Conventional thinking is that automation and technological improvements may reduce employment.
But the growth of telemedicine during the COVID-19 pandemic appears to be having the opposite effect.
Fifteen months into the pandemic, health care employment is maintaining the same trajectory — competition for health care professionals remains intense.
Overall, health care professionals who were sought before the pandemic remained in demand after the virus took hold in spring 2020, and experts expect that trend will continue as the disease wanes.
Since the pandemic has put extreme pressure on the industry — the first line of defense against the virus, health care organizations have had to do more with less.
Telemedicine has greatly assisted with that, but it has also meant retraining and redeploying people to meet the unique demands of the pandemic.
“The pandemic is accelerating trends that were moving in that direction anyway,” said Tom Binnings, founder and senior partner at Summit Economics.
Telehealth services, from virtual appointments to health monitoring devices, have become much more widely available to patients during the past year, but people are still required to aggregate and interpret the new data that telehealth is generating.
Health care “is a very labor-intensive industry,” said Tatiana Bailey, health care economist and executive director of the UCCS Economic Forum. “There’s only so much you can automate.”
Besides the shortage of trained health care workers that has existed for years and pandemic-generated needs, an aging population requiring more health care services means that demand is likely to continue to outweigh supply in the industry’s job market well into the future.
BY THE NUMBERS
A report from labor market data company Emsi, received earlier this month by the Pikes Peak Workforce Center, starkly illustrates the critical shortage of health care professionals.
Between February 2020 and May 2021, health care and social assistance job postings led all other industries and sectors.
An average of 804 jobs per month for registered nurses was posted, while average monthly hires totaled only 138.
Similar discrepancies between the number of available jobs and the number of people hired showed for most other health care positions, including:
•LPNs: 143 average monthly postings, 40 average monthly hires
•Family medicine physicians: 124 postings, five hires
•All other physicians: 93 postings, eight hires
•Physician assistants: 60 postings, 10 hires
•Physical therapists: 68 postings, 23 hires
•Occupational therapists: 64 postings, 15 hires
•Nurse practitioners: 36 postings, 27 hires
But home health and personal care aide hires outnumbered postings (264 postings, 479 hires), as did medical assistant hires (83 postings, 123 hires).
Median job posting duration in Colorado Springs was 32 days.
Job postings for health care professionals appear to be increasing, the report showed. The number of postings between May 8 and June 6, 2021, increased 22.8 percent over postings in the comparable period of 2020.
UCHealth and Centura Health were the top organizations in terms of the number of job postings during the pandemic.
UCHealth posted a total of 16,308 times (1,960 unique postings), and Centura Health posted 13.886 job openings (767 unique postings).
Organizations such as Peak Vista Community Health Centers, private health groups, senior care facilities, in-home care providers, health care staffing agencies, and insurers such as Humana and Anthem also sought health care professionals during the pandemic.
Health care and social assistance constituted 12.5 percent of U.S. employment in 2019 and is expected to increase to 13.9 percent of the labor force by 2029, according to projections from the U.S. Bureau of Labor Statistics.
“The supply of workers is going to decrease and be even more challenged because of retiring Boomers,” Binnings said. “The pandemic really burned people out.
Another factor is high turnover, he said: “If you’re a nurse and you’re not happy where you’re working, pick your next spot.”
Technology will augment the provision of medical services and improve accessibility to health care, but it will also change how medical personnel need to be trained, he said.
“I tell every young person who asks me the question, ‘What should I focus on?’ that, whatever they’re interested in, to get a certificate in analytics, get a data science perspective,” he said.
“It’s no good just to be a nurse practitioner anymore; you need to be a nurse practitioner who knows how to operate some pretty sophisticated machinery,” he said.
Binnings thinks the pandemic also may have created the perception of health care workers as heroes.
“If promoted correctly in the coming decade, that can improve the amount of young people getting into the profession,” he said.
The UCCS Economic Forum’s dashboard for May shows health care and social assistance continuing to lead quarterly employment in the top 12 economic sectors in the Colorado Springs metro area.
Like most other sectors, there was a dip in employment in the second quarter of 2020, but the sector showed recovery in the last two quarters of the year.
“It’s going to continue to rebound,” Bailey said.
