A spike in health care demand prompted by the “graying” of America – coupled with an exit of many burned out nurses and doctors, and a baby-boomer retirement wave – is spurring a health care professional shortage that will affect practitioners, the health care system and patients, according to published reports. Nurses account for a big chunk of the gap, with some 203,000 openings for registered nurses projected each year for the next decade, according to the U.S. Bureau of Labor Statistics, but the nation also faces a projected shortage of up to 124,000 physicians within 12 years, according to a report released by the Association of American Medical Colleges.

“We’ve seen a shortage of physicians for a long time,” said Dr. Stephen Brunnquell, president of the Englewood Health Physician Network, which has more than 500 providers practicing at more than 100 locations across northern New Jersey. “It’s a labor crisis. I’m not sure why we can’t educate more people domestically, why some bright people have to go abroad for their education. Right now, there just are not enough medical schools — when the Hackensack Meridian School of Medicine opened [in 2015] it was the first new one in the state in many years [decades, according to an announcement from Seton Hall University, which originally collaborated with Hackensack Meridian Health on the facility].”

Rising demand for primary care physicians accounts for much of the shortage, “and helps to drive up hiring prices,” he added. “We’re still able to fill our staffing needs — in part, I think, because we’re located in Bergen County, in the New York metro area. But I can’t say what it’s like for smaller practices in rural areas, where new doctors in small offices may not have the mentoring opportunities they have here, along with the ability to rub elbows with experienced cardiologists and other specialists. I worry about whether those small-office practices will be able to find replacements when the founding physicians retire.”

Brunnquell sees a similar shortage of mental health professionals. “There’s been a boom in the number of professionals who are likely to retire soon at the same time that the inflow of new professionals has been limited,” he explained. “And the demand for mental health professionals has been increasing, post-COVID.”

More than 150 million people live in federally designated mental health professional shortage areas, according to the Association of American Medical Colleges (AAMC), and, “Within a few years, the country will be short between 14,280 and 31,109 psychiatrists, and psychologists, social workers, and others will be overextended as well,” Brunnquell added.

At Englewood Health Physician Network, “we review the demographics of our medical staff every seven years, so we have an idea of who may be retiring, and what we’ll need to do to replace them,” Brunnquell said. “We have not had to postpone procedures, but we do have to be aware of staffing levels when we schedule surgeries. So maybe we’ll have to schedule a patient at 1:00 p.m. instead of 9:00 in the morning. We try to attract and retain staff by making the environment as welcoming as possible.”

He thinks that burdensome government regulations contribute to physician burnout. “Individually, all of the mandated procedures make sense, but when you consider them in total, they take up a lot of a physician’s time and contribute to a stressful environment,” Brunnquell said. “We have to screen everyone for depression and anxiety, and about smoking and their hypertension and back pain. I don’t argue with any of that, but how much more do you expect us to do?”

The Englewood Health Physician Network is taking some steps to lower the stress, he added. “Our medical staff meets monthly to discuss sources and solutions of stress,” he said. “It’s a forum to let physicians talk and share thoughts so we can focus on patient care.”

All hands on deck

Some solutions include having medical assistants help with the questioning and paperwork. “Every mandated request has been developed for a good reason,” he added. “For example, falls among the elderly is a big cause of morbidity, but it is still one more thing we have to do. If we can have someone else take care of this kind of information gathering, that lets me spend more time with my patients, discussing their issues and suggesting next steps. That’s what we love to do and why we became doctors.”

Other health care professionals are also coping. “The shortage of nurses has been the biggest challenge for our health system,” according to RWJBarnabas Health Executive Vice President, Chief Medical and Quality Officer Dr. Andy Anderson. “We also have certain types of physicians that are harder to recruit because of nationwide shortages such as Pathology, Neurology and Anesthesiology. On the positive side, our partnership with Rutgers University provides access to graduating physicians, nurses, advanced practice providers, and many other health professionals that we then hire into our health system. For procedures, we have successfully shifted staff and hired temporary staff so we can provide full access to needed procedures and other services for our patients and communities.”

He puts the burnout blame on the “pace of work and the impact of being challenged by COVID and now other infectious diseases, has resulted in fatigue and psychological stress. Many have skipped vacations, worked long days and nights, and not taken enough time away from work to refresh and recharge.”

To respond, “We are purposefully recognizing our team members including nurses and physicians for the heroic work they have done and continue to do,” Anderson noted. “We are doing this by rounding at our sites of care, personally thanking our people, encouraging employees to take needed time away, and asking sincerely how we can help our frontline workers more easily do their work. We have numerous programs in place to help recognize and support our employees and clinicians, including the RWJBH Recognizing You program, the RWJBH BHealthy Wellness Program, and numerous resources through the RWJBH Employee Assistance Programs, including access to counseling, behavioral health services, and support groups.”

The medical community is also getting help from government agencies. “State and federal governments have been very helpful in tracking and reporting data, as well as providing access to resources such as vaccines and therapies,” he added. “The pace of work continues to be fast, and we need to remain vigilant and reactive to infectious diseases and pathogens such as COVID-19, seasonal flu and the recent emergence of pediatric respiratory illness. We also must continue to evolve and be proactive as a health system. We must keep the patient at the center of everything we do, including providing easy access, great service and exceptional outcomes. By doing this, the communities we serve will be healthier. We also must continue to ensure that we are resolving health disparities and ensuring health equity across all areas of RWJBarnabas Health.”