COVID-19 has altered the way Americans think about work, underpinning what many call “The Great Resignation.” The Bureau of Labor Statistics announced that 4.3 million Americans quit their jobs in August. That’s 2.9% of the entire US workforce, a record-breaking figure—and the healthcare industry is no exception to this trend.
According to a report published by NPR, decades of stagnant pay are partially to blame. But the impacts of the pandemic—including child care demands, business closures, and fear of the virus itself—also contribute. Some speculate that the pandemic is also having a more nebulous effect, which one psychologist is calling “pandemic epiphanies.” In short: The disruption to normal life has changed the way we view work’s role in our lives.
The findings of a survey published this month by Morning Consult illustrate how this affects healthcare workers. Researchers found that 30% of care providers have left the field during the pandemic (18% quit, while another 12% were laid off). Of those who have kept their jobs, 31% are considering quitting. Most notably, 79% of healthcare professionals said that the national shortage of employees has affected them, stretching them to their limits with more patients to handle and fewer colleagues to offer support.
Insufficient pay or opportunities, burnout rates, and pandemic-related safety concerns are all driving the healthcare exodus, the survey found. Many survey respondents said their workload has increased, resulting in rushed or lower-quality care for patients. Almost one in five respondents reported disapproval over how their employers had handled the pandemic, citing “poor communication around changing safety protocols, inadequate personal protective equipment, low pay and a general sense of being disposable.”
While the pandemic has exacerbated the rate of resignations, staff shortages were already an issue prior to COVID-19. Here are four reasons why doctors are quitting, according to recent research and testimony from professionals.
1) Too much time in the EHR
A study published in Mayo Clinic Proceedings analyzed survey results from 6,560 physicians in active clinical practice between August-October 2014. Results suggested that the increased use of electronic health records was leading to lower physician satisfaction and higher rates of professional burnout. One Mayo Clinic physician said that the unintended consequences of EHR included reduced efficiency, increased clerical burden, and increased risk of burnout for physicians.
“Burnout has been shown to erode quality of care, increase risk of medical errors, and lead physicians to reduce clinical work hours, suggesting that the net effect of these electronic tools on quality of care for the US healthcare system is less clear,” the physician wrote.
However, research measuring the impact of EHRs on care have garnered mixed results. A study published in JAMA this month examined a cohort of 314 physicians to assess the association between EHR use and physician turnover. Past research indicated that increased use of EHRs is linked to lower physician satisfaction, higher rates of burnout, and a desire to reduce clinical work, but authors of this study came to a different conclusion: Less time spent on EHRs was linked to a higher rate of physician turnover. While researchers hypothesized that reduced EHR use may simply be a sign that a physician is already preparing to leave practice, they concluded that more research is needed to understand the association.
Click here to read about improving efficiency with EHRs, on MDLinx. Also, check out this article on our PhysicianSense blog: The surprising way to actually address physician burnout.
2) Gender and specialty pay gaps
Far less ambiguous drivers of The Great Resignation in healthcare are the gender pay gap and the specialty pay gap. According to Medscape’s Female Physician Compensation Report 2021, male physicians earn 35% more than female physicians overall; male specialists earn 33% more than females, and among primary care physicians, males earn 27% more than women.
Compounding this is the fact that specialty fields also tend to have a gender imbalance. According to an article published by Modern Healthcare in May, 82% of nursing assistants and 90% of home health aides are women. Care workers in these roles earn an average wage of $14.82 an hour and $13.02 an hour respectively. In comparison, surgeons (nearly 75% of whom are men) earn an average of $250,000 a year, which is more than $100 per hour.
The speciality pay gap has prompted some institutions to take action. For example, in 2018, New York University announced it would begin offering free tuition to its medical school students with the aim of encouraging more graduates to choose lower-paying specialties.
3) Lucrative opportunities outside of the hospital
The findings of the Morning Consult survey illustrate the general desire among healthcare professionals for better pay or more growth opportunities. Of those who left their jobs during the pandemic, 50% said they wanted higher wages or that they’d found a better opportunity elsewhere.
As noted by the researchers for the Morning Consult survey, more nurses are turning to “traveling nurse” positions. The reason for this is simple: Hospitals aren’t offering raises, but traveling nurses are paid extra to fill staffing gaps. An influx of federal emergency funding to help hospitals and clinics during the pandemics is a big part of why this is possible. According to a report by WUNC radio, traveling nurses can earn up to $10,000 per week. One nurse recruiting company based in San Francisco estimated that the number of full-time nurse openings has shot up by 200% in the last year.
Read more about how the pandemic affected doctor pay on MDLinx.
4) Abuse from patients and the public
According to an article published in JAMA in April of this year, attacks on physicians from patients and members of the public have increased during the pandemic.
The rate of violence-related healthcare worker injuries increased by 67% from 2011 to 2018. Based on data from that year, healthcare and social workers were five times more likely to experience workplace violence than other workers. This has intensified during the pandemic, with roughly three in 10 nurses reporting an increase in violence in the workplace, due to factors like staff shortages and visitor restrictions. (Read more about attacks on physicians here).
A New York Times report based on interviews with 140 local health officials and information provided by almost 300 health departments found that “public health agencies have seen a staggering exodus of personnel, many exhausted and demoralized, in part because of abuse and threats.”
In related coverage, check out How old is too old to practice? on MDLinx.