1. CHAPTER The Health Care Workforce Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. Stephen N. Collier, PhD

2. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 2 Changes in Health Care Workforce Aging and becoming more diverse Baby boomers retiring Shortages Growth in health care workforce Increase in medical assistants Additional information: http://bhpr.hrsa.gov/healthworkforce/

3. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 3 Economy and Health Care Primary job growth area for U.S. economy 13/30 fastest-growing occupations States aware of importance of a health care workforce Cannot be moved offshore Multiplier effect on local economy

4. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 4 Health Care Workforce Cyclical supply and demand Imbalance causes problems Current shortage may not be cyclical Employers want an oversupply Educators want excess applicants

5. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 5 Physician Workforce Shortage AMA 30% increase in enrollment by 2015 Demand growing as population ages Allopathic increasing number of grads Osteopathic opening more schools Picture source: http://kesehatan.kompasiana.com/medis/2010/08/10/medical-doctorthe-dangerous-profession/

6. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 6 Nursing Workforce Long-term shortage RNs have an increasing average age Retirement will increase shortage International nurses filling gaps Limited ability of U.S. educational system Additional information: http://bhpr.hrsa.gov/healthworkforce/rnsurvey/2008/ Picture source: http://www.edupics.com/i mage-nurse-i10369.html

7. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 7 Workforce Education Educational system slow to respond to workforce changes Accreditation Reimbursement changes cause changes in workforce demand Demand for therapists after BBA of 1997 Large gap between demand and capacity of programs for most health professions Picture source: http://www.who.int/topics/education_medical/en/

8. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 8 Workforce Regulation Voluntary, self-imposed, governmental Mostly governmental at state level To provide protection to the public Licensure Certification Accreditation Picture source: http://familynursepractitionersalary.com/

9. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 9 Workforce Gender Majority are women Shift Additional information: http://www.who.int/hrh/documents/gender/en/index.html http://www.who.int/hrh/documents/gender/en/index.html

10. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 10 Workforce Training Bimodal More at lower and higher levels Professions increasing educational level Occupational and physical therapy Bachelor’s to doctoral “Degree creep” Increasing centralization of functions

11. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 11 Workforce Training “Degree Creep” Increasing degree levels Expanding knowledge Advanced technology Additional expense for students Staffing more expensive Additional information: http://www.hrsa.gov/about/pdf/bhpr.pdf Picture source: http://www.prevention.com/health/health/ healthy-living/use-your-nurse-practitioner/article/ 20c9ac2175d69110VgnVCM10000013281eac____

12. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 12 Frontline Workforce Patient contact Bachelor’s or lower <$40,000 annually Mostly women High stress, low wage High turnover Picture source: http://www.themedicalguru.com

13. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 13 Workforce Shortages Reasons for shortages: Education sector Employment characteristics Work setting Professional organizations Credentialing mechanisms Payer policies Additional information: http://bhpr.hrsa.gov/about/default.htm

14. Copyright © 2010 Delmar, Cengage Learning. All Rights Reserved. 14 Additional Resources World Health Organization – Health Workforce http://www.who.int/hrh/resources/en/index.html Global Health Workforce Alliance http://www.who.int/workforcealliance/about/en/ World Health Organization - Human Resources for Health online journal http://www.human-resources-health.com/ U.S. Department of Health and Human Services http://bhpr.hrsa.gov/healthworkforce/ http://datawarehouse.hrsa.gov/hpsadetail.aspx#anchor http://arf.hrsa.gov/ Public Health Service Act - Title 42 "The Public Health and Welfare", Chapter 6A "Public Health Service“ http://www.law.cornell.edu/uscode/html/uscode42/usc_sup_01_42_ 10_6A.html