The dockworker strike: A harbinger of the coming health care workforce crisis

Across the United States, physicians are facing a perfect storm that threatens to reshape the landscape of health care as we know it.

The recent dockworker strike that paralyzed East Coast and Gulf ports might seem worlds away from a primary care physician’s clinic, but it’s a canary in the coal mine for what’s coming in health care. While we’ve been distracted by supply chain disruptions and their impact on consumer goods, we’ve missed a far more critical story unfolding right before our eyes.

Let’s connect some dots.

Neal Shah
_{© CareYaya}

Mary Furlong, EdD
_{© Mary Furlong & Associates}

The dockworkers’ strike highlighted a crucial issue: an aging workforce in a physically demanding job. Nearly half of dockworkers are older than 50. Now, let’s pivot to health care. Over half of certified nursing assistants in the U.S. are older than 50, and nearly one-fifth of registered nurses plan to retire in the next five years. Demand for these workers is about to skyrocket in order to meet the growing health care needs of our aging population. Where will we fill these jobs?

Every health care executive and policy maker should read the recent report “We’re Getting Older, and the Labor Market Shows It” put out by the Atlanta Federal Reserve. It discusses the impact of an aging workforce on the labor market. Since 2019, the middle-aged workforce (ages 25-54) in America has barely budged, while the 65-and-older workforce has grown by nearly 5 million. This is a demographic disaster awaiting our health care system.

Source: “We’re Getting Older, and the Labor Market Shows It” - © Atlanta Federal Reserve

Now, you may think that younger workers will step up to fill the needed roles. But, research from ADP released in August suggests that the brief trend of Gen Z flocking to blue-collar work has plateaued. Sadly, they’re still more interested in being social media influencers than in becoming nurses.

But it’s not just about numbers. It’s about the changing nature of work itself. The dockworker strike highlighted the tension between human labor and automation. In health care, we’re seeing a similar dance with artificial intelligence (AI) and robotics. The promise of efficiency clashes with the fear of job losses and the very real need for human touch in patient care.

Many of your colleagues likely find themselves caught in this crossfire. They’re struggling to keep up with the increasing administrative burden while maintaining the personal connections that drew them to health care in the first place. The introduction of AI-powered diagnostic tools and electronic health records was supposed to make the work easier. Instead, many often feel like they’re working for the technology, not the other way around.

So, what’s a nation — and more importantly, what are health care providers — to do?

First, we need to rethink our approach to workforce development. The dockworkers’ union has been sounding the alarm about the need for training programs to help workers adapt to new technologies. In health care, we need to do the same, but on steroids. We’re talking about massive investment in education and training, from better pathway programs for nursing to midcareer retraining initiatives to encourage more people to pursue work in these fields.

For health care providers, this means more than just keeping up with the latest care protocols. It means embracing a new paradigm of lifelong learning and adaptability. Just as dockworkers are grappling with automation, physicians, nurses and nurse aides must become adept at leveraging new technologies, from AI-powered clinical decision support systems and predictive analytics for patient deterioration to computer vision tools for medical imaging and natural language processing for clinical documentation to ease physician workload.

But here’s the critical part: We need to help essential workers integrate these tools into their daily routines in a way that enhances rather than replaces the compassionate care that drew them to these careers in the first place. It’s not about turning health care providers into robots. It’s about empowering them to become tech-savvy care providers who can navigate the complexities of 21st-century health care while maintaining the empathy and personal touch that our patients desperately need. This shift will require significant investment in training programs and a reimagining of education to prepare the next generation.

Second, we all need to advocate for policies that support and strengthen health care. The dockworker strike cost the U.S. economy an estimated $5 billion a day. A health care worker shortage of similar magnitude would be catastrophic, not just economically but in terms of human lives. We need to push for policies that incentivize careers in health care, from loan forgiveness programs to reforms in reimbursement models that better reflect the value of preventive care and care coordination.

Third, we need to have a serious conversation about immigration. Like it or not, foreign-born workers are the backbone of many health care roles, with immigrants comprising almost 40% of home health aides and 30% of physicians in America. If we want to avoid a catastrophic workforce shortage, we need a rational, comprehensive immigration policy that prioritizes health care workers. Consider this data from the Bipartisan Policy Center:

Source: “Immigrants in the Health Care Workforce: An Explainer.” - © Bipartisan Policy Center

The dockworker strike has given us a glimpse of what happens when an aging workforce collides with technological change and shifting labor expectations. In health care, the stakes are even higher. We’re not just talking about delayed deliveries. We’re talking about life or death.

So here’s our call to action for every health care provider reading this: Use this moment as a wake-up call. Society needs to be proactive about shaping the future of health care work. We need to engage with policy makers, health care administrators, tech companies and educators to hammer out solutions before we find ourselves in a crisis we can’t manage.

Because if we don’t act now, you might find yourself longing for the days when your biggest worry was whether you could squeeze in one more patient before lunch. Instead, we’ll be wondering whether there’s anyone left to staff our clinics at all. And that is a future none of us wants to contemplate.

Neal K. Shah is CEO of CareYaya Health Technologies, one of the fastest-growing elder care platforms in America. He runs a social enterprise and applied research lab utilizing artificial intelligence (AI), neurotech and workforce innovation to advance health equity for the aging population. He has advanced AI projects to improve neurological care with support from the National Institutes of Health, Johns Hopkins AITC and Harvard Innovation Labs. He is a “Top Healthcare Voice” on LinkedIn with a 40k+ following.

Mary Furlong, EdD, is the eponymous founder of Mary Furlong & Associates, a leading consultancy in the $8.3 trillion longevity market. She serves as an adviser to the Ziegler Link-Age Longevity Funds, and as the Dean’s Executive Professor for Entrepreneurship at Santa Clara University. For more than 30 years, she has guided the strategies of leading corporations and emerging companies whose innovations improve the lives of older adults.