of the Florida Bar.