"Health care workforce challenges persist..."

I hate to start off a new year with bad news, but the NEJM Catalyst just released a new Insights Report "Health Care Workforce Challenges Persist as a Legacy of COVID-19".  It's a good read, as well as a sobering one.  The Insights team surveyed 691 members of the NEJM Catalyst Insights Council, which is a group of physicians, clinical leaders, and health care executives working in health care organizations in 292 different countries around the world.  These senior leaders reported that the top two challenges that their organizations will face in the new year are (1) staffing shortages and (2) clinical burnout.  

Just over half (53%) of the senior leaders surveyed reported that staffing shortages have actually worsened since the COVID-19 pandemic, which is not a reassuring trend.  Frederick P. Cerise, MD, MPH, currently President and Chief Executive Officer at Parkland Health & Hospital System in Dallas, Texas, said, "Our staffing challenges are dramatically different from the height of the pandemic to now.  It's no longer the desperation of filling shifts.  But pressure is still there."

Recruiting physicians and other clinicians remains a significant concern, with 83% of senior leaders reporting that recruiting physicians and nurses is difficult, very difficult, or extremely difficult.  Recruiting challenges have, in fact, worsened since the last Insights Council survey in November, 2022.  These challenges are particularly impacting pediatric subspecialties, as fewer medical students are choosing pediatric residency training programs.  Similarly, fewer anesthesiology, radiology, and surgical residents are choosing pediatric subspecialty fellowship programs.

Retention is almost as difficult as recruitment, and again these challenges have increased since the November, 2022 survey.  Part of the issue here is the ongoing crisis of clinician burnout.  Nearly half of the respondents reported experiencing signs of burnout related to work-related stress.  

Finally, 45% of Insights Council members reported that trust in leadership/hospital administration has worsened in the last 2 years.  Dr. Cerise said, "The erosion of trust was going on before the pandemic, and almost half of respondents say it worsened in the past 2 years."  Staff shortages and burnout certainly contribute to the lack of trust, but so too have ongoing financial challenges with the consequent need to emphasize productivity, the lack of autonomy that many clinicians perceive, and ongoing administrative hassles that clinicians encounter every day as they try to provide the best care for their patients.

The results of the NEJM Catalyst Insights survey probably shouldn't surprise too many of leaders in health care.  I hope you agree that the findings are important.  What is clear is that we have an obligation to work hard to address some of the findings in this survey, at least those that are under our direct control.