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No One on Duty: Will Healthcare Be in Jeopardy in 2020?


It's a complex problem with no easy answers, industry leaders say.

The aging "baby boom" generation is creating more demand for healthcare services, says James Bentley, senior vice president for strategic policy planning at the American Hospital Association. However, the size of the workforce has decreased steadily -- with no end in sight.

Predictions made at the Congressional hearing were startling: While the nation will need 1.7 million nurses by 2020, just over 600,000 will be available.

People aren't drawn to health care as a profession, not like they were 20 or 30 years ago, says Bentley.

"In the 1960s, when baby boomers started entering the workforce, health care was attractive as a career. In a manufacturing economy, we were high-tech. Now we're in an information economy, and many people perceive us as low-tech. Right or wrong, that's how they perceive us. If you think of this as hands-on care, touching sick people, you have a different view than if you see this as the wired ICU."

Hospital employment, once viewed as stable, now faces looming mergers, closures, and downsizing, says Bentley. And while nursing was once one of the few careers open to women, that's all changed.

Other things that have changed: There's not so much "emotional compensation" for health care workers as patients' hospital stays have shortened. There's much more emphasis on documentation and paperwork. The "24/7/365 world" of health care also makes it less attractive.

Another problem, says Passiment: The healthcare workforce is aging.

"The majority of people working in health care today entered the profession in the 1970s and 80s," she says. "The median age in our profession is 47. That means 50% of practitioners are over age 47, and retirement is looming for all of them."

If the shortage problem is not stemmed, your healthcare in the year 2020 will likely be much different. Among the changes:

  • Elective surgeries will get deferred. Hospitals will begin offering fewer services. More patient care units will be closed down in hospitals. "I am not one of those who thinks we're going to wind up with a treadmill, rat-race kind of hospital environment," says Bentley. "I think nurses will simply leave the profession in increasing numbers, saying this just isn't worth it. They will look for other opportunities. Hospitals will have to change the work environment or limit the number of patients they can handle."
  • Hospital pharmacies would have to reduce services and cut back staffing schedules. "There will be no other alternative," says Charles Myers, RPH, MS, MBA, vice president of professional and scientific affairs for the American Society of Health-System Pharmacists. "We feel that every pharmacy in every hospital should be staffed 24 hours a day, but that won't be possible. There's a good deal of worry about this, that if the shortages become any worse, it could impact patient care. Lots of our members are starting to say, 'We're feeling very, very concerned.'"
  • Outpatient support services will deteriorate. "It's really going to fall on the "nexters," or whatever you want to call the next generation," says Passiment. "They're going to find themselves in a caretaker role that is remarkably different than what the baby boomers are finding with their parents. They're not going to have the support services they need when they need them."
  • The possibilities of the human genome project would not be realized. "The mapping of the genome project has such incredible potential for our future," Passiment tells WebMD, "but it's the laboratory technologists who will help make that happen. If all those people are not in place, the advances will not be made. We will not be better off than we are today. We will just be marking time."

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