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U.S. hospitals to face massive staffing shortages: RPT

As COVID-19 cases continue to surge across the U.S., the country is projected to face a staffing shortage in the healthcare industry in the next 30 days. Yahoo Finance’s Brian Sozzi, Myles Udland, and Julie Hyman discuss with Dr. Patricia Pittman of Fitzhugh Mullan Professor of Health Workforce Equity.

Video Transcript

JULIE HYMAN: Well, let's get to what has been going on with coronavirus cases rising-- continuing to rise-- although at a slower rate to some extent than we've seen in recent weeks. Hospitalizations, though, do continue to rise as well. And we have seen a lot of concern about staff shortages-- for people who are caring for those with coronavirus as well as just hospital staffing generally.

We're joined now by Dr. Patricia Pittman. She's George Washington University director of the Mullan Institute for Health Workforce Equity. Thank you so much, Dr. Pittman, for being here. And this is something that you all have researched and focused on, the staffing flows that we have seen over the course of the pandemic. Talk to me about your findings and what is most notable or remarkable to you.

PATRICIA PITTMAN: Well, I mean, I think the first point is precisely the one that you made-- and thanks for giving me the opportunity to talk about this-- which is that the issue of expanding beds is only one part of the problem we're facing. If we don't have staff to provide services at those bedside sites, it's really not that helpful to have additional beds. So for example, in my home state of Maryland, there are a number of areas where they're planning to expand [INAUDIBLE] emergency sites with additional beds. But the problem is we don't have the staff to be able to accompany that initiative, so they can't open them.

So what we've done at GW is create a tool that allows you to look across different specialists by state to see where we're likely to have the most shortages in the coming month. So we're looking at the projections of hospitalization in relation to the supply in that state. And the news is not good.

Basically we see that in 43 states we have shortages already of at least one specialist. And in the remaining seven states, we actually have insufficient number of staff for non-COVID patients. So the issue of staffing for COVID patients but also we continue to have to provide services to patients that have other kinds of needs. So the situation is very serious at this time.

MYLES UDLAND: Dr. Pittman, throughout the pandemic we have heard stories of doctor-- you know, staff burnout. And then, of course you're going to have a lot of doctors and nurse practitioners and so on getting sick as well. Is this factoring in those dynamics, or is this just a raw "we don't have the bodies even if everyone shows up all the time and feels great"?

PATRICIA PITTMAN: So the tool we've created actually allows you to put in what we call the attrition rate. And we are estimating that there's about a 7% attrition rate across states, but it really varies tremendously, even within states. And so what we've done is preset it at 0 attrition, as if nobody ever not only gets sick but might not show up for work because they're fearful or because they have to take care of their kids because their kids aren't in school or they have aging parents, or whatever the reason may be. There are a lot of people that are not coming to work, or because, as you said, of burnout.

So even when you sort of preset this tool at zero attrition-- in other words, assuming that everybody came to work-- we're seeing these massive shortages in 43 states. So when you increase the attrition to the levels that we think are actually there and the user of this tool can actually plug in their own attrition rates, it looks even worse. And there's no question that this issue of burnout and fear and also just the requirements of being a-- staying at home-- a mom and needing to stay at home for your kids is really taking a toll on the workforce, particularly for nurses, which is a predominantly female profession, of course.

So even though we may have in some states for nurses what appear to be adequate supply, if you look at the maldistribution within the state and if you look at the issue of attrition, you're likely experiencing even worse shortages.

BRIAN SOZZI: Doctor, how should hospitals go about addressing these massive shortages?

PATRICIA PITTMAN: So hospitals are sort of one level of solutions. It's important to remember that the state government and the federal government can do things too. But speaking to the question specifically of what hospitals can do and are doing, essentially they're flexing their staff. They're thinking about the other inpatient staff that are not in ICUs, that are in acute care units, and sort of repurposing, if you will, those doctors and nurses and support staff for ICU beds.

The problem is that when you take people off of those acute beds, you're leaving them unstaffed. So currently we are continuing to allow what's called elective surgeries, for example, in ORs and other departments. And if you take that staff off of those other departments, you basically-- it basically means you can't continue to care for patients who don't have COVID. So it's not an ideal solution but it's certainly one that has to be used when you're facing shortages. So we're seeing in particular the most severe shortages in the ICU, as opposed to just the acute beds.

JULIE HYMAN: I think the effect of all of this is clear in terms of patient care, in terms of the effect on workers, as Myles alluded to. What about the economics of the hospital, right? We know that hospitals are already stretched because they are not able to do as many of those more profitable elective surgeries, for example, that fund hospital operations. So what then happens when you have worker shortages on top of that issue?

PATRICIA PITTMAN: Well, there are a couple of economic considerations. One is, as we said, this question of elective surgeries, which initially in-- and during the pandemic, the federal government had asked hospitals to suspend elective surgery. So there was obviously a huge economic impact there. Currently they are allowed to proceed with them if they have the staff. So if they don't have the staff, they're obviously having to scale back those services.

The other economic factor, though, is that particularly in the case of nurses, we have this phenomenon of what's called per diem staffing agencies that provide nurses to the highest bidder, if you will. And in the early phases of the pandemic, they were really essential in terms of moving particularly nurses across states and taking them to where they were the most needed. At this point, however, because we have sort of the high hospitalization rates in all states, the problem is everyone wants those staffing agencies and so it's a bidding war.

And you may have read in the press today that there are nurses that are basically earning up to $11,000 a week to move around the country with these staffing agencies. The problem is, for those hospitals that are least advantaged economically, particularly rural critical access hospitals, that's essentially unaffordable. They've basically quadrupled the pricing for hospitals of using these travel agencies. So that's sort of an additional level of economic pressure on hospitals as they seek solutions to these staffing crises.

JULIE HYMAN: Wow, that is really fascinating and dismaying for those folks in those rural areas. Doctor, thank you so much for your time and for walking us through these issues. Dr. Patricia Pittman is George Washington University director of the Mullan Institute for Health Workforce Equity. We appreciate your time.

PATRICIA PITTMAN: Thanks so much for having me.