Daily Briefing

It's not the great resignation, it's the great realignment

It's no secret that health care is facing a workforce crisis. The good news is that workers aren't leaving the industry entirely, but instead moving on to other roles that enhance their quality of life—and it's not just about the money.

Radio Advisory's Rachel Woods Woods sat down with health care workforce experts Eliza DaileyMonica Westhead, and Alex Polyak to discuss workplace qualities that have become more important to health care workers and what leaders can do to cement themselves as the employer of choice.

For workforce strategy, forget 'return to normal.' Your workforce certainly has.

Read a lightly edited excerpt from the interview below, and download the episode for the full conversation.

Rachel Woods: So by now I'm sure that each of you has heard this common term, that's not just in health care, but is in practically every headline that I see. It's this concept that there's a great resignation, certainly in America right now, as we deal with the ongoing effects of the Covid-19 crisis. This is of course not just affecting health care. This is affecting all industries, but I want to ask you, how is the great resignation impacting health care specifically?

Monica Westhead: I think the great resignation is very much showing up in all industries, and we're seeing reflections of that in the health care world as well. What's potentially interesting is that, although we're seeing a lot of people leaving their jobs, they're not necessarily leaving health care entirely.

So if we think about nursing, for example, what we've been saying is it's more of a great reallocation than it is a great resignation.

Nurses aren't necessarily leaving nursing together, but they are certainly willing to leave their current organization and their current role for another role that provides them with something that aligns with what they need, whether that's more flexibility, or whether that's different hours, or even just better pay. So we've been thinking about it as the great reallocation rather than the great resignation.

Woods: And why is that nuance important, that it's more of a realignment/reallocation than an all-out resignation?

Westhead: I think it's a little bit of a silver lining. Certainly it's always really scary and really intimidating when you're seeing a lot of staff leave, especially in a critical role like nursing. But I think what the good news is in this case is they're largely not leaving the profession entirely. We're not seeing a mass exodus from people working in nursing.

Now that doesn't lessen the pain of the churn and the turnover that organizations very much are seeing. But at the same time, I think it's important to realize this is not an exodus from being nurses. It is a desire to look for a role that better fits what an individual needs at a specific time.

Eliza Dailey: That nuance is important too, because they are two different problems, and so they require different solution sets, and we'll get into that a little bit later. If your workforce isn't planning to leave health care but is just looking for different opportunities that does mean that there is space for you as the employer to better retain them at your organization.

Alex  Polyak: It's not only the opportunity for a fix, but where I want to come back to what Monica and Eliza have said is that, yes, they're not looking necessarily to leave health care for other industries, but they are looking to other industries in terms of what benefits, what flexible work offerings, what type of new evolution of work-life balance you're seeing.

Even though we work in health care, we have friends in every other industry. And when it seems like every other industry has done something better for their employees during Covid, health care undoubtedly will come across as a bit of a laggard.

Woods: So there's this nuance in the health care space where there's all this inspiration coming from every other industry. But what we're not seeing is, let's make fun of ourselves for a second, consultants leaving their cushy health care business research job to, I don't know, open up a brewery in the rural parts of Ohio, which I may or may not have thought of at certain points during this pandemic.

Instead, what we're seeing is exactly what we've talked about on this podcast before, Monica, where people are leaving their employer or their specific role or their specific job to find something that is better.

Here's the thing—I have to believe that this might play out differently, depending on which stakeholder we're talking about. Monica, you obviously work with nurses. Eliza, you are our representative for the docs. And, Alex, you kind of work with everyone. Are there differences in how we're seeing this play out across the health care workforce?

Westhead: I think to some degree in the nursing world, we're dealing with systemic issues that have been in place for a long time, desire for more flexibility, that sort of thing. But now we're reaching a point where nurses are more willing to leave to get those things.

And I think I totally agree with Alex when you were saying that they're looking to other industries to see what is out there. Now, what I will say is we've been hearing a lot, at least I've been hearing a lot, from nurse leaders about concerns about nurses moving into non-clinical or non-direct care roles. The reality is that there really are not that many positions available.

So nurses that are leaving, they can't necessarily go to these non-direct care roles because they don't exist in the numbers that we would need them to for everybody who wants them to do that. So I think for nurses, it's more about how do we try to work on some of those older systemic issues, like flexibility, like rewards, like scheduling, that would really have a significant impact on the way that they feel the level of respect that they feel in their jobs.

Dailey: And I would say when we think about the physician side of things, I think we are seeing a little bit of this great realignment, but it's playing out to a lesser degree than what we're seeing in other roles. So generally, physicians tend to be more risk averse.

There are some structural barriers that tend to keep them in their jobs for longer. For example, they built up a panel. They've built up a practice, there's a huge opportunity cost for them to shift roles, they also have more regulatory things in place like non-competes and licensing. And so we do see a little bit of movement in the physician space, but less than what we're seeing in nursing, or maybe other roles in the workforce.

Woods: Do we have actual numbers to back up what the both of you are saying? Because I agree. These are things that I hear. There are definitely things that I hear from my conversations with health care executives, but how does it actually play out proportionally? Do we have actual data here?

Westhead: I will say that on the nursing side, we will. We are in the process of putting together the results of a very large clinician survey that we did across the late spring. And that survey will speak to things like how many people are considering leaving their roles? What are the primary drivers that would make them make that decision? And what's keeping them in their current role. So a little bit of a spoiler alert, but we don't have the results just yet, but that certainly will be coming.

Woods: Eliza, do we have anything for the docs?

Dailey: On the physician side, we do have some longstanding data going back to about 2012, so 10 years of data showing that about half of physicians have considered a career change. So this could be switching employers, retiring early, leaving medicine altogether. And then over that same period of time, we've seen that turnover has remained fairly constant.

So you have about half of doctors who are considering a career change, but turnover has stayed around 7 to 8% annually. I will say that we're seeing some data showing across the last year or so there may be a little bit more movement due to Covid. You're seeing more physicians actually acting on that discontent, but that is more so maybe changing practice settings or maybe switching employers, not leaving the field altogether.

And the one thing I want to say, because I don't want our listeners to hear this and think, oh, this is the same problem we've had for 10 years. They're not actually leaving. We don't need to do anything about that. The fact that half of our physician workforce is so unhappy that they're considering a major career change should set off huge alarm bells and should be something that all executives are focusing on and trying to fix.








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