Category Archives: Workforce supply and demand
Health care employment accounted for 10.74 percent of total employment in the United States in March, according to a report by the Altarum Institute. One out of every nine jobs was in the health care sector—an all-time high, the report says.
Bureau of Labor Statistics (BLS) March 2013 employment data show that health care employment rose by 23,000 jobs in March, and most were in ambulatory care. Health care has added 1.4 million jobs since the start of the recession in December 2007, the report says, while non-health employment has fallen.
The Altarum Institute is a nonprofit health systems research and consulting organization.
More U.S. medical students “matched” to primary care residency positions this year than in 2012, according to data from the National Resident Matching Program (NRMP). Almost 400 more students chose primary care fields— internal medicine, family medicine, and pediatrics—than last year. NRMP is a private, non-profit organization established in 1952 to provide a mechanism for matching the preferences of applicants for U.S. residency positions with the preferences of residency program directors.
Of the 17, 487 graduating seniors who participated in Match Day 2013, 3,135 matched to internal medicine—a 6.6 percent increase from last year. The number of seniors who matched to pediatrics (1,837) represents a 105 percent increase over last year.
This year’s Main Residency Match was the largest in NRMP history, with more than 40,000 student and independent registrants. NRMP attributes the increase to three new medical schools graduating their first classes, and expanded enrollment in existing medical schools.
Conducted annually by the NRMP, The Match uses a computerized mathematical algorithm to align the preferences of applicants with the preferences of residency program directors in order to fill the training positions available at U.S. teaching hospitals.
This is part of the March 2013 issue of Sharing Nursing's Knowledge.
Study: APRN-Staffed Clinic Produces Shorter Wait for Diagnoses at Lower Cost for Women with Benign Breast Conditions
A nurse-based approach to diagnosing women with breast conditions is saving money and producing shorter wait times for diagnoses, according to an article in the January issue of Health Affairs.
In 2008, the Virginia Mason Medical Center, a Seattle-based multidisciplinary health care network that logs 800,000 outpatient and 17,000 hospital visits per year, opened a new breast care clinic, with the goal of streamlining the diagnosis and care for women with breast conditions. These include such benign conditions as cysts and fibrocystic breast disease, as well as breast cancer. As part of the clinic’s model, Advanced Practice Registered Nurses (APRNs) take the lead role in diagnosing patients, working with on-site equipment to perform mammography, ultrasound, and magnetic resonance imaging. Patients whose conditions cannot promptly be confirmed as benign meet with breast surgeons for diagnosis and care, if appropriate.
A report completed this month by the Congressional Research Service (CRS), which conducts analysis for members and committees of Congress, examines how the Affordable Care Act (ACA) will affect the nation’s supply of physicians. In particular, the report focuses on the workforce’s size, composition and geographic distribution.
The health care system cannot work effectively or efficiently without a physician workforce of appropriate size. Too few physicians means delayed care, and too many physicians can mean unnecessary or duplicate care. But measuring the size of the physician workforce—and the future physician population—is challenging, and estimates vary. The CRS report notes that “predicting the timing, content, and effect of policy change is difficult, which adds to the uncertainty of the projections.”
The ACA authorizes funding for additional medical residency training programs through the Health Resources and Services Administration (HRSA) and the ACA’s own Prevention and Public Health Fund. It requires that Medicare-funded residency training slots be redistributed from hospitals that are not using them or that have closed, to hospitals seeking to train additional residents. It also includes provisions designed to increase physician productivity and the volume of physician services available. The law encourages care coordination—in medical homes and accountable care organizations, for example—and expands the non-physician workforce that can augment or substitute for physician services.
The United States will need 52,000 additional primary care physicians by 2025 to meet demand that is growing due to three trends: population growth, population aging and insurance expansion. That is a key finding from a study published in the November/December issue of the Annals of Family Medicine. The researchers estimate that population growth will account for the majority of the needed increase in primary care doctors.
