It sounds a ridiculous statement: how could hospitals be hiring too many nurses, physicians, and other medical staff? It could be ridiculous, then again, it may not be. The number of people hospitals have been hiring lately is under debate. Some say that it is a sign that the healthcare industry is growing in response to the passage of the Affordable Care Act. Others wonder if the industry is expanding faster than it needs to be and is hiring too many people at lower salaries. There may be larger staffs, but are they as productive? Are they as medically trained and experienced as they need to be?
A Lack of Efficiency
Some experts fall on the lack of efficiency side of the debate. Dr. Robert Kocher is one of these. He believes that the increase in the number of healthcare jobs is due to the fact that there is horrible organization in hospitals. A lack of clear-cut duties for advanced nurse practitioners, for example, means that they are under-utilized in many cases. The reliance on physician assistants to fill the gap for actual primary care givers may also lead to a decrease in efficiency even though the hospital may be seeing more patients every day.
Supply Growing, Demand Decreasing
Kocher works with Venrock, an investment firm that analyzed the medical industry to arrive at this conclusion. He and his team looked at federal labor data from 1990 to 2012. During that time, the healthcare industry grew by an amazing 75 percent. More than 90 percent of these new jobs were support staff, nurses, PAs, and other non-physicians. However, the number of patient intake actually dropped. From 2002 to 2012, patient intake dropped by 12 percent, while hospitals increased their medical personnel by 11 percent.
To Kocher, this increase in supply without a corresponding increase in demand indicates a lack of efficiency somewhere in the system. Why, he wonders, would there need to be almost 120,000 new healthcare employees in early 2013 if there was only a small increase in the number of patients being seen? Many would argue that this was because hospitals were already gearing up for the increase in the number of patients that the Affordable Care Act would bring, but Kocher does not believe so.
In fact, it is easier to see that buildup occurring in 2014. In October of 2014, almost 25,000 new jobs were added to the healthcare industry. This was above the monthly average of the past 12 months – an average of 21,000 healthcare jobs had been created each month since the end of 2013 and the first three quarters of 2014. Since the ACA went into law, Forbes pointed out that over 1 million new healthcare jobs had been created.
An Increase in Low Paying Jobs
Many of these jobs paid less than $20,000 a year, and even those that were over that amount were typically lower paying jobs. These positions often do not require as much education or training, which means it takes the appointed staff longer to perform basic tasks or, indeed, are unable to perform specific duties. Hospitals may have larger staffs, but this staff is not made up of the right people for the right jobs. There is a lack of qualified nurses, physician assistants, and primary care physicians. Without these key individuals, it may not matter how many people the hospital hires—they are still going to be inefficient.