Economic Evolution in Healthcare

Running head: ESSAY 1
Economic Evolution in Healthcare
Name of the Student
Name of the University
Author Note

ESSAY 2
Introduction
It is imperative to provide training to healthcare professionals and design a clinical
workforce that will be able to effectively execute healthcare services to a wider range of
audience. The healthcare industry is segmented with a plethora of quality benchmarks that are
dispersed in the metropolitan and remote or private and public healthcare units. Trained
healthcare workers act as an association between the health facilities and the patients, thereby
emphasizing on the dependence of the prospect of healthcare system on the training and
expertise of the specialists (Hagimoto, Nakamura, Masui, Bai & Oshima, 2018). Presence of
trained workers also suggests that they have the necessary knowledge and expertise to meet
the growing demands of the patients, and that they will be able to foster a medical
administration that will caters to the patient’s evolving needs. This essay will elucidate the
impacts of shortage of trained workers and will also propose strategies for addressing the
shortage.
Shortage of workers
According to HRSA Health Workforce (2016) while the national workforce will
comprise of around 239,460 FTE primary care physicians in the year 2025, there will be a
demand of roughly 263,100 FTEs, thus signifying the shortage. However, the increase in
Primary Care Physician Assistant (PA) and Primary Care Nurse Practitioner (NP) is expected
to exceed the demand for the following professionals by 2025 (58,770 FTE vs. 39,060 FTEs
and 110,540 FTE vs. 42,500 FTE, respectively). The same has been affirmed by Chiaravalloti
(2018) who stated that the USA could have a shortage of approximately 120,000 physicians
by the year 2030. As per the reports, there will arise a need of 33,800-72,700 physicians and
13,800 primary care physicians in near future. Some of the most common healthcare facilities
that are expected to demonstrate shortage of skilled workers are namely, family medicine,
internal medicine, hospitalist, psychiatry, and nurse practitioner. It has been estimated that

ESSAY 3
across the USA, the mean physician to patient ratio is around 271.6 per 100,000 individuals.
Some of the leading states that have poor ratio of the same are Mississippi, Idaho, Wyoming,
and Arkansas.
In the words of Naylor et al. (2019) there exists unequal distribution of the healthcare
workforce across the United States. While there are certain regions that struggle to deliver
elementary healthcare amenities to the residents, other regions have a profusion of healthcare
personnel. Such geographic disparity in the healthcare labor force is not exclusive to the
USA, and it has been observed that concentration of healthcare workers is typically high
within affluent and/or urban regions, in contrast to a comparative undersupply in low-income
or rural areas. Furthermore, according to the Association of American Medical Colleges the
population of the nation is expected to increase by as much as 10% by the year 2031, with a
48% increase amongst people aged more than 65 years. Moreover, the aging population will
create an impact on the supply of physician, considering that one-third of the doctors who are
currently active will be older adults in the following decade (Heiser, 2019).
Potential effects
The absence of sufficient human resources in the domain of health and social care
creates significant negative effect on different aspects of public health and wellbeing. Not
only does this shortage of trained medical workers bring about an increase in mortality, but
also creates a substantial influence on the quality of care delivered to the patients (Griffiths et
al., 2019). The increase in mortality rate can be accredited to the fact that if the shortage of
trained clinical workers persists for a continued duration, it would become unfavorable to the
patients. All patients who seek healthcare assistance will become subjected to extended wait
times at the healthcare facilities. This in turn will increase the complexity that patients will
have to face in order to get admitted. According to Ahmad, Khairatul and Farnaza (2017)
waiting time generally refers to the time that all patients and their family members have to