Given the current number of visits to primary care physicians and an expected population increase of 15.2 percent, the researchers predict that office visits to primary care physicians will increase from 462 million in 2008 to 565 million in 2025. This trend will be especially evident among people 65 and older, a segment of the population that is expected to grow by 60 percent. Population growth will require an additional 33,000 physicians, the study says, and aging another 10,000.
Insurance expansion under the Affordable Care Act will also require additional physicians, the researchers find. Eight thousand physicians will be needed to meet that growth.
The 52,000 additional primary care physicians would represent a 3 percent increase in the workforce.
Data from the Bureau of Labor Statistics shows that health care employment rose by 44,000 jobs in September.
Most of the gains were in ambulatory care services (+30,000 jobs), with much of the growth in outpatient care centers. Hospitals added 8,000 jobs, and nursing and residential care added 6,000 jobs. Over the past year, employment in health care has risen by 295,000 jobs.
September’s gains are the second largest for the health care industry in a decade, according to a brief from the Altarum Institute, and the strong showing drove the health sector share of total employment to a new high of 10.81 percent.
Last week, NPR aired a story examining the prognosis for primary care providers in the United States. The country will have tens of thousands fewer health care providers than it needs to care for its the population by 2015, and the shortage is expected to hit rural and underserved areas especially hard.
Part of the problem, the story reports, is that medical students—often saddled with massive student loan debt—are choosing specialties over primary care and family medicine. In addition to higher salaries, specialties allow more schedule flexibility and predictability, and less stress. The nursing workforce, too, has a looming shortage. Many nurses are close to retirement, and a shortage of nurse faculty is making it difficult for nursing schools to educate the next generation.
Provisions of the Affordable Care Act may help alleviate the shortage in the areas most hard-hit, by providing loan forgiveness or other incentives for providers who practice primary care in underserved areas. “A lot of the money in the Affordable Care Act went to beef up programs that train primary care providers, not just doctors but nurse practitioners, physician assistants, what we call mid-level providers,” Julie Rovner, NPR health policy correspondent, said. Primary care “doesn’t necessarily have to be provided by someone with an MD after their name… [There are] lots of studies that say good primary care can be delivered by people like nurse practitioners, by physician assistants, by nurses.”
The show also took calls from listeners—a neurologist, a recent nursing school graduate, a surgical subspecialist, and a nurse practitioner, among them.
Listen to the NPR story or read the transcript here.
The number of trained nurse practitioners (NP) in the United States is expected to increase by 94 percent from 2008 to 2025, according to a study published in the July issue of Medical Care. Those providing care as NPs will rise 130 percent, from 86,000 in 2008 to 198,000 in 2025.
“Nurse practitioners really are becoming a growing presence, particularly in primary care,” David I. Auerbach, PhD, the study author and a health economist at RAND Corp., told American Medical News.
New care models like patient-centered medical homes and accountable care organizations increasingly rely on nurse practitioners, Auerbach says, and “people have gotten the message that becoming a nurse, and especially an NP, is a very good, solid career choice.”
The United States health care workforce will have to expand by almost 30 percent between 2010 and 2020 to meet growing demand for care, according to a new study from Georgetown University’s Center on Education and Workforce. The estimated 5.6 million health care job vacancies created over the next ten years is expected to be the most dramatic growth in any job sector in the country during that time period.
“Nursing will grow the fastest among healthcare occupations… but that won’t be enough to meet the demand,” the study says. Demand for health care “support occupations,” like home health aides, is also expected to increase at a rapid rate.
The study also predicts that demand for post-secondary education and training in health care jobs—which is already high—will continue to increase.
In a month when national employment data were largely unchanged, the U.S. Bureau of Labor Statistics reports that the health care industry added nearly 33,000 jobs in May, continuing as a strong and growing field. Over the year, health care employment has risen by 340,000 jobs.
Employment in ambulatory care services accounted for the majority of the new jobs in the industry (23,000). That growth was seen mostly in physicians’ offices (9,900), home care services (6,900) and outpatient care centers (4,600).
Demand for health care employees remains strong. Nurse.com reports that data from Wanted Analytics finds that employers posted more than 620,000 online job ads for health care careers in May, an increase of 5 percent from a year prior.