When you’re trying to learn more about the health workforce, you may want to search the Health Workforce Information Center. February marks the one year anniversary of the launch of the center, a free online library of health workforce resources funded by the Health Resources and Services Administration (HRSA). If you haven’t already made use of our website or reference services to find statistics, funding, program ideas, or other information, check it out http://www.healthworkforceinfo.org/.
Archive for the ‘health workforce’ Category
February 5, 2010
President Obama: Focus on Jobs in the Health Workforce
President Obama –and the Congress for that matter–need to focus on JOBS in the HEALTH WORKFORCE. The Bureau of Labor Statistics reports that the health sector ranks high among the areas that will provide the greatest number of new jobs over the next decade. Four million jobs will be created in the health care sector will be a leader in producing new jobs, including high-skill, high-paying jobs like doctors and nurses. Among the top ten occupations needed will be: Registered nurses, home health aides, personal and home care aides, and nursing aides, orderlies and attendants.
With the aging baby boomer population, the need for a greater number of trained people in the health professions goes well beyond nurses and home care workers. Shortages across the professions will be exacerbated by the retirement of physicians, nurses, pharmacists, dentists and other professionals. In 2004, 23 percent of licensed pharmacists, for example, indicated they were leaving the profession within the year and 80 percent of pharmacy directors said they would leave within the decade. Substantial retirements of faculty in all schools of the health professions add to the problem.
With the overwhelming need for a health workforce for the nation, President Obama should be focusing his Jobs Initiative on education and innovative training programs for the health workforce. President Obama should be looking for ways to provide incentives to academic health centers and their health professions schools for new ideas and innovative ways to develop a quality health workforce in a short time frame.
One way is to receive funding and other incentives to create new career ladders for those people who are already employed within the health system and want to raise their skill levels and receive education in one of the more-skilled professions (and this can include the myriad allied health, imaging, medical records and IT jobs that are critical to the system).
There should also be funding to health professions schools to create innovative, perhaps fast tracked, retraining programs for the thousands of people who are losing their jobs in America’s dying manufacturing industries.
The Obama Administration needs to look beyond small business and the green industries with regard to JOBS. The health workforce should be the priority when it comes to jobs.
November 2, 2009
More on Interprofessional Education and Practice
As we have previously noted, interprofessional education and practice is somewhat of a buzz word these days. While there might be an informal consensus of opinion that the health care of the future needs to involve meaningful integration of various health professions into patient-care teams, we have pointed out how the rhetoric in this area is far in front of the reality (see Oct 22 post). We are aware of many fine institutions engaging in important interprofessional activity, but not enough has been done to focus on this issue at the national level. At a recent meeting that we convened on the topic, the following observations emerged:
- The current approach to interprofessional education is a study in grass roots development, as opposed to top-down leadership;
- Interprofessional education and practice sometimes operate at the periphery of the institution, and are not engrained in the institutional fabric;
- Attaining accurate predictions and assessments of the skill sets that will be required of health professionals in the future is vital;
- Determining whether the “education tail” wags the “practice dog” or vice versa is important in developing the content and substance of these programs;
- The drivers of interprofessional education and practice need to move beyond “belief” and be more empirically driven; and,
- Health care reform may create demand for interprofessional education and practice by pushing to better align health professional education with the evolving health care needs of the public.
Health care reform holds the potential to serve as a catalyst for disruptive innovation in health care, and, in so doing, bring interprofessional health care into the mainstream. Indeed, the drive to create value in health care may lead to team-care as a paradigm that needs to be integrated with health professions education.
October 30, 2009
House Health Reform Takes AAHC Health Workforce Recommendation: More Needed
Yesterday, House Speaker Nancy Pelosi (D-Cal.) unveiled proposed health reform legislation from the House. Put together from the work of three House Committees the bill includes a public option.
Also significant, the legislation also now includes language identical to the recommendation made by the Association of Academic Health Centers (AAHC) that a permanent health workforce advisory committee develop and implement “an integrated, coordinated, strategic national health workforce policy.” The AAHC has advocated for a national workforce planning entity because it believes that the nation’s workforce policy must be changed; the nation’s customary piecemeal approach to the workforce is no longer viable or appropriate for the 21st century.
A comparable Senate bill is still being negotiated. The Senate should not only include such language in any final bill but also move to ensure the creation of a permanent planning entity that operates continuously, makes ongoing findings and recommendations, and is available at any time to provide consultative support to federal, state, and private health workforce stakeholders. The planning entity must serve as an active policymaking partner, not a passive advisor.
The AAHC has been urging the congressional committees and congressional leadership to broaden the scope of activity of the proposed advisory committee/national commission to fully support a strategic national policy approach.
Specifically, the AAHC recommends the following modifications be incorporated into any health reform legislation considered by the full House and Senate:
- Make development and implementation of an integrated, coordinated, strategic national health workforce policy the primary objective of any advisory committee or national commission.
- Constitute the advisory committee or national commission as a continuously available policy research and consultative resource, not simply as a body of external experts that convenes from time to time to make periodic recommendations.
