The healthcare labor market is facing a crisis like never before. Workers, who were already experiencing burnout before the pandemic, are leaving in droves. In July, more than 500,000 healthcare workers quit their jobs, with job openings reaching 1.8 million—both all-time highs, according to the U.S. Bureau of Labor Statistics.
The pandemic only exacerbated pre-existing challenges. In 2018, The Physicians Foundation found that 78% of physicians were experiencing burnout, with 80% saying they were operating at full capacity or were overextended. The dour healthcare labor outlook matches a sentiment spreading throughout the country: Workers across all sectors are leaving their jobs in a movement that’s been dubbed “the Great Resignation.” “This has been trying for the healthcare population,” says Anne Robinson, Executive Vice President, Provider Growth and Talent Acquisition, VillageMD, Chicago. “They’ve seen a lot. They’ve been through a lot. It’s been a scary time.”
This new workforce dynamic is requiring healthcare companies to scramble and remake how they value and treat workers. That’s especially true for pockets in the South and Southwest, which were hit hardest by COVID-19 and faced the greatest job losses. Robinson’s organization has felt the pinch of allied healthcare workers, with a particular need for medical assistants. “From our organization’s perspective, this is going to be an ongoing demand, and I do think competition will continue,” Robinson says. “The good news for the profession is that organizations are going to have to find new and unique ways to show that they are investing in this population and investing in them in the long-term.”
There’s no magic bullet for fixing healthcare’s labor issues, Robinson says. But greater compensation is one of the more immediate fixes. At Kaiser Permanente, for instance, more than 30,000 workers authorized a strike in October, largely to demand better pay. That’s a sentiment that resonates with a lot of workers right now: Of the 37% of the labor force who are considering leaving their job in the next six months, 74% say they’re doing so to earn more, according to a July 2021 survey by The Hartford. The next-highest reason for leaving is for career growth or promotion, at only 44%.
“Medical assistants are being asked to do more than ever, at least in our clinic setting, so we have to ensure there’s a competitive living wage—especially when we place so much trust in their ability to take care of patients,” Robinson says.
Many organizations have also looked to expand benefits, especially mental health resources. “In early March 2020, at the onset of the pandemic, we evaluated our employee assistance plan and decided that it would not suffice,” Robinson says. “We deepened our relationship with our vendor and offered a much more substantial benefit around in-person and online counseling.”
Solving labor shortages and burnout also requires organizations to create an environment where people feel valued and have opportunities to grow. When you have a population that’s as critical to an organization’s success as allied healthcare workers, Robinson says, you need to actively invest in them all the time: “How do you keep and grow these resources who are critical to your front-line interactions, versus reacting with compensation or another strategy when you’re faced with a shortage?”
Ultimately, the labor issue comes down to the pandemic ending and peoples’ individual choices and circumstances. Three AMT members confronted the decision that many healthcare workers are considering every day: Do you stay, pivot careers—or leave healthcare altogether?
Tasha Ezell, MLT (AMT), Medical Laboratory Technician, Jackson Medical Hospital, Grove Hill, Alabama, always found her job rewarding. As a phlebotomist and lab tech for more than two decades, she knows she made a difference in people’s lives. “How do you know if you have cholesterol problems if you’re not looking at your lab?” she says. “How do you know you’re dealing with diabetes if you’re not looking at your lab? Everything boils down to your labs, and I love that.”
Like many other healthcare workers, Ezell experienced a shift in her outlook during the pandemic. Before COVID-19 hit, Ezell would work three 12-hour shifts a week. But because her clinic has been shortstaffed, she’s now regularly working four 12-hour shifts a week. That already increased workload can intensify if, say, someone takes off work for a sick day or to look after their kids: “Because we’re shorthanded, I feel a moral obligation to go in and help out.”
