Category Archives: Workforce supply and demand
The number of trained nurse practitioners (NP) in the United States is expected to increase by 94 percent from 2008 to 2025, according to a study published in the July issue of Medical Care. Those providing care as NPs will rise 130 percent, from 86,000 in 2008 to 198,000 in 2025.
“Nurse practitioners really are becoming a growing presence, particularly in primary care,” David I. Auerbach, PhD, the study author and a health economist at RAND Corp., told American Medical News.
New care models like patient-centered medical homes and accountable care organizations increasingly rely on nurse practitioners, Auerbach says, and “people have gotten the message that becoming a nurse, and especially an NP, is a very good, solid career choice.”
The United States health care workforce will have to expand by almost 30 percent between 2010 and 2020 to meet growing demand for care, according to a new study from Georgetown University’s Center on Education and Workforce. The estimated 5.6 million health care job vacancies created over the next ten years is expected to be the most dramatic growth in any job sector in the country during that time period.
“Nursing will grow the fastest among healthcare occupations… but that won’t be enough to meet the demand,” the study says. Demand for health care “support occupations,” like home health aides, is also expected to increase at a rapid rate.
The study also predicts that demand for post-secondary education and training in health care jobs—which is already high—will continue to increase.
In a month when national employment data were largely unchanged, the U.S. Bureau of Labor Statistics reports that the health care industry added nearly 33,000 jobs in May, continuing as a strong and growing field. Over the year, health care employment has risen by 340,000 jobs.
Employment in ambulatory care services accounted for the majority of the new jobs in the industry (23,000). That growth was seen mostly in physicians’ offices (9,900), home care services (6,900) and outpatient care centers (4,600).
Demand for health care employees remains strong. Nurse.com reports that data from Wanted Analytics finds that employers posted more than 620,000 online job ads for health care careers in May, an increase of 5 percent from a year prior.
By 2020, nearly one in nine jobs in the United States will be in the health care sector, according to new research from the Center for Health Workforce Studies at the University at Albany, State University of New York. The industry is expected to add 4.2 million jobs during that time, growing at twice the rate of the overall economy.
The United States will need nearly 7.5 million health care workers to fill new and existing jobs, the report says, including 1.2 million registered nurses (RNs). The largest job growth is expected among RNs, home health aides, and personal care aides.
“With an aging health care professional workforce, we will not only see new job growth but also openings in existing positions as workers retire or leave for other job opportunities," Robert Martiniano, principal author of the report, said in a news release.
The report also found that the majority of jobs (63 percent) are expected to be concentrated in ambulatory care (non-institutional settings).
The analysis is based on data from the biennial U.S. Bureau of Labor Statistics 10-year (2010-2020) occupational and industry projections for employment.
Read a news release about the study.
Carol S. Brewer, PhD, RN, FAAN, a professor at the University of Buffalo School of Nursing, leads the Robert Wood Johnson Foundation (RWJF)-supported RN Work Project with Christine T. Kovner, PhD, RN, FAAN. The 10-year, longitudinal study is the only one of its kind to study the careers of new nurses. Most recently, the RN Work Project released a study on the recession’s impact on new nurses.
Human Capital Blog: Your most recently-published study looked at registered nurses in the recession. Can you review the most important findings?
Carol Brewer: What we found was fairly interesting and fits with some of the other studies and data we’ve collected on new graduates in the recession. We found that the nurses’ intent to stay at their current job and their organizational commitment was higher than before the recession. We also found some indicators that the work environment was a little better. The nurses report that their relationship with physicians was better, and they had a lighter workload and fewer organizational constraints.
We can interpret this in a few different ways. One is that there has actually been a change for the better in the work environment, and stress and workload are going down a little bit. But we also found that nurses perceived fewer job opportunities, so they may feel like they can’t leave their jobs because there aren’t many other opportunities. They could be making their perceptions fit their reality, which would cause them to rate their environment higher than if they knew they had options and could afford to be pickier.
More likely, these nurses are just biding their time. We found that, despite perceiving fewer opportunities, the nurses were more likely to be searching for a job. Even though the perception is that things seem to be little better with their current employer, they’re still looking for other jobs.
With unprecedented numbers of Americans nearing old age, experts say the health care system will need tens of thousands more providers with training in geriatrics to handle the population’s increasing, and increasingly complex, needs. But too few physicians, nurses and dentists who specialize in geriatrics, or who have completed geriatric training, are in the pipeline.
Last week, the New York Times explored the problem, along with some emerging solutions. The story observes that geriatricians usually make much less money than other primary care providers or specialists, and Medicare reimbursements for geriatric care are comparatively low. For a doctor with debt from medical school, those factors can be a powerful deterrent to going into the field. “Geriatrics is also seen as a plodding area of medicine, set apart from the glamour of life-saving heroics,” the New York Times asserts. “That may be why the specialty has made little headway among nurses as well.”