- Amend the enumerated issues to be addressed by the advisory committee or national commission to include the harmonization of conflicting national and state-based regulatory and private self-regulatory standards (e.g., licensure, scope of practice, accreditation).
4. As an interim step, create a national health workforce coordinator to assess current federal capabilities and prepare agencies for their interactions with the advisory committee or national commission once it is fully functional.
This is the way to ensure that the nation has the health workforce it needs for the short and long-term.
October 29, 2009
Create Health Workforce Jobs for U.S. Economic Recovery
We all know that the employment picture in the U.S. continues to be dark. One in 10 Americans who wanted a job last month were unemployed. What many do not know is that private sector employment growth fell short of the number of new people entering the labor force by more than 500,00 jobs each year throughout the 1990s! The bottom line: Economists say the U.S. job creation engine has been stalled for the better part of a decade. New enterprises are not coming on line. As older industries die, established industry and entrepreneurs are not entering the market place and using capital to create jobs.
So where will jobs come from? Health care is an obvious choice. It’s time for a public policy to support this growth industry with a Jobs Bill for Health Care (similar to the post World War II GI bill). The bill would provide funds to train all comers – from the returning war vets to the unemployed, from the dying manufacturing industries to the recent high school graduates. This will produce not only the health workforce that the U.S. so desperately needs in the near and long term but also create a “product” that can be exported overseas – trainers for other countries’ healthcare challenges.
In addition to direct investment, the government should ensure funding from the insurance industry and providers who do not now train health professionals but depend on the health workforce . Let’s ensure the health and economic future of the United States with a public-private partnership that makes sense.
October 22, 2009
Interprofessional Education and Practice: Infrastructure Needed to Go From Rhetoric
For years there is talk about interprofessional teams. For more than 20 years, educators and policymakers have put this forth as part of the health care vision for the 21st century. It is also directly and indirectly referred to in health reform legislation before the Congress. Policymakers are enamored of the idea of an interprofessional team of caregivers providing patient centered care (whatever that means).
I learned about some of the latest innovations in interprofessional programs in academic health centers throughout the nation. Students from two or more health professions are educated together and/or engage in practice together and, in so doing, are not only improving the learning environment but also patient care and outcomes.
Rural practitioners tend to embrace interprofessional practice more fully than practitioners anywhere else in the country for obvious reasons. However, in the last decades, interprofessional education has not gone mainstream and been fully embraced by health professions schools and academic health centers. Interprofessional activities have been person directed (by a passionate advocate), thus remaining at the margins of health professions education. Passion on the part of institutions is not quite as evident.
What’s the problem. Money is always an issue. With universities and hospitals waiting for the next budget cut, institutions are hampered from creating new programs so needed for the future. In addition, we still don’t have enough evidence that such practices make a difference. There has not been enough study of the long-term impact of interprofessional initiatives. Research is needed. And that also cost money. Regulations don’t support it. State licensing boards and accreditation agencies often inhibit innovation within institutions. Scope of practice laws are barriers to interprofessional practice. Faculty incentives are still based on what makes a difference to the “profession,” whichever that may be—thus making it hard to engage appropriate teachers in the process. Finally, the current health care delivery system—specifically the reimbursement system—does not support interprofessional practice—and may not support it for the future.
The bottom line: Interprofessionalism lacks focus. There is no standardization, no uniformity anywhere in the nation. There is no framework for programs, policy or practice. There is no infrastructure and no guidelines for establishing the infrastructure that is needed within institutions, particularly academic health centers where most of health professions education takes place. To fill this void, leaders of academic health centers are engaging on the issue—not only to mainstream interprofessional education and practice but to educate policymakers about the best way to deliver care for the future.
October 20, 2009
Challenges for the Health Care Sector
I recently returned from the World Health Summit in Berlin, a large substantive meeting dealing with many aspects of health and well-being. On one of the meeting’s many panels, I was asked to address what the health care sector needs in order to thrive. In thinking somewhat about this topic, I decided to focus on the serious challenges that health care, from a global perspective, faces, and chose to comment on five of them.
1. Increasing Dualism. By this I refer to the growing health disparities that exist within and among countries, as well as the significant gap between what we know scientifically and what we practice clinically.
2. Overextension of the health system, such as in needed responses to pandemics, wars, natural or man-made disasters, emerging diseases, behavioral and planetary changes, and so forth.
3. Loss of Focus on the Patient and the Community. Here the concern relates to growing economics of health care and the delicate balance between seeking profit and good health.
4. Shortage and Maldistribution of Healthcare Workers. Readers of this Blog should not be surprised by this one. These shortages range from a general lack of practitioners to specific kinds of medical specialties, and include ethical issues of the international migration of health workers.
5. Support of Research. Research is a critical engine of progress for health care delivery. Continuing the flow of these dollars and directing them to areas with the highest yield remain substantial challenges.