Centura Health’s facilities throughout Colorado are seeing a tightening of the labor market and a need for increased hiring to accommodate patients, said Cathy Roberts, group vice president of human resources.
“It’s not primarily COVID patients,” Roberts said. “We knew that during COVID, other patients delayed their care, so we’re now seeing increased volumes, and we kind of anticipated that.”
Some vacancies were created because of retirements, but a bigger trend, Roberts said, was “people relocating to be closer to family.”
While demand is especially high for nurse and medical assistant positions, “it really spreads across a number of different professions and job categories,” Roberts said.
During the pandemic, “we’ve definitely become adept in adjusting our approach,” Roberts said. “That’s probably a core competency we’ve all come out of COVID with.”
Rather than laying off or furloughing employees during the early stages of the pandemic, “we were able to share staff across our system.”
Centura also was able to retrain employees so they could flex into other areas.
Using CARES ACT dollars, the Pikes Peak Work Force Center supported retraining of 1,218 health care workers at Centura and UCHealth facilities, as well as Children’s Hospital.
According to a Workforce Center report, the program benefited 438 nurses who were retrained to work in acute and critical care; 145 nurses who were retrained in respiratory rehabilitation and therapy, 452 medical staff who were trained in behavioral health and 183 administrative staff who were trained to manage COVID-19 impacts on the health care system, including functions such as taking temperatures.
While Roberts sees a very positive outlook for people who are looking for jobs in health care, “at this point, there’s so many unknowns,” she said. “And maybe that’s another lesson of the pandemic — we forecast and we project, but we’ve got to remain flexible, because we just can’t always anticipate where things are going.”
The Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences at UCCS has been chipping away at the shortage of nurses, Dean Kevin Laudner said.
Although the school’s enrollment has been steadily increasing, “we are really limited by … the number of clinical spots we can get our students into,” he said.
“Our nurses have to do a lot of clinical rotations,” Lauder said. “Because clinical rotations are so valuable, we are getting a lot of competition from out of state programs that are bringing their students into our state, and some of them are actually paying the hospitals to take those students.”
The college of nursing is not in a position to pay hospitals to take its students, but Laudner said he stresses the quality of its students to clinical providers.
“They know that if they take these students in their clinical rotations, there’s a much greater chance that they’ll actually stick around and fill some of the positions in the hospital once they graduate,” he said.
Students are getting other job offers as well, with starting salaries ranging from $66,000-$70,000 a year.
“Usually the problem is they get multiple offers and have to decide which one’s going to be best for them,” he said.
Most students, even those from out of state, stay in Colorado when they graduate. They’re primarily starting their careers in hospitals.
Beth-El offers undergraduate and master’s degrees in nursing and doctorate of nursing practice degrees in a variety of areas.
“One area I that has been increasing for us — and I see it increasing even more now — is on the mental health side,” Laudner said. “So there is a psychiatric mental health nurse practitioner.”
The school is delving more into telemedicine as well, as a result of the pandemic.
“When they first started doing telehealth, the doctors and nurses didn’t like it,” Laudner said. “But they started to realize that they can see a lot more patients, and patients that they normally wouldn’t have access to — patients in rural areas that weren’t always able to come in, and elderly patients that didn’t have rides.”
Interest in and focus on nutrition and dietetics also have been increasing, and the college is offering a biomedical undergraduate program that prepares students who want to get into medical school or go into physical or occupational therapy.
“Those have always been very popular, but they’re growing steadily,” Laudner said.
Over the past 10 years, Laudner said, health care has been evolving, and medical educators have adjusted their approach to training students to bear more responsibility.
Formerly, “you saw a doctor, and the doctor pretty much decided everything — made the diagnosis, decided what the treatment was and handed down the orders,” he said.
“Research has shown over and over again that that is not the most efficient way to treat patients.”
Now the model is interdisciplinary or interprofessional treatment planning that may involve a diagnosing physician, a nurse providing acute care, a nutritionist, a physical therapist and other practitioners.
“They all have their specialties and their responsibilities, and they work together,” Laudner said.
The team approach not only has proven to have better results, it also improves the cost of care for the patient, Laudner said.
“That’s the direction medicine is moving,” he said, “and it’s a win-win on both sides.”