Completing geriatric training after medical school can also pose financial challenges, as providers may be reluctant to take a financial hit for programs that would keep them out of the workplace for longer. With that in mind, the geriatric residency required for board certification has been reduced from two years to one, and the federal government and several private groups offer funding for geriatric education fellowships. The American Geriatrics Society also offers a variety of flexible training options, including weekend workshops and online courses.
Similar barriers keep nurses from specializing in geriatrics. Fewer than 1 percent of registered nurses and fewer than 3 percent of advanced practice registered nurses are certified in geriatrics, according to the American Geriatrics Society.
Geriatrics should be integrated into nursing school curricula, experts say, as a stand-alone component or included in clinical practice.
The Department of Health & Human Services (HHS) has awarded $9.1 million to medical students participating in the National Health Service Corps’ Students to Service Loan Repayment Program. In exchange for funds to repay their medical school debts, the 77 students in the pilot program commit to provide primary care services in communities with shortages of health professionals and limited access to care.
After their residencies, participants will spend three years full-time, or six years half-time, working in clinical practice in underserved or rural communities. They can receive annual student loan repayment funds of up to $30,000 while in the program.
The pilot program, created by the Affordable Care Act—the health reform law—aims to help alleviate a shortage of primary care professionals. “This new program is an innovative approach to encouraging more medical students to work as primary care doctors," HHS Secretary Kathleen Sebelius said in a statement.
Read more about the shortage of primary care providers and efforts to recruit primary care physicians in underserved areas.
Convincing a medical student, sometimes tens of thousands of dollars in debt, to take a lower-paying job or move to a low-income, rural community can be a tough sell. So perhaps it’s not surprising that many new physicians gravitate toward high-paying specialties or urban sprawls with modern-day conveniences. But with an aging population and millions of people poised to gain insurance coverage under the health reform law, the nation is in desperate need of general primary care physicians, particularly in rural and underserved areas.
Last week, NPR reported on a technique that one rural community has used successfully to recruit primary care providers – “mission focused medicine.” At the Ashland Health Clinic in southwest Kansas, CEO Benjamin Anderson is recruiting primary care providers not by pointing to all the advantages the community offers, but by highlighting its most severe needs. And to further appeal to prospective providers’ desire to do meaningful work, Anderson offers candidates eight weeks off to do missionary or other service work overseas. Anderson hopes to find providers who are engaged and motivated by the challenges associated with providing care in a rural community.
“When you recruit a mission-focused provider…,” Anderson said, “they want to know that there's no Spanish-speaking provider in more than a one-hour drive. They want to see houses that are falling down, widows that are uncared for. They want to know that there's need and that by them coming there, they would fill a disparity that would otherwise not be filled.”
Specialization also poses a challenge to building the primary-care workforce, the Washington Post reports. A medical resident who chooses a specialty over general primary care has the potential to earn millions more over a lifetime, making it an attractive option to the often deeply in debt medical student.
Last summer the White House launched the Primary Care Residency Expansion, providing financial support for three-year primary care residency training programs at 82 hospitals around the country. Participating residents are required to work in underserved areas. All of the 172 slots funded in the first year of the program have been filled, the story reports.
What do you think? How can we recruit more primary care physicians for general practice or in underserved areas? Register below to leave a comment.
Read the Washington Post story.
The health care industry added 22,600 jobs in December, according to a report released last week by the U.S. Bureau of Labor Statistics. The data is consistent with the upward trend the industry demonstrated throughout the year; health care gained about 315,000 jobs in 2011.
Ambulatory health services were responsible for 11,300 of the new jobs, and hospitals accounted for approximately 10,000 jobs.
Perhaps due to the increase in health care jobs filled, a new report from The Conference Board finds that online advertised vacancies for health care practitioners decreased in December. A decrease in advertised vacancies for Registered Nurses (RNs) was largely responsible for the drop, but demand for other health care practitioners remains high. “The number of advertised vacancies in this occupational category continues to be quite favorable and outnumber job-seekers by 2.9 to 1,” the report says.
The Bureau of Labor Statistics national employment numbers for September show continued expansion in the health care industry, with an additional 44,000 health care jobs. That includes 26,000 in ambulatory health care services and 13,300 in hospitals.
A survey released by health care staffing company Merritt Hawkins & Associates [registration required] suggests that hospital employment may continue to rise, in part because new physicians increasingly prefer working in a hospital to solo private practice. The survey finds that 32 percent of final-year medical residents say they would like to be employed by a hospital, up 10 percent since the 2008 survey.
Part of the reason for the growing trend may be that physicians report feeling unprepared to handle the business side of medicine (48 percent). “The days of new doctors hanging out a shingle in an independent solo practice are over,” Merritt Hawkins founder James Merritt said in a news release. “Most new doctors prefer to be employed and let a hospital or medical group handle the business end of medical practice.”
Those medical students who do want to work in their own practices, once they graduate, say that partnering with another physician is their preferred approach. Fully 28 percent of the surveyed students opted for such a partnership, while only 1 percent said they would prefer to work in a solo practice.
Read our previous coverage on this topic.
What do you think? Is working in a hospital more desirable than private practice? Register below to leave a comment.