What’s Causing The Great Resignation in Healthcare?

 

The Great Resignation is pulling a lot of healthcare workers out of our profession for a variety of reasons

(First of a 2-part series)

The employee exodus following the COVID-19 pandemic has been referred to as “The Great Resignation” or the “Big Quit,” and it has affected healthcare and other industries with record numbers of Americans leaving their jobs. Many medical practices and hospitals have unfilled positions, placing stress on the existing staff. This blog covers the reasons employees are leaving. Part 2 offers practical suggestions to stop the bleeding.

Employee turnover, which includes physicians among nurses and allied professionals, is one of the costliest challenges in healthcare and threatens to become worse as the demand for care exceeds the supply of healthcare workers. If a practice doesn’t work on employee retention, it will experience understaffing, financial insolvency and deterioration in patient care.

The Great Resignation in healthcare jobs by the #s

• About 1 in 5 healthcare workers have left medicine since the pandemic began.
• Nearly half a million workers left healthcare since February 2020.
• 18% have quit since the pandemic began; 12% have been laid off; of the remaining, 31% have considered leaving.
• In 2022, nearly 1.7 million people have quit their healthcare jobs – equivalent to almost 3% of the healthcare workforce each month.
• It is estimated that replacing a healthcare employee averages the cost of an entire year’s salary for that position.

Excluding those who have left the field because of layoffs or conditions linked to long COVID, below are the most common reasons for The Great Resignation in healthcare.

Healthcare administration & leadership concerns

This is probably more important than all other reasons for The Great Resignation in healthcare by a significant margin. During the pandemic, employees received erratic scheduling and mandatory overtime. Fitting available square pegs into shift holes resulted in good employees being turned off to the healthcare profession. Unfavorable shifts may be unavoidable, but flexibility and communication from office managers and healthcare administration can make the difference. Lack of consideration by leaders is a sign of disrespect toward healthcare workers.

Lack of employee recognition & advancement opportunity

Healthcare workers often complain about not being valued by management. They know they play an essential role in the healthcare system, yet their work tends to be undervalued by doctors, office managers and hospital administrators. This underappreciation may spill over to their patients not appreciating their extra work and challenging conditions. Healthcare workers do not expect to be thanked for every task they perform, but employees do want to be recognized as valuable healthcare team members. Doling out “employee of the month” certificates can become meaningless if the award’s rationale is absent.

Lack of advancement opportunity is another management deficit concerning healthcare workers. They don’t want to rest in their current position even if it is highly specialized. Many practices do not offer enough opportunities for advancement or the means to get there. These opportunities can mean more to employees than better pay or compensation packages. Employees are leaving the profession because they desire more from their current role. With the flexibility of their medical background and their knowledge, many employees realize the income potential in a related field that is not clinical medicine.

COVID-19 pandemic effects, including healthcare burnout

Many are leaving the medical profession because of how their institutions acted during the COVID-19 pandemic. Often healthcare providers complained that hospitals cut salaries and benefits and limited raises and bonuses. Some hospitals and practices:

• Forced staff to work additional shifts.
• Denied or reduced paid time off.
• Failed to provide sufficient personal protective equipment.
• Downplayed the severity of their experiences and the risks they were taking to care for COVID-19 patients.
• Hospitals in particular are flooded by non-COVID patients who delayed care and now require more intensive care.

Healthcare employee and physician burnout due to COVID-19

Before the pandemic, between 35% – 54% of U.S. nurses and physicians experienced one or more symptoms of burnout. Now, burnout has increased in frequency, and more healthcare employees are leaving the profession because burnout has resulted in mental and physical issues. A recent survey of 1,000 healthcare professionals showed that 28% quit a job because of burnout.

Medicine is already a physically and emotionally demanding job. The pandemic created additional responsibilities, workflows and potential virus exposure that compounds the stress and exhaustion already felt by so many providers. Often there is not enough staff for the increase in patient volume and acuity of illnesses.

Burnout can lead to lower quality care and medical errors, negative health outcomes and patient dissatisfaction.

Work-life balance issues behind The Great Resignation

Many employees are evaluating their work-life balance, contemplating why they continue to clock into a job that does not fit within the lifestyle they desire. Medicine is a great career, but it may not be worth time away from home compared to other professions. Allowing more time away from work can provide workers the clarity to figure out what they want their careers to look like.

The pandemic allowed many healthcare providers to work remotely and now many are deciding they want a position, even if it is in another area or profession, that allows them to work in such a way. Childcare is a significant concern for some employees. Depending on family situations, it might make more sense for one parent to stay at home or to work part time.

A healthcare career can be exhausting. The exhaustion makes it easy to lose sight of why men and women went into this profession. When employees can’t take care of themselves, they find it harder to take care of others.

Mental health issues

Medicine is a mentally exhausting career. Many employees are put into difficult situations and often have little time to process or cope. Over time it can take a toll on the employee’s mental well-being, and the person may leave the healthcare profession to pursue something else. For many healthcare employees, it is often difficult to seek guidance or help if they are struggling.

Problems with profits coming before patients

Healthcare workers have trouble trying to justify the situation where profits come before patients. Most healthcare workers enter medicine “as a calling” and are idealistic and altruistic. They want to help patients, and their inability to adequately do so is taking its toll.

I have noted this disappointment in middle-aged and older physicians who have become employed by hospitals or large medical groups, where their productivity is measured in relative value units (RVUs) and told how many patients they need to see in an hour or day to reach quotas set by their employer.

Many healthcare workers feel their employers are not looking out for their best interest and only care about profiting in the current healthcare system.  Providers aren’t exiting the field because they can’t handle their jobs – they’re quitting because they can’t handle being unable to do their jobs.

Employee salary dissatisfaction

A career in medicine is gratifying, but that doesn’t necessarily translate into more money. Doctors and other healthcare workers can earn a lot of money, but it’s not always the case. In some areas of the country, employees must work more than one job to make ends meet. Many people who initially wanted to be healthcare workers find themselves overshadowed by the low pay and high student debt. Some are making career moves that could allow for a more sustainable career that pays more than their healthcare salaries.

Other factors feeding The Great Resignation

Staffing shortages and the extra work burden may lead to dissatisfaction and personal illness.

Work-related injuries and illnesses cause many healthcare professionals to leave the profession because they feel that the working environment is unsafe. Whether it is harmful exposure to the patient population or the working conditions they endure, it is hard to get someone to stay at their job if they feel unsafe.

Long commutes are not unusual, with some employees spending 30-90 minutes a day commuting from their homes to their places of employment.

Spending too much time on documentation and not on their patients. Doctors and allied health professionals did not undergo arduous training and education to conduct data entry for nearly half of their workday.

Bottom line: The Great Resignation is a major problem for the healthcare industry. If the one-third to one-half of nurses and physicians carry out their expressed intentions to cut back or leave, there won’t be enough staff to meet the needs of patients. In the next blog, I will discuss possible solutions to The Great Resignation.