Not Enough Care in the World

An aging population combined with a severe hiring shortage creates a challenging time in healthcare recruiting.

Russ Banham

Looking for a career with wide employment availability? On the last day of business in 2016, there were 1.1 million job openings in the healthcare industry: the largest number recorded since the Bureau of Labor Statistics (BLS) started surveying the sector in 2006.The war for talent in the industry stems from several factors, including a fast-aging population that uses the healthcare system more frequently, the retirement of specialized medical professionals, and a growing demand for nurses outside the healthcare sector from businesses that offer highly competitive compensation and benefit packages. The Affordable Care Act—whatever its fate— and the recovery of the U.S. economy have also expanded public access to healthcare.

Doctors and nurses are not the only professionals in short supply. Hospitals are also struggling to attract non-clinical employees such as data scientists/analysts, lab technicians, respiratory therapists, technology imaging personnel, and pharmacists, given that there are greener pastures outside of hospital work. But clinical professionals such as specialized nurses are the toughest hires for many healthcare institutions.

In Florida, for instance, the nursing shortage has reached epic proportions. The Florida Center for Nursing tallied more than 12,400 vacant nursing positions across the state last year—up more than 30 percent from the number in 2013. “There’s been a mass exodus of nurses here leaving for other opportunities elsewhere,” says Mark Marsh, president of Orlando Health Central, which serves 1.8 million central Florida residents.

In Philadelphia, the general nursing shortage is not as acute, but the same pressures are at play to recruit other specialized nurses. “We’re experiencing significant challenges in our intensive care nursing line,” says Rob Croner, senior vice president of HR at Children’s Hospital of Philadelphia (CHOP), a pediatric healthcare facility and primary care provider. “These nurses need to have long experience and seasoning and are harder to find. It takes years to train a nurse just beginning their career.”

CHOP is also experiencing problems hiring physicians who are experts in sub-specialties such as neurology, and the facility endures an uphill climb recruiting non-clinical positions. “Like other institutions, we’re having issues recruiting data scientists to analyze and understand our outcomes-based patient data across multiple disciplines,” says Croner. “Finding quality control and process improvement professionals to enhance our operational efficiency is another recruitment challenge.”

Both healthcare institutions are improving the status quo through recruitment process outsourcing (RPO), transferring parts of their recruitment processes to external service providers specializing in the healthcare sector. CHOP retains Cielo Healthcare, and Orlando Health Central retains Cross Country Healthcare to target quality job candidates with compelling pitches, leverage technology and social media to create sustainable talent pools, and cost-effectively manage recruitment and onboarding workloads on a scalable basis, among other benefits.

“RPO alone is not the `great savior,’ given the broad dimensions of the problem. But having a dedicated person working alongside management to rapidly identify, source, and connect with high quality candidates fitting our culture has helped us be more successful acquiring needed talent in a quicker timeframe,” says Marsh. “A two-week window can make all the difference in recruiting skill sets that are in high demand. Wait three weeks and the talent goes elsewhere.”

Sustainable Recruiting

Boiled down, the critical talent shortage in the healthcare sector is a consequence of increasing demand colliding with decreasing supply. The senior population in the U. S. is predicted to double between 2017 and 2050, from 47.8 million people to 88 million. Many of these individuals are going to spend a portion of their golden years utilizing healthcare services or confined to hospitals for short-term stays. However the number of physicians and other clinical care professionals available to treat this growing volume of people cannot keep pace. For example, BLS projects 1.2 million vacancies for registered nurses through 2022.

The physician workforce is similarly expected to decrease by somewhere between 61,700 and 94,700 people through 2026, with significant shortages in many surgical specialties, according to a 2016 study by the Association of American Medical Colleges (AAMC). As healthcare utilization increases, the patient-doctor ratio will rapidly dwindle. “If currently underserved populations utilized healthcare at the same rate as the rest of the population, an additional 40,100 to 96,200 physicians would be needed (in 2026),” the study stated.

Toss in an expected 8.6 percent growth in the overall U. S. population, from 319 million to 346 million people by 2025 and the lopsided nature of the supply-demand equation becomes painfully evident and extremely concerning. “The physician shortage is real. It’s significant, and the nation must begin to train more doctors now if patients are going to be able to receive the care they need when they need it in the near future,” says AAMC President and CEO Darrell G. Kirch, MD.

The problem isn’t just a dwindling supply of medical professionals colliding with a growing cohort of people needing healthcare. Doctors and nurses can find jobs outside hospitals, often with better terms and conditions. “With the upswing in the economy, nurses can now choose from a variety of career paths that often lead away from providing direct patient care,” explains Buffy Stultz White, senior vice president, recruiting strategy and operations, at Cross Country Healthcare.

Better hours, salaries, and lower stress levels are compelling nurses who’ve previously chosen a hospital setting to careers in telehealth, insurance, and other alternatives, she adds. “With nurses comprising the largest group of healthcare professionals, a lack of qualified nursing staff can have a greater organizational impact than shortages in other fields.”