Her hospital network, which has outposts throughout the state, is short on technicians. What’s particularly frustrating, she feels, is that the lab community hasn’t gotten the same sort of elevated praise—and compensation—as other front-line healthcare workers during this time. “They’re not pushing laboratory personnel, they’re pushing nurses,” Ezell says. “We’re not getting the help that I feel we need. Our government has created this program to pay traveling nurses, but it leaves the lab out. We swab. We draw blood. We give you your results just as nurses treat patients. Why is it more important to pay nurses than lab techs? Everybody seems to realize nurses are getting burnt out, but nobody seems to realize that we’re getting burnt out as well.” After all, Ezell says, she—and other less-mainstream healthcare workers—have to interact closely with patients and don protective gear just like doctors and nurses: “We put our lives in just as much danger.”
Her breaking point came in November 2020. Her dad died from COVID-19 complications. He had no underlying health issues, Ezell says—no diabetes, no high blood pressure. His death served as a reminder of what could happen with this virus. “I’m just tired,” Ezell says. “I’m burnt out and need a break. If I can help it on my days off, I don’t leave my house.”
Her dad’s passing, in combination with the grueling hours and low pay, spurred her to look for a new career path. “My dad always said, ‘Only you can change your situation, and the only reason you say you can’t is because you don’t want to,’” Ezell says. “I felt like everything that happened was a positive sign for me to go, go, go.”
At the time of publication, Ezell was about to complete her Master of Business Administration degree. If her working conditions were different—if the pay was higher, if the hours were better, if the recognition was greater—she might have stuck around in healthcare.
A Safe Distance
When COVID-19 hit, Calvin Moses Jr., RMA (AMT), MSMgt, was on the front lines. He was playing a dual role as an HIV case manager and a registered medical assistant. “When the pandemic started, everything went from zero to 100.” He tried to take everything one day at a time. The news, the confusion of what the virus was and how it spread, wearing PPE—everything was moving so fast, everything was heightened. “I had to come to terms that some of my patients will make it, and some of my patients won’t make it.”
Somewhere in these stressful months, his views shifted. “I still love healthcare. I still love what I do. But the pandemic took a toll on me.” In December 2020, Moses moved away from a patient-facing role and found a job as a Hospice Clinical Support Coordinator at Interim HealthCare Inc. in Greenville, South Carolina. It’s new work for him: reviewing records, starting intakes—all back-office work to make sure every patient’s medical chart is reviewed and ready for all clinicians. Most importantly for Moses, his new work environment is a safe distance away from patients.
“I made the decision for myself before I got burnt out and didn’t like healthcare anymore,” Moses says. “I see a lot of people like myself who have been in healthcare for a very long time going out of patient facing roles.”
Moses hasn’t regretted the move. “I’m happy with the decision I made because it allows me to better serve people.” If you’re burnt out, he says, it can lead to situations where you’re not fully engaged—going through the motions, rushing to get work done, just generally not giving your best effort. Now, he says, “I’m able to focus on what the patient really needs.”
Of course, not all workers have left their jobs. In fact, as hard as it’s been, 76% of all front-line healthcare workers feel hopeful about going to work, according to a Washington Post and Kaiser Permanente survey.
Helen Thomas, RMA (AMT), a Registered Medical Assistant at a gynecology office with Bon Secours Mercy Health in Cincinnati, has never felt more impassioned to do her job: “The pandemic has actually provoked me to strive to get even more involved in healthcare.”
In part, that’s because Thomas feels called to this field and to help people. That’s been true since she was young, with Thomas holding a range of medical jobs, everything from working as a dietary aide to being a state-tested nursing assistant in a nursing home. It helps that her job didn’t change much during the pandemic. Her hours never ballooned or cratered. While the hospital network where she works experienced furloughs and layoffs, the core team at her gynecology office remained mostly unchanged. Naturally, the last couple years haven’t been easy. “There were times I felt like I needed a break. Later in 2020, I really started to feel like I could use a vacation. I had to figure out a way to put self-care on the forefront. As a healthcare worker, we can get consumed with taking care of other people and forget to do those things for ourselves.”
In those moments, Thomas found herself wondering: “Why am I doing this? Of course, we all need a paycheck, otherwise we’d just be chilling at home. But we must have a why to do what we are doing in life.” Seeing patients reminds Thomas of her “why”: the conversations, the things that patients share, the touching words they say about Thomas—like that she made them less nervous about the appointment. “It’s why I press through my own feelings of defeat or my moments where I’m tired.”