Ways to address the expanding healthcare staffing shortage
The growing shortage of healthcare workers across the United States is being driven by a mix of economic pressures, policy uncertainty and long-standing training constraints, according to the American Medical Group Association (AMGA).
Health Exec spoke with Darryl Drevna, the group’s senior director of regulatory affairs in the above video interview. He said the staffing crisis extends well beyond physicians and nurses, affecting nearly every role in the care continuum—from advanced practice providers to front desk personnel.
“I think if you look at staffing and healthcare, you can start with either the shortage of clinicians, physicians and the pipeline to that with advanced practice nurses, physician assistants and the clinical care teams, all the way down to your front office staff,” Drevna said.
Healthcare employers are seeing increasing competition for non-clinical jobs with competitive pay, which has further complicated recruitment and retention efforts.
“I've heard from our members that they've lost frontline administrative staff to other industries because it's less stressful than working at a front desk in a healthcare facility, so they go work at the Home Depot,” he said.
At the same time, providers face declining reimbursement rates, leaving organizations with fewer resources to raise wages or expand hiring.
“In a decreasing reimbursement environment, it makes it incredibly difficult to keep and retain qualified staff,” Drevna added.
On the clinical side, he said stability in federal healthcare policy regarding paying for education and increasing resident slots would go a long way to help offset current challenges.
Healthcare training pipeline under strain
Beyond immediate workforce pressures, structural issues in the education and training pipeline are limiting the number of new clinicians entering the field. Graduate medical education, which is largely funded through Medicare, has not kept pace with demand, resulting in a shortage of residency positions for qualified medical graduates.
Compounding the issue are proposed regulations from the U.S. Department of Education that would cap student loan borrowing for certain healthcare professions, including nurse practitioners and physician assistants. Drevna warned such limits could discourage students from entering the field.
“If you're not able to get federal loans, or if you're only able to offset some of the costs, it's going to make it that much more difficult to pursue a career in healthcare,” he said.
Loan forgiveness uncertainty affects recruitment
Uncertainty surrounding federal loan forgiveness programs is another factor complicating workforce planning, particularly in rural and underserved areas. The current program forgives the balance of loans if a clinician works for 10 years at a rural or non-profit health system. But if that program goes away, as it has been suggested under the Trump administration, clinicians will take higher paying jobs in urban and for-profit health systems.
“We recruit folks to get into healthcare with the promise if they practice in a rural area for a few years, their loan will get forgiven. But if that program goes away midstream, how is that going to affect the ability to recruit in rural areas?” Drevna said.
He emphasized that stability and predictability in policy are critical to long-term workforce development.
Health systems seek staffing workarounds
In response to federal limitations, some health systems are investing in their own residency and training programs to build internal pipelines of talent. Others are exploring international recruitment, though immigration policy adds another layer of complexity.
Addressing the staffing shortage will require coordinated action across multiple fronts, including expanding training capacity, maintaining access to student financing, stabilizing reimbursement and ensuring consistent federal policy, Drevna said. Without those changes, healthcare organizations may continue to struggle to maintain adequate staffing levels as demand for care rises and a wave of clinician retirements looms.
“Our members and health systems are scrambling to come up with a plan with the understanding that the federal support that historically has been there just might not be,” he said.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]