One of the most significant issues facing our healthcare system today is the shortage of providers, from primary care doctors to specialists and nurses. This would be hard enough, but the fact is that the shortage is likely being compounded by two problems outside the control of physicians and nurses: an aging population and the increased use of technology, which is creating a new and unexpected burden on practitioners.
Faced with these two interlocking concerns, how can the healthcare field provide patients with the care they need as the population ages and chronic disease rates rise? The most valuable changes are unlikely to come from the world of technology and more likely to call upon conventional strategies like better training and unionization, approaches that have served the industry for decades.
Technology Troubles
If you read the headlines in any major outlet, you’d most likely get the impression that health technology is transforming the field for the better. Telehealth delivers specialist care to remote areas, robotic surgery increases accuracy and improves outcomes, and electronic health records help doctors communicate.
The reality, however, is not that simple. Among the issues that have emerged with increased digitization include a shift toward healthcare entrepreneurship; as skilled health and science professionals court their fortunes in app design and device development, they’re pulled away from traditional practice. Yes, some of their innovations are beneficial, but many of those working in health tech could do more good as doctors, nurses, or other direct support staff.
Another problem with the uptick in technology use in the healthcare industry can also be seen as an issue with the current insurance model. Taken together, the two have created a perfect storm of coding and documentation – so much so that providers just can’t keep up with it all.
This includes the upcoding phenomenon, in which doctors and facilities code for a higher level of service to increase insurance payments, as well as the high level of documentation that insurance providers demand regardless of the level of services rendered. Research has shown that in order to both provide primary care and chronic disease management and complete all the documentation demanded of them, doctors would need an 18 to 20-hour workday.
Of course, once we introduce new technology into a system, there’s no going back. The only way to address this gap between how much time providers have and how much work they have to do is to add more ancillary professionals to the healthcare industry. Young people studying the health sciences need to be exposed to the full scope of allied health professions so that they understand just how many people go into making our medical system run and the diverse ways they can apply their skills to serve patients.
Staff Shortages And Discontent
The burdens of technology notwithstanding, our healthcare system is also suffering from a major staffing shortage, and one of the areas in which this shortage is most serious is among nurses. In the UK, the nursing shortage is so serious that there are plans to hire 5,000 nurses from abroad each year for at least the next 15 years to work for the NHS. Why do the nurses have to come from overseas? Because in both the UK and the US, nurses are underpaid relative to the skill and intensity of the labor they do. Typical UK migration restrictions would actual bar 40% of foreign nurses because they don’t meet income requirements.
Similar problems plague the United States’ healthcare system, but unlike in the UK, the lack of nationalized healthcare means there’s no established resolution for the staffing crisis. One simple change that would help close the gap, however, would be increased unionization.
Across the country, nurses regularly attempt to unionize, but are thwarted by hospital systems that are prepared to hire union-busting groups rather than provide staff with greater protections. Underpaid, regularly facing workplace assault and injuries, and often forced to cover more patients than is deemed appropriate, nurses need the support of a union to keep themselves and their patients safe.
Gray Waves And Growing Disparities
Even with the emergence of telehealth services, a greater reliance on NPs and Pas, and other stopgap efforts, the US and the UK are facing two gray waves – an aging general population as well as aging physicians in certain specialties and regions, particularly rural primary care providers. These changes are driving greater health disparities among populations, and the stress of current patient loads are pushing more doctors into concierge medicine.
Taken together, new healthcare stresses are hard on providers but worse for patients who can’t access care at all. ERs and urgent care centers can bridge some of the gaps, but things will only get worse if we can’t increase the number of skilled professionals entering the medical and allied health fields.
Unfortunately, given the crisis cycle created by understaffing, the healthcare field may already have reached its tipping point, leaving a broken system and sick and vulnerable patients in its wake.