Leveraging Health Care Workforce.pdf

Leveraging Health Care Workforce.pdf - Workforce Issues...

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Workforce Issues Perspective: Leveraging the Health Care Workforce: What Do We Need and What Educational System Will Get Us There? Arthur Garson, Jr., MD, MPH Abstract Shortages of 100,000 physicians and up to one million nurses are projected in the next 10 years. If these statistics are close to true, medical schools would need a 100% increase in graduates over the next 4 years, and nursing schools a 100% increase over the next 13 years. These calculations are instructive in that they demonstrate the absurdity of expecting schools to provide these sorts of increases in that time frame. Other solutions must be considered. For instance, do doctors and nurses need to do everything they are currently called on to do? Could not other members of the health care workforce, such as well- trained lay workers, be leveraged to do some of the more routine work, freeing medical professionals to perform their unique roles? How is such a workforce built, and how shall learners be educated to fill those needs? This article presents a hypothetical model that could be implemented based on carefully researched pilots to meet health care education needs. The model features three essential components: (1) a school for the public in which lay teachers develop curricula with members of the public, for example, about how to incentivize healthy behavior, (2) a college for health as part of a university with interdisciplinary teaching, where patients, faculty members, and students interact in each of the schools and learn together, and (3) the most effective and efficient nursing and medical school curricula, developed together based on evidence of what the student needs to know. S hortages of 100,000 physicians and 300,000 to 1 million nurses are projected in the next 10 years. 1,2 The professional societies have called for a 30% increase in the number of graduating physicians and nurses. 1,2 If the projected shortages are close to true, medical schools, which currently graduate 25,000 trainees per year, would require not a 30% but a 100% increase in graduates for the next 4 years, and nursing schools, which graduate 76,000 trainees annually, would require a 100% increase in graduates for between 4 and 14 years. These calculations are instructive in that they demonstrate the absurdity of expecting schools to provide these sorts of increases in that time frame. So, we need to think about making changes to our delivery system at a very low cost while still providing very good care to patients. Instead of striving to achieve impossible numbers of graduates, we must work to leverage the health care workforce we have. Here, I examine what we need from our health care workforce and what kind of educational system we need to achieve these goals. What Do We Need? A shortage occurs when there is a mismatch of supply with demand for services. The supply of physician services is headed for a steady decline as our newest colleagues work fewer hours and place increasing emphasis on lifestyle in their career choices, hopefully leading to happier lives and less burnout. At the
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