ESSAY 4
wait at different clinics, prior to being checked by a medical personnel. However, long
waiting time due to staff shortage will result in worsening of the health condition of the
patients, thereby possibly compounding the difficulty of care and increasing the associated
healthcare costs.
Moreover, the doctors and physicians will not be able to sufficiently treat the patients,
while addressing their exclusive physical and emotional needs owing to extended work shifts
and patient burden. When there occurs a shortage in healthcare workforce, there workload
augments for those staff who remain at the job. An increase in workload negatively
influences the time that trained healthcare workforce can allot to patient care (Orique, Patty
& Woods, 2016). This in turn will prevent physicians and nursing professionals to spend
adequate time while collaborating with one another and delivering tailored interventions, thus
affecting patient safety by increasing the rates of avoidable patient deaths while waiting for
treatment. Patient quality and safety also gets threatened due to staff shortage since workload
results in absenteeism, low morale, poor job performance and turnover. Little or no
enthusiasm amid the staff to care for the patients and poor commitment to enhanced levels of
performance makes the healthcare staff feel frustrated, thereby significantly contributing to
the onset of negative perception towards the task of delivering care services. Inadequate
healthcare workforce has also been associated to errors that are generally categorized into
two groups namely, (i) knowledge or mistake errors and (ii) execution error or lapses
(Gholipour et al., 2016).
When there occurs a shortage of trained physician in a remote or rural area, the
affected patients are generally not able to access the services that they require. The patients
have difficulty while seeking help from a physician or while making appointment with the
workers. This in turn results in aggravation of untreated physical ailments, which might often
be accompanied by mental health conditions as well. Shortage of trained medical personnel

ESSAY 5
also results in an increase in price for the practicing physicians and nurses, which can be
accredited to less competition, in relation to the norms of supply and demand in the
healthcare economy. Workforce shortage in the USA has also been associated with the
condition ‘Maternity desert’, a quiet crisis that has affected millions of women. Staff shortage
had caused a closure of different maternity wards and hospitals on a worldwide basis (Jones,
Lattof & Coast, 2017). The increase in pregnancy-associated complications across the USA
requires specialized treatment for most women and dearth of midwives and local physicians
in remote regions force the pregnant females to delay or skip prenatal care, thereby causing
premature birth or death. According to Marchofdimes.org (2018) maternity care deserts
report increased rates of poverty and decreased median household earnings, in contrast to
regions that have access to maternity care. Moreover, an estimated 1.1 million females reside
in maternity desert in urban or large metropolitan settings, where one out of eight females do
not have proper health insurance.
Proposed actions
With the aim of addressing the shortage of trained healthcare workforce across the
USA, three fundamental steps need to be adopted that are namely, (i) recruiting workers at
rural and remote healthcare organizations, (ii) avoiding retention and recruitment perils, and
(iii) developing a gender-balanced and sustainable workforce. It has often been found that
healthcare workers value practicing medicine, lacking unwarranted influence from the
managers and administrators. Therefore, recruiting them at rural service centers will help
their voices get heard, particularly when associated to the concerns that affect their practice
of medicine, thereby protecting their autonomy (Riis, Jensen, Maindal, Bro & Jensen, 2016).
Presence of a family-friendly work environment increases commitment of the workers
towards the organization. Therefore, efforts need to be taken to foster collaborative decision-
making and teamwork. There occur a range of pitfalls while retaining and recruiting clinical

ESSAY 6
members. While monetary incentives might appear promising, they do not always help in
retention (Nguyen, 2019). Therefore, focusing on loan forgiveness and signing bonuses might
prove beneficial in increasing workforce. Creating opportunities for personal and professional
development and promoting an essential culture change by decreasing shift hours and length
of workweek will also instil a sense of obligation amid nurses, and improve staff number.
According to the World Health Organization (2019) there exists significant disparity
and gender imbalance in medical education and health employment and 70% nursing staff are
female, when compared to 30% physicians. This calls for the need of taking pro-active step to
ensure identical pay for healthcare delivery of equal value, regardless of gender, while
targeting major investments towards educating the female workforce (Penfold, Knight, Al-
Hadithy, Magee & McLachlan, 2019). Improved mapping of healthcare resources will also
foster exchange programs and collaboration, thereby enhancing the workforce.
Conclusion
To conclude, currently all nations, particularly the USA are facing a shortage of
trained healthcare workers owing to international migration, poor incentives, and restricted
numbers of medical schools. Furthermore, inefficiencies that have been incorporated in the
healthcare system, repeatedly driven by government enterprises, have decreased the number
of healthcare staff, whom the patients can see, thus decreasing the time they spent on direct
patient care. Not only does this shortage deteriorate the quality of care delivered to patients,
but also compromises patient safety and increase mortality rate. Therefore, efforts must be
taken to address this shortage of healthcare workers in order to increase life expectancy of all
patients, regardless of their geographical distribution. Increasing recruitment, creating a
positive workplace environment, financial incentives, and maintaining gender balance will
largely help to alleviate the shortfall.