There has never been a more relevant opportunity for those institutions educating the next generation of health professionals, conducting biomedical and clinical research, and caring for patients to work together collaboratively. In response, AAHC International has been created to foster the concept of an international academic health center community driven by the ideal of improving the public good.
October 8, 2009
Include Health Workforce Planning Entity in Health Reform Legislation
It’s still not too late to put a national workforce planning entity into health reform legislation (or I am supposed to say health insurance reform). This would neither be a commission nor a short-term advisory or research group. This would be a permanent entity–perhaps a quasi-governmental organization that has some clout–not only to bring constituencies together but also to get things done that change the shape of health workforce policy in this nation. The goal–plan so that the health workforce can care for the American people now and in the future.
Academic health center CEOs said as much this week when they told congressional staff and representatives of national health care organizations at a congressional briefing that pending health reform legislation(including the Senate Finance Committee proposal) does not yet reflect the strategic emphasis on health workforce needed to implement successful health system reform.
“Pending bills include numerous important workforce-related provisions, but they lack sufficient means to effectively coordinate workforce policy among federal, state, and private laws, regulations, and standards,” said Dr. Steven A. Wartman, President and CEO of the Association of Academic Health Centers (AAHC).
Dr. Wartman was joined in the panel discussion by: Dr. Nancy Dickey, President, Texas A&M Health Science Center, and Vice Chancellor for Health Affairs, Texas A&M University System, and past chair of the AAHC Board of Directors; Dr. Philip A. Pizzo, Dean, School of Medicine at Stanford University, and chair of the AAHC Board of Directors; and Dr. M. Roy Wilson, Chancellor, University of Colorado Denver, and a member of the AAHC Board of Directors.
Dr. Wilson told the group that the nation must have a national agenda for the workforce. Without such an effort, federal, state and local governments and agencies will continue to work in isolated silos as they attempt to solve workforce issues.
Dr. Dickey emphasized that health workforce reform has to start today so the nation can build a viable infrastructure and rationalize our health workforce policy. With a permanent national workforce planning body, the nation can address the full range of workforce issues — from shortages and geographic disparities, to regulatory and policy conflicts that prevent health professionals from practicing to the full extent of their training, to the paucity of reliable data on the workforce — in a comprehensive and coordinated manner.
Dr. Pizzo cautioned that when policymakers consider changes in health care reimbursement, they must take account of the unique academic health center education and research missions, which in part are dependent on clinical revenues. The nation must ensure that reimbursement reform does not financially undermine these academic health center missions that are so vital to the nation’s economy and its preeminence in education and research worldwide.
“Comprehensive health workforce reform is necessary for successful health system reform, and the key to health workforce reform is creation of a permanent, ongoing health workforce planning body,” concluded Wartman.
It’s about health care. It’s about jobs. It’s about the economic future of the nation. We can’t make the health workforce a second-class issue.
August 20, 2009
Health care and jobs
The pressures to cut health care costs are enormous, but these cuts can also be a double-edged sword. Certainly, no one would argue against cutting fraud and overuse. But at a time when job creation is so important, the health sector is and will be a key player. These jobs are not just for a broad variety of health care providers, but also for a large range of administrative and management positions. A recent article points this out by focusing on individuals who cross over from other economic sectors to work in health care. As health care exceeds one-sixth of the economy and one out of every ten jobs, it becomes increasingly difficult to disentangle needed job growth from excessive health care spending in terms of driving the economy. This is especially true if there is some kind of health reform that increases access to a substantial number of persons who are currently either uninsured or underinsured. As we have pointed out in our report, Out of Order, Out of Time: The State of the Nation’s Health Workforce, we need to gain a more in-depth understanding of the kinds and numbers of health providers that are needed to take care of patients now and in the future. Perhaps by engaging in this discussion we can address the complex issues around “right-sizing” health care.
July 21, 2009
Who will be taking care of us?
In the growing debate over health care reform, there has been relatively little mentioned about one of the most important aspects of any health system (reformed or not): the nation’s health workforce of doctors, nurses, dentists, pharmacists, allied health professionals, public health workers, psychologists, veterinarians, and so forth. It seems that it is taken for granted that whatever does (or does not) happen in health care, there will be an adequate health workforce backbone to take care of us. But this is, in fact, not clearly the case. There have been reports and calls alerting us to impending or actual shortages of health professionals. These shortages are not necessarily profession-specific; they may also involve specialties within a given health profession, such as primary care. Another perspective posits that the principle workforce problem is a maldistribution of the kinds and locations of providers as well as variations in their practice styles. An additional concern is that the kinds of types of providers that will be needed in the new era of genomic and personalized medicine are probably going to be somewhat different from what we have now.
Yet there is no overarching approach or policy concerning the nation’s health workforce. We instead rely on a myriad of market forces, agencies, regulatory and accreditation bodies in a patchwork quilt arrangement. As a result, it is exceedingly difficult to answer the question: what would be the ideal composition of the U.S. health workforce to best meet our health care needs? For now, it’s like trying to compute an equation without a denominator. It’s time for the health workforce discussion to be front and center regardless of the extent of health care reform.
