With three years of COVID under their belt, clinicians are armed with more information, power, and ability to dictate the types of jobs that they want. Now that federal spending on health care workers has diminished, and with the Public Health Emergency declared for the pandemic to expire on May 11, the health care labor market is undergoing a fundamental shift, which will bring a new set of opportunities for hospitals and health systems in 2023 and beyond.

Flexibility of scheduling for staff roles will increase.

Recent findings from leading health care jobs marketplace Vivian Health’s fourth annual Future of Healthcare Work Report revealed that 86% of clinicians who have been on long- and short-term travel contracts over the past couple of years surveyed that they are more willing to explore permanent employment in 2023, with 46% indicating that they already plan to begin permanent employment this year. This number has grown significantly from 2022, where only 55% were considering the switch to permanent positions—likely a result of the decline in average travel wages and an increased appetite for the stability that permanent roles offer.

This is promising news for employers who have been chronically short-staffed and relying heavily on premium labor. However, clinicians who have been traveling are demanding higher wages in exchange for permanent roles, and now have a taste for the flexibility and work-life balance that comes with short-term contracts. In fact, survey respondents ranked “flexible schedules” as one of the top five most important factors they consider when evaluating a new job. As a result, health care employers that offer flexible work schedules and a variety of shift options will ultimately retain and attract the most talent. This may bode well for physician practices, which have more traditional hours and do not require overnight shifts, giving them a competitive advantage over hospitals and other 24/7-care facilities.

A greater emphasis on career progression will influence job decisions.

Flexible career paths will become critical to clinician retention, career progression and autonomy. Recent policy shifts in telehealth and reimbursement for health care services delivered at home—such as the Johns Hopkins Hospital at Home initiative, which is allowing more clinical care to be delivered outside hospitals and nursing homes—will create entirely new categories of job options for clinicians, creating additional competition for workers. It will also give opportunities for vertically integrated care providers to provide flexible career paths within a single organization.

The overall work experience in core staff positions will improve as health care employers invest heavily in retention.

Health care employers are investing in supporting their core staff with improved salaries, benefits and retention bonuses, and mental health and wellbeing services. Without additional federal aid for travelers, the core staff positions need to be competitive and for physician practices that can’t always offer market-leading salaries, investing in more staff benefits will go a long way. In Vivian’s Future of Healthcare Work Report, health care benefits such as medical and dental insurance proved to be the most important offering, followed by retirement or pension benefits, vesting length for 401(k), short-term and long-term disability, and tuition reimbursement benefits.

We’ve also learned that 100,000 clinicians who resigned were predominantly 49 years of age and younger, and left due to a lack of affordable childcare and virtual learning for their children. Conversely, the pandemic also exacerbated the complexity gap: There are too few nurses with extensive experience and knowledge working with new nurses who feel unprepared for today’s patients requiring complex care. These two trends unfolding concurrently pose a concerning threat to the health care industry, but health systems that implement the aforementioned benefits and ensure a safe, well-staffed and flexible work environment will be best positioned to meet this challenge and retain experienced and newer clinicians alike for longer.

Pay transparency will become the norm, not a COVID-influenced exception.

During the height of COVID, job marketplaces like Vivian established the expectation of transparency with travel job rates. Now that clinicians are more willing to accept core staff roles, they want as much information as possible upfront. Employers that reveal their hourly wages will have to meet that expectation of pay transparency from the onset. This trend is being reinforced with policy changes implemented by many jurisdictions across the country, such as The City of New York, California, and Colorado, which are now requiring employers to include compensation ranges on their job listings.

Advanced Practice Practitioners will be in even higher demand.

Nurse practitioners, certified registered nurse anesthetists, certified nurse midwives, clinical nurse specialists, and physician assistants already provide much-needed clinical care and are meeting the increasing demand for health care services. The Bureau of Labor Statistics estimates that the employment of nurse anesthetists, nurse midwives, and NPs will grow 40% between 2021 and 2031 and employment of PAs will grow 28%. This year, we anticipate more states will expand the scope of practice for these roles, fueling even higher demand for advanced practice professionals.

This demand will continue to grow, especially for those who provide geriatric primary care. As Baby Boomers age—the elderly population is expected to double by 2050—they will need long-term care in nursing homes, retirement communities, home care, hospice, and acute-care settings more than ever before. Currently, there aren’t enough providers specializing in geriatrics to keep up with the demand of the aging population. This is likely the driving force behind the 1.9 million new health care jobs expected to generate nationwide by 2028. Concerns and opportunities for advanced practice practitioners also apply to underserved communities where health disparities may be exacerbated by the lack of primary care providers’ access.

Healthcare employers will invest in creating a positive experience for job candidates.

The immense shortage of clinicians will lead to an increased focus on minimizing drop-off during the recruitment process. Currently, the average hiring time ranges between 45 to 60 days to fill an open acute-care position, and 30 to 67 days for a position at a skilled-nursing facility. Employers are losing strong candidates because they aren’t acting swiftly, and the gap between offer and orientation is coming down to communication tools like texting versus emailing to chat with candidates and employer responsiveness. Health care employers will invest in technology, operations, and talent acquisition professionals to create a speedy and positive experience for job seekers.

Beth Brooks, PhD, RN, FACHE, is clinical advisor to Vivian Health

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Medical Economics | March 10, 2023

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