In the coming months and years, I anticipate that Monster.com and other online job services will grow their revenues from the health industry. Three important studies this month confirm that, while health care eats up nearly one-fifth of the U.S. economy, there are shortages of professionals to fill two important jobs that are growing: primary care physicians (PCPs), nurses, and health information technology (HIT) workers.

Let’s talk about the doctors, first. The Journal of the American Medical Association (JAMA) reports this week that doctors cut back their working hours since 1998 to 2008. At the same time, the second chart shows that doctors’ pay, adjusted for inflation, has fallen in the same period. The charts tell the story.


Mean physician fees fell 25% between 1996 and 2006, which may have resulted in the reduced number of hours worked. That is only part of the story, as many physicians take on non-patient care tasks (e.g., investing in ancillary health businesses such as physical therapy or labs). Some choose to spend less time per patient.
The researchers calculate that the 5.7% decrease in overall physician hours translates to a loss of 36,000 physicians all things being equal. With fewer incoming medical students opting in to primary care, this is more evidence for a primary care physician shortage forecast.
As for nurses, a report from AMN Healthcare, surveying nurses’ job satisfaction, also anticipates a worsening of the nurse deficit in the U.S. According to the 2010 Survey of Registered Nurses: Job Satisfaction and Career Plans, 40% of nurses in the U.S. plan to alter their career path in the next 1 to 3 years. At the core of this is broad dissatisfaction and concern for a declining level of health care quality. Only 59% of nurses would choose this career path if they had to do it all over again. The immediate concern is that 6% of the nurses said they would leave the hospital setting int he next 1 to 3 years, which if it comes to pass, would result in a reduction in the number of nurses in the U.S. of 70,000. The U.S. Bureau of Labor Statistics forecasts a shortage of over 260,000 nurses for 2025.
As tens of thousands of health IT stakeholders flock to Atlanta next week for the annual HIMSS 2010 meeting, it’s useful to ponder the labor implications of the ARRA stimulus as well as the continued adoption of all sorts of HIT in health. A survey by Beacon Partners published this week finds that the biggest hurdle for EHR adoption is internal resources — not vendor shortcomings or lack of ready solutions. Hospital executives are concerned about the lack of leadership commitment to adequately funding, staffing and maintaining EHR adoption projects. 45% of resondents said they weren’t sure they actually had the resources required to adequately adopt and implement EHRs over the next few years.
According to the American Society of Health Informatics Managers, between 50,000 and 200,000 new jobs will be created for health IT pro’s by 2015. Thus, a sure forecast is a deficit of skilled, competent HIT workers for U.S. health providers and other settings where HIT happens.


Health Populi’s Hot Points:
Here’s a novel thought for health reform: let’s fund a jobs bill for health — to employ upwards of 500,000 professionals for primary care, nursing, and HIT. It’s a sure shortage, and a sound return. Perhaps this is a health issue that could curry favor across the parties — perhaps…

More from me directly from the floor of HIMSS next week in Atlanta…stay tuned, and Health Populi will translate the HIT-hype through the lens of the dismal scientist…

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