Virtual Care May Be One Answer to Healthcare’s Labor Shortages-The HSB Blog 1/31/22
Leveraging virtual care is one way to deal with a number of the issues that healthcare’s workforce shortages have brought to light due to the Pandemic. Following huge spikes in demand in almost every part of the country as it deals with COVID, the industry had had to deal with countless labor issues and shortages due to burnout and the overwhelming physical and mental demands placed on caregivers. While healthcare workers are experiencing elevated levels of stress, patients may also experience a different type of stress when it comes to patient quality and overall care. It is important to understand the dynamics of the overlapping crisis we currently face as healthcare professionals quit and the barriers hospitals and Healthcare systems face to catch up. As an alternative, many providers have opted to provide virtual care albeit the future of telehealth is unpredictable. However, the flexibility and convenience that virtual care provides for both the patient and the provider may be here to stay.
According to the Association of American Medical Colleges (AAMC), physician shortage in the United States is anywhere from 40,800 to 104,900 physicians by 2030
A study conducted by Wheel found that clinician burnout impacts 80% of patients and 1 in 3 patients believe burnout impacts their quality of care
Providers have delved into the virtual care world since the pandemic in order to allow for a more flexible and accessible environment for patients
If high-value providers no longer pursue in-person care and decide to go on the route of virtual care, patients may follow (where in-person care can be supplanted) to maintain their provider relationship
The challenges of the pandemic have exacerbated and crystalized labor challenges and the preexisting labor shortages that existed in healthcare prior to the Pandemic. The relatively non-stop confrontation with the Virus and its variants has forced clinicians to work long hours donning layers of PPE often short-staffed due to illness caused by COVID itself as well as employees who refused to comply with vaccine mandates. Consequently, the stresses on clinicians such as the increased administrative burden and inability to focus on patient care have reached a breaking point. For example, issues such as the decline in the supply of nurses and doctors reflecting the retiring of practitioners from the Baby Boomer generation as well as others in the demographics requiring more care left a significant supply-demand imbalance. While demand is high many providers cite insufficient staffing models, insufficient benefits/raises, and lack of flexibility as main concerns along with burnout and the inability to de-stress. This in turn has pushed providers to take a stand as they will no longer tolerate the reduction in their overall quality of life and have chosen to leave the profession or set up virtual practices.
In light of the heightened demand during COVID, issues around the healthcare labor shortages have garnered nationwide attention. For example, during the so-called “Great Resignation,” where large numbers of working-age people have simply dropped out of the labor force, approximately half a million healthcare workers have quit since February 2020 according to a recent article in Forbes. Understandably the stress of dealing with a continuous over two-plus years has taken a great toll on clinicians' emotional, and physical health leading to burnout. For many, this has left them with two options–either to step away or go digital. Many have chosen to go digital and work in telehealth or start their own virtual practics which provide flexibility and a work/life balance that many so desperately desire.
Healthcare is a service industry that depends on the dedication and manpower of the individual clinicians and support staff responsible for maintaining the facilities, diagnosing their illnesses, and treating them to care for the lives of patients. A key element in this equation is the hiring and support systems that go into creating a physically and emotionally safe environment for clinicians to operate in where they feel their concerns can be heard and addressed. If not, the burnout and stress associated with working long hours under severe emotional stress, such as those experienced during COVID, can negatively impact the quality of patient care. For example, while the medical profession has long been sought after for its high wages it had also enjoyed significant professional prestige which helped attract a growing labor pool. That may no longer be the case. For example, according to “Amid Rampant Provider Burnout, Marketplace Platform Companies Focus on Clinician Experience” a survey conducted by Wheel, approximately forty percent of respondents would not want their children to go into the field of medicine as it is not worth their time or investment.” In many ways, this may serve as a wake-up call for administrators and public policy officials looking at the causes of the shortage of clinicians as we look for ways to improve the quality of care and lower costs for patients.
In addition to the stresses noted above, many practitioners are facing a working environment that is filled with aggression and constant abuse. According to “Nursing Shortages” approximately eight to thirty-eight percent of health care workers are at accelerated risk of facing emotional and physical abuse, which some attribute to insufficient staffing ratios. Following the explosion in digital care during COVID, digital has emerged as an option for many nurses and physicians. Going virtual is a way to create work-life balance and still practice their craft, optimizing the benefits for everyone involved. Many digital and virtual-first solutions are specifically designed to address administrative inefficiencies inherent in current electronic medical record systems (EMRs) and designed to improve information flow for patients and providers.
Addressing the void between provider flexibility and patient care is the future of telehealth. While there is still room for improvement in the delivery of virtual care such as patient privacy and broadband access, virtual platforms have the potential to move healthcare to a more consumer-centric omnichannel experience and address many of the issues of burnout. As noted, newer technologies are specifically designed to address many of the challenges adding to the administrative burdens that clinicians face thereby allowing them to spend more direct time on patient care. In addition, given the number and variety of digital providers, both traditional and non-traditional, doctors and nurses will choose both the type of provider and work schedule that is customized to their needs. Moreover, virtual care will facilitate the use of value-based care by allowing more effective triage of patients into the system, better tracking of care across care settings, and improved analytics (although this will be a function of data sharing and interoperability). Treating patients holistically and funneling them to the proper sites of care should help clinicians work “at the top-of-their” licenses” and focus less on certain types of routine or chronic care which can be handled by other providers in the system or even prevented by higher quality care. Also, as some of the technical hurdles to providing these care delivery mechanisms are addressed, underserved communities and seniors can be given access and training on the technologies, so that virtual care can broaden the scope of care delivery, theoretically increasing provider satisfaction.
However, it is important to note that as currently configured there are limitations that come along with virtual care, such as current levels of reimbursement which if left unaddressed following the end of the PHE may discourage the use of virtual care (assuming they revert back to the lower pre-pandemic levels). There are also the issues of patient preference and accessibility and comfort with technology as mentioned, particularly within elderly and underserved communities. Of course, there will be some patients that require “hands-on” procedures or other forms of care that are acute and/or cannot be resolved through a virtual visit. Finally, digital health has the potential not just to reinvent care delivery but many of the tools that can be used or repurposed for education and training of future practitioners which could allow practitioners more options to finish their degrees and ultimately help resolve the current labor shortages.