It isn’t over. (Plus insights on how to address it.)
For those who thought the lessening of the COVID pandemic and all of its attendant stressors on healthcare personnel would solve or at least markedly reduce the projected clinician shortage, we regret to report: uh uh.
To learn more about the current state of and outlook for the long-running physician shortage, check out the excellent report issued on September 10 by McKinsey stemming from its 7th national survey of physicians. https://www.mckinsey.com/industries/healthcare/our-insights/the-physician-shortage-isnt-going-anywhere?cid=eml-web
The McKinsey research showed that the US is facing a shortfall of 64,000 physicians by the end of this year. That number is expected to increase to 86,000 by 2036 — even as the percentage of the age 65+ cohort will increase from 17 to 23 percent of the total population by 2050.
That the physician shortage remains a pressing concern is hardly new information. But what’s particularly helpful in McKinsey’s survey of 631 physicians is illuminating the 4 factors that are fueling the desire of physicians to retire early, cut back their work hours, move into non-clinical roles, and/or leave the field altogether.
According to McKinsey, the 4 factors most at play in determining whether physicians will stay, modify, or leave their current role are:
1. compensation and incentive structures
2. lifestyle needs (aka work-life balance including, especially, greater scheduling flexibility)
3. involvement in decision-making, especially regarding patient care issues
4. staffing and support systems (especially reassigning, delegating, or eliminating tasks which do not require physician-level expertise)
While the results in the McKinsey report may not be surprising, the relative lack of urgency on the part of senior leaders to make significant changes in the conditions of the healthcare workplace continues to surprise my OWS colleague Paul DeChant, MD, MBA, and me.
To be sure, many organizations have made adjustments to compensation and incentive plans and have started to create more flexibility with respect to clinicians’ schedules. Good!
However, we see relatively little effort being expended with regard to increasing the ability of front-line clinicians to modify clinical workflows, staffing or task allocation patterns, and/or inflect policy and procedure with respect to day-to-day patient care issues.
Half a loaf will not carry the day. Hospital and health system leaders will need to tackle all 4 factors identified by McKinsey if they are to be successful in their clinician recruitment and retention efforts.
Solutions for Hospitals, Health Systems, and Medical Group Practices: Leadership-Driven Changes
The locus for curing clinician burnout and staffing shortages runs through the C-suite.
Here are examples of leadership-driven changes to the workplace that my colleague Paul DeChant, MD, MBA and I often recommend:
regard clinicians as knowledge workers who are given significant latitude to make clinical decisions without unnecessary administrative encumbrances or delays
consistently apply one or more of the improvement sciences (Lean, Six Sigma, operations research, agile, design thinking) in consultation with front-line staff to improve workflow and reduce delays, waste, inefficiency, and job skill mismatches
expect all leaders, but especially senior executives, to do periodic job shadowing of front-line staff (where observing and deep listening are emphasized) in lieu of "rounding" (a largely ineffectual, if widely practiced activity)
create and require leader standard work (LSW).
develop and deploy a sophisticated, deeply ingrained, and rigorous daily management system (DMS) supported by visual display boards or monitors
judiciously invest in AI/ML solutions -- selected, tested, and endorsed by front-line staff -- that eliminate or at least markedly reduce data entry, administrative requirements, and/or repetitive tasks that are non-value add
support near-continuous optimization and remediation of the EHR (there's no such thing as "it's all set")
get rid of superfluous or outdated policies, procedures, redundant approvals, and other stupid stuff (GROSS)
Ready to transform your hospital or workplace?
Are you frustrated by adversarial relationships between front-line clinicians and senior leadership? Organizational Wellbeing Solutions was formed to enable senior leaders to identify the specific drivers of clinician burnout in their organization; and to support leaders in designing and executing a comprehensive plan to stop clinician burnout, increase retention, and improve operating results. A hallmark of our consultancy is correcting the all-too-frequent distrust and alienation clinicians feel toward the C-Suite generally and the CEO in particular. Let us help you help your organization and its clinicians develop a more trusting, aligned, and productive working relationship.
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