MD, nurse shortagesreaching crisis levels
WASHINGTON, (UPI) -- Shortagesof surgeons, pharmacists and nurses in hospitals across the UnitedStates are reaching crisis levels and may worsen over the nextseveral years, health care experts warned.
The nursing shortage --more than 126,000 positions currently remain unfilled -- has becomeso severe it is endangering the lives of patients and is a primaryreason for overcrowding in emergency departments and cancellationof surgeries, according to a report by an Experts Roundtable panelconvened by the Joint Commission on the Accreditation of HealthcareOrganizations.
The Society for ThoracicSurgeons recently warned that a shortage of heart surgeons loomswithin a few years and a survey of hospitals found pharmacists,X-ray technicians and therapists are leaving at such an alarmingrate it already is impacting the quality of care patients receive.
Joan Luciano, a senior managingconsultant with the Boston human resources consulting firm, DrakeBeam Morin, who conducted the hospital survey, said there is enoughof a shortage of qualified people at hospitals that the generalpublic should be concerned, particularly in light of the increasein health care services that will be needed as the post-WorldWar II, baby boomer generation ages.
One reason for the shortagesis that "hospitals have serious retention issues," Lucianotold United Press International. The survey, which included 44hospitals, found those hospitals lost 18 percent to 22 percentof their pharmacists, radiologists and therapists in 2001. Thisis significantly higher than other industries, which have averageattrition rates of 13 percent to 15 percent, she said.
Amy Lee, a spokeswoman forthe American Hospital Association in Washington, told UPI thesituation is "something that hospitals have well been awareof." Hospitals are taking steps to "become employersof choice" and employing strategies to retain staff, sheadded.
Hospitals also might belosing doctors and surgeons at the same rate. The hospitals involvedin the survey told Luciano they did not track doctors, so "wejust don't know ... but the situation with doctors and surgeonscould be the same" as with the other health care workers,she said.
At least one type of surgicalspecialty looks to be in trouble as well. Kevin Accola, a heartsurgeon at Florida Hospital in Orlando and chairman of the healthpolicy workforce for the Society of Thoracic Surgeons, told UPIalthough the heart surgeon shortage will not become apparent forthree to six years, "it's a crisis now. There have to bechanges now."
This is because it takeseight to 10 years to train heart surgeons and there already aredrop-offs in residency applications, Accola said. There were notenough applicants to fill all the available heart surgical residentspots last year, and a number of general surgery residencies --the program surgeons must complete prior to specializing in heartsurgery -- also were left unfilled.
"So basically, we'reending up with less and less available people," Accola said,and "the implication is that we're going to have a crisisin access to heart surgeons."
There will not be enoughsurgeons to perform operations for bypasses, lung cancer and otherheart- and lung-related surgeries, he said. The situation likelywill be compounded by the aging baby boomers and the fact thatpeople are living longer, so there will be an increased need forthese types of surgeries, he said.
"People should be concerned"about the health care shortages, Mohammad Akhter of the AmericanPublic Health Association in Washington, told UPI. The shortageshave significant potential to affect quality of care, he said.
Akhter said the shortagesare a result of HMOs and managed care companies attempting tocut costs and staff to save money and increase profits. This hasplaced an "excessive demand" on health care workers,which coupled with low salaries has deterred young people fromentering these fields.
Congress, which "hasnot been kind" to the health care industry, needs to takea comprehensive look at this situation, Akhter said. This year,Congress increased funding for nursing schools to spur peopleto enter that field, but the same needs to be done for other healthcare specializations, he said.
Accola also said Congressmust step in and address the issue. One change he said he wouldlike to see is an increase in Medicare reimbursement. This hasbeen cut almost 40 percent since 1997 and has created a situationwhere "someone gets paid more to work on my roof at homethan I do to do a heart procedure," Accola said.
The Joint Commission Roundtableconcluded solutions to the nursing shortage must involve transformingthe nursing workplace, increasing enrollment in nursing trainingprograms and paying financial incentives to spur health care organizationsto lay out necessary expenditures for high quality nursing care.
"Failure to addressthis problem aggressively is likely to result in increased deaths,complications, lengths-of-stay, and other undesirable patientoutcomes," the roundtable said in a written statement.