ESSAY 7
References
Ahmad, B. A., Khairatul, K., & Farnaza, A. (2017). An assessment of patient waiting and
consultation time in a primary healthcare clinic. Malaysian family physician: the
official journal of the Academy of Family Physicians of Malaysia, 12(1), 14.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420318/pdf/MFP-
12-14.pdf
Chiaravalloti, D. (2018). Physician Shortages: Where They Are & The Most Needed
Specialties. Retrieved from https://www.boardvitals.com/blog/physician-shortages/
Gholipour, K. H., Mashallahi, A., Amiri, S., Moradi, Y., Moghaddam, A. S., & Hoorijani, F.
(2016). Prevalence and cause of common medication administration errors in
nursing. Journal of Chemical and Pharmaceutical Sciences, 2016, 18-21. Retrieved
from https://www2.scopus.com/inward/record.uri?eid=2-s2.0-
85050091027&partnerID=40&md5=0a72a2b3ffb97b32f90979d7a6f19c30
Griffiths, P., Maruotti, A., Saucedo, A. R., Redfern, O. C., Ball, J. E., Briggs, J., ... & Smith,
G. B. (2019). Nurse staffing, nursing assistants and hospital mortality: retrospective
longitudinal cohort study. BMJ quality & safety, 28(8), 609-617.
http://dx.doi.org/10.1136/bmjqs-2018-008043
Hagimoto, A., Nakamura, M., Masui, S., Bai, Y., & Oshima, A. (2018). Effects of trained
health professionals’ behavioral counseling skills on smoking cessation
outcomes. Annals of Behavioral Medicine, 52(9), 752-761.
https://doi.org/10.1093/abm/kax049
Heiser, S. (2019). New Findings Confirm Predictions on Physician Shortage. Retrieved from
https://www.aamc.org/news-insights/press-releases/new-findings-confirm-
predictions-physician-shortage

ESSAY 8
HRSA Health Workforce. (2016). State-Level Projections of Supply and Demand for
Primary Care Practitioners: 2013-2025. Retrieved from
https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/
projections/primary-care-state-projections2013-2025.pdf
Jones, E., Lattof, S. R., & Coast, E. (2017). Interventions to provide culturally-appropriate
maternity care services: factors affecting implementation. BMC pregnancy and
childbirth, 17(1), 267. https://doi.org/10.1186/s12884-017-1449-7
Marchofdimes.org. (2018). Nowhere to go: Maternity care deserts across the U.S. Retrieved
from https://www.marchofdimes.org/materials/Nowhere_to_Go_Final.pdf
Naylor, K. B., Tootoo, J., Yakusheva, O., Shipman, S. A., Bynum, J. P., & Davis, M. A.
(2019). Geographic variation in spatial accessibility of US healthcare providers. PloS
one, 14(4). https://doi.org/10.1371/journal.pone.0215016
Nguyen, H. (2019). The Influence of Job Motivation on Nurse Retention: A Study of
Vietnamese Private Hospital. Retrieved from
https://digscholarship.unco.edu/cgi/viewcontent.cgi?article=1181&context=theses
Orique, S. B., Patty, C. M., & Woods, E. (2016). Missed nursing care and unit-level nurse
workload in the acute and post-acute settings. Journal of nursing care quality, 31(1),
84-89. doi: 10.1097/NCQ.0000000000000140
Penfold, R., Knight, K., Al-Hadithy, N., Magee, L., & McLachlan, G. (2019). Women
speakers in healthcare: speaking up for balanced gender representation. Future
healthcare journal, 6(3), 167. doi: 10.7861/fhj.2019-0027
Riis, A., Jensen, C. E., Maindal, H. T., Bro, F., & Jensen, M. B. (2016). Recruitment of
general practices: Is a standardised approach helpful in the involvement of healthcare

ESSAY 9
professionals in research?. SAGE open medicine, 4, 2050312116662802.
https://doi.org/10.1177%2F2050312116662802
World Health Organization. (2019). Why the workforce is important. Retrieved from
https://www.who.int/whr/2006/overview/en/