Category Archives: Workforce supply and demand
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.
By 2020, nearly one in nine jobs in the United States will be in the health care sector, according to new research from the Center for Health Workforce Studies at the University at Albany, State University of New York. The industry is expected to add 4.2 million jobs during that time, growing at twice the rate of the overall economy.
The United States will need nearly 7.5 million health care workers to fill new and existing jobs, the report says, including 1.2 million registered nurses (RNs). The largest job growth is expected among RNs, home health aides, and personal care aides.
“With an aging health care professional workforce, we will not only see new job growth but also openings in existing positions as workers retire or leave for other job opportunities," Robert Martiniano, principal author of the report, said in a news release.
The report also found that the majority of jobs (63 percent) are expected to be concentrated in ambulatory care (non-institutional settings).
The analysis is based on data from the biennial U.S. Bureau of Labor Statistics 10-year (2010-2020) occupational and industry projections for employment.
Read a news release about the study.
Carol S. Brewer, PhD, RN, FAAN, a professor at the University of Buffalo School of Nursing, leads the Robert Wood Johnson Foundation (RWJF)-supported RN Work Project with Christine T. Kovner, PhD, RN, FAAN. The 10-year, longitudinal study is the only one of its kind to study the careers of new nurses. Most recently, the RN Work Project released a study on the recession’s impact on new nurses.
Human Capital Blog: Your most recently-published study looked at registered nurses in the recession. Can you review the most important findings?
Carol Brewer: What we found was fairly interesting and fits with some of the other studies and data we’ve collected on new graduates in the recession. We found that the nurses’ intent to stay at their current job and their organizational commitment was higher than before the recession. We also found some indicators that the work environment was a little better. The nurses report that their relationship with physicians was better, and they had a lighter workload and fewer organizational constraints.
We can interpret this in a few different ways. One is that there has actually been a change for the better in the work environment, and stress and workload are going down a little bit. But we also found that nurses perceived fewer job opportunities, so they may feel like they can’t leave their jobs because there aren’t many other opportunities. They could be making their perceptions fit their reality, which would cause them to rate their environment higher than if they knew they had options and could afford to be pickier.
More likely, these nurses are just biding their time. We found that, despite perceiving fewer opportunities, the nurses were more likely to be searching for a job. Even though the perception is that things seem to be little better with their current employer, they’re still looking for other jobs.
With unprecedented numbers of Americans nearing old age, experts say the health care system will need tens of thousands more providers with training in geriatrics to handle the population’s increasing, and increasingly complex, needs. But too few physicians, nurses and dentists who specialize in geriatrics, or who have completed geriatric training, are in the pipeline.
Last week, the New York Times explored the problem, along with some emerging solutions. The story observes that geriatricians usually make much less money than other primary care providers or specialists, and Medicare reimbursements for geriatric care are comparatively low. For a doctor with debt from medical school, those factors can be a powerful deterrent to going into the field. “Geriatrics is also seen as a plodding area of medicine, set apart from the glamour of life-saving heroics,” the New York Times asserts. “That may be why the specialty has made little headway among nurses as well.”
Completing geriatric training after medical school can also pose financial challenges, as providers may be reluctant to take a financial hit for programs that would keep them out of the workplace for longer. With that in mind, the geriatric residency required for board certification has been reduced from two years to one, and the federal government and several private groups offer funding for geriatric education fellowships. The American Geriatrics Society also offers a variety of flexible training options, including weekend workshops and online courses.
Similar barriers keep nurses from specializing in geriatrics. Fewer than 1 percent of registered nurses and fewer than 3 percent of advanced practice registered nurses are certified in geriatrics, according to the American Geriatrics Society.
Geriatrics should be integrated into nursing school curricula, experts say, as a stand-alone component or included in clinical practice.
The Department of Health & Human Services (HHS) has awarded $9.1 million to medical students participating in the National Health Service Corps’ Students to Service Loan Repayment Program. In exchange for funds to repay their medical school debts, the 77 students in the pilot program commit to provide primary care services in communities with shortages of health professionals and limited access to care.
After their residencies, participants will spend three years full-time, or six years half-time, working in clinical practice in underserved or rural communities. They can receive annual student loan repayment funds of up to $30,000 while in the program.
The pilot program, created by the Affordable Care Act—the health reform law—aims to help alleviate a shortage of primary care professionals. “This new program is an innovative approach to encouraging more medical students to work as primary care doctors," HHS Secretary Kathleen Sebelius said in a statement.
Read more about the shortage of primary care providers and efforts to recruit primary care physicians in underserved areas.