Another factor adding to the talent shortages is the upswing in the economy. “With the economy improving, more people can afford healthcare, which makes them more apt to go to the doctor,” says Dan White, president of Workforce Solutions, a division of RPO provider AMN Healthcare.

The consequence of the stark and growing imbalance in supply and demand has been intense competition for skill sets in the healthcare sector. “Talent is the key initiative for any healthcare organization, no matter where you are in the country,” says Marsh. “We’re all fighting for the same pools of highly skilled people. But good people always have options.”

RPO alone cannot solve the shortage in nurses, doctors, and non-clinical professionals that are essential in the healthcare industry. But it can help, says Jill Schwieters, president of Cielo Healthcare. “RPO offers healthcare facilities expertise and access to great recruiters, great recruitment processes, and great technology,” she asserts.

Schwieters has personal experience coping with the sector’s talent recruitment challenges—she’s the former regional vice president of human resources at Wheaton Franciscan Healthcare: an integrated healthcare delivery system with nearly 25,000 employees in four states. “Too many hospitals look for a quick fix to a problem that requires a sustained response,” she says. “Instead of throwing money away on external search agencies, RPO is a cost-effective and highly sustainable recruiting strategy, presenting the means to find, attract, and hold onto great talent.”

Cross Country’s Stultz White shares this opinion, noting that RPO providers are specialists in targeted marketing campaigns that find qualified skill sets eager to work for a particular healthcare facility. “RPO solutions increase candidate flow for hospital vacancies, support the employment brand of the healthcare facility, and widen the talent net to fill even the most challenging positions,” she says. “We have experts solely dedicated to the recruitment of clinical professionals.”

These experts rely on research and analytics to develop leads to particular skill sets, which are then nurtured through ongoing communications with this talent pool. “Most often, the first benefit realized through a healthcare-focused RPO provider is [the client’s] speed to access qualified talent pools,” Stultz White says.

AMN’s White distilled the value of RPO as enhanced recruitment marketing. “Recruiting is essentially sales—you’re looking to `sell’ someone to join your organization,” he explained. “You can’t just post a job opening and expect people to be drawn to it. You have to go out and proactively find the right people and then carefully draw them in, selling them on your value proposition. That requires a set of marketing skills that normally does not exist in the typical healthcare setting.”

Casting a Wider Net

Both CHOP and Orlando Health Central have found value in leveraging RPO. Marsh is a longtime proponent, having utilized RPO in the three previous healthcare facilities he led as CEO (Tennessee’s Gateway Medical Center and Marshall Medical Center and Greenview Regional Hospital in Kentucky), prior to helming Orlando Health Central.

“We want to be sure we always recruit the best people by offering a ‘best-place-to-work’ environment, but to retain them you have to constantly make good on that pledge,” says Marsh. “If we don’t create and cultivate the right culture, we’re at risk of them heading out the door.”

Croner at CHOP has relied on RPO the past five years to address the healthcare facility’s skill set shortages. “The reason is pretty simple, really—you’re engaging a firm whose specialty is recruitment in your industry,” he says. “The people Cielo hires are, by design and choice, healthcare recruiters—individuals well-versed in the sector’s talent problems and needs.”

This expertise assists RPO recruiters in identifying and tracking passive job candidates—skilled people who are currently employed and not looking for a job, but may be open to the right opportunity in future. “We’ve had several success stories where Cielo leveraged social media and our mission branding to reach out to people we were otherwise not getting,” Croner says.

AMN has achieved similar success for its clients. White cited the example of a healthcare facility in Springfield, Illinois, that had difficulty attracting skilled people to the region. In this case, the institution was looking to fill a position for a clinical care nurse. “We used very sophisticated sourcing tools to figure out how to find the right person with the right pitch,” he says.

Ultimately, AMN’s recruiters learned on Facebook that a highly skilled clinical care nurse had family in Springfield. “Upon further digging, we realized she actually came from the area,” he says. “The pitch we made to her was to `Come back home to join the ranks of the best healthcare system in the area,’ which was true. She hired on.”

An additional benefit of RPO is the scalability of the process. “We do about 2,500 hires per year, but the number can go up or down significantly,” says Croner. “When it does, we’re paying a rate [to the provider] that is hinged with this up-and-down movement.”

Providers also offer a way for hospital staff to focus on their strategic mission: the care of patients. “Cielo takes care of things like background checking, compliance, prescreening, and onboarding, allowing us to make better use of our internal resources,” says Croner. “This liberates us to deliver a quality employment experience improving our talent retention.”

Tougher Road Ahead

The supply-demand imbalance for both clinical and non-clinical skill sets in the healthcare sector is likely to worsen in the years ahead, intensifying the competition among hospitals for the best of the best. RPO is just one tool that healthcare facilities can use to improve their odds of attracting the candidates they need and want. Other tools include a strong brand, competitive salaries and benefits, and meaningful and satisfying job experiences.

Russ Banham is a veteran financial journalist and author of more than two-dozen books.

 

Posted April 4, 2017 in Healthcare Workforce

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