Health Care Workforce Exodus Persists Beyond the Post-COVID Era

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The health care sector continues to face challenges recruiting and retaining employees, even after the tail end of the COVID-19 pandemic, according to a new study that looked at data from 2018 through 2021.

Although hiring trends appear to be improving, high turnover continues to disrupt continuity of care, resulting in poorer patient outcomes.

Why Is It a Disproportionate Exodus?

Health care employers are struggling to recruit Black workers. Women in particular are leaving at disproportionate rates, according to the study, which was published in the Journal of the American Medical Network.

Female and Black health care workers are overrepresented in lower-paid direct care roles, which faced the greatest risks during the pandemic. Thus, it is unsurprising these workers appear less likely to return to or enter health care, the researchers wrote, noting this pattern will exacerbate the field’s lack of diversity.

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Although employment levels stabilized in late 2020, more people were leaving the industry than ever before. Exit rates rose first in the Northeast, then spread to the South and West.

Rates stayed above pre-pandemic levels through 2021, even as increased hiring compensated for the churn. Consequently, health care providers operated with less experienced staff. “Health care organizations after the pandemic are operating with more staff with less experience than in the pre-pandemic period,” the authors wrote.

What’s Causing the Exodus?

The COVID-19 pandemic put unprecedented pressure on the American health care system. The workforce was under extreme stress on, resulting in staff shortages and heightened burnout, exhaustion, and trauma among health care workers, the Office of Health Policy reported in May 2022.

These challenges occurred against the backdrop of significant pre-existing workforce shortages and maldistribution, compounded by a workforce already grappling with burnout, stress, and mental health issues.

Total employment within the health care industry declined, particularly impacting ambulatory care employees, according to a 2022 issue brief released by the Office of Health Policy.

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Hospitals faced challenges in securing adequate staffing, especially during the early days of the pandemic and amidst the Omicron surge in January and February 2022. Despite the escalating demand for critical COVID-related care, some health care workers found themselves furloughed, terminated, or subjected to reduced working hours, as numerous clinics were forced to temporarily close.

What Does This Mean for Public Health?

The research team warned that reduced adequacy in patient care could be an exodus consequence. When patients encounter different doctors throughout their care, it not only erodes doctor-patient trust but also makes it challenging to grasp the complete picture of one’s health.

The escalating turnover in the health care workforce may result in substantial costs for both organizations and patients. This is due to the potential disruption of continuity of care and a decrease in staff with industry- and firm-specific experience, the authors wrote.

In light of these concerns, the researchers recommend that policymakers explore strategies to address health care worker burnout.

Their suggestions for retaining health care employees include:

• Enhancing wages and working conditions for direct care workers
• Establishing staffing ratios
• Providing support for dependent care
• Creating opportunities for career development