More than 145,000 health care providers – including 71,309 physicians – left the workforce from 2021 to 2022, according to published reports. What’s causing the exodus and what can be done about it?

“There is a challenge, but at RWJBarnabas Health we have an advantage because of our affiliation with Rutgers University,” said RWJBarnabas Health Executive Vice President, Chief Medical and Quality Officer Dr. Andy Anderson. “This enables us to establish relationships with a health care ‘pipeline’ of more than 1,000 residents and fellows in training, as well as nurses, some of whom may end up working with us.”

RWJBarnabas is also focused on retaining the qualified nurses, doctors and other health care professionals currently employed by the system, he added. “We have been able to maintain our turnover at a lower-than-industry average, but it’s more than just offering competitive salaries,” Anderson explained. “For example, we have a ‘wellness initiative’ that helps to combat burnout or fatigue with peer-to-peer and vertically integrated support systems. Our Active Docs initiative, for example, features teambuilding events, off-site retreats, social gatherings, and invited speakers and panels that help to educate, integrate and empower health care professionals.”

To encourage a “team” outlook, RWJBarnabas locations hold daily “huddles,” noted Anderson. “Besides keeping everyone updated, we use this time to recognize our team members and let them know their frontline work is appreciated.”

And to reinforce RWJB Health’s commitment, “System administrators meet with nurses, clinical care technicians and others to get their input about systems and procedures,” added Anderson. “We also meet with patients and speak with them to enhance the provider-patient relationship.”

The health care system is also taking steps to reduce employee workload through greater efficiencies. “We are using technology to optimize and upgrade our electronic medical records,” he explained. “This can reduce the number of activities that professionals need to go through to accomplish their activities, while maintaining patient quality.”

RWJBarnabas also uses technology to supplement the human touch. “We’re improving our internet connectivity so doctors, nurses and others can communicate easier,” he said. “And we’re integrating artificial intelligence into certain functions, like using it to scan patients’ EMRs and then alerting nurses and doctors about possible reactions to combinations of medicines.”

In the future, he added, “AI will be able to listen to conversations and create draft notes for doctors or pull all of the elements of patient notes and histories together and generate recommendations for the patient’s health care providers.”

Human touch

But these kinds of advances will never replace human professionals, according to Anderson. “This will all save paperwork and improve communications and patient care,” he said. “But it’s still up to the physician to validate a course of care.”

Other institutions are also addressing the challenge of fewer physicians and other health care professionals. “There’s no question that, across health systems, there was an increase in the number of health care providers leaving or retiring during COVID,” noted Virtua Health Chief Operating Officer Dr. John Matsinger. “Fortunately, Virtua has been following the trend and tracking demographics, so for the past five years we had been successfully preparing for this kind of exodus.”

Benchmarked competitive salaries “are table stakes,” he added, “but offering an inclusive, hospitable environment with opportunities for flexible hours – like a four-day workweek – and hybrid arrangements, with some remote-work days are also important, where possible. Some of our non-clinical staff [such as medical billers and coders, transcriptionists, receptionists and other administrative/corporate personnel] can work fully remotely, if they wish. People respond positively to these kinds of incentives.”

Virtua’s academic affiliation with Rowan University has also helped bolster staffing opportunities. “Working with Rowan, we’ve grown our residency programs,” Matsinger said.

Established in 2021, the Virtua Health College of Medicine & Life Sciences of Rowan University encompasses an osteopathic medical school; an expanded nursing and allied health professions school; a school of translational biomedical engineering and sciences; multiple research institutes and centers; and aligned clinical practices.

“We also brought Our Lady of Lourdes School of Nursing into our Rowan affiliation,” Matsinger added. “It’s part of our multipronged approach to ensure healthy staffing levels.”

Virtua also attracts employees with a culture “that ensures our professionals’ voices are being heard,” according to Matsinger. “We have regular colleague meetings where people are encouraged to speak up and represent their team or campus, and this has resulted in initiatives like a primary care practice that serves as a safe space for members of the LGBTQ+ community and their allies.”

Established in 2022 and based in Marlton, the Virtua Pride Primary Care provides a range of services and has dedicated schedulers, staff and clinicians who are trained to care for members of the LGBTQ+ community.

Matsinger noted that Virtua is also leveraging technology to improve outcomes by automating some repetitive, manual tasks, like chart reviews, freeing up staff to focus more on mission-critical issues. “We have embedded artificial intelligence in EMR and are using it to identify trends by studying patient vital signs,” he explained. “We’ve also deployed AI in a ‘chatbot’ on our phone lines and our website, which gives people the opportunity to schedule their own appointments. Prior to that, someone would have to answer a phone and consult multiple schedules. It is more efficient for the caller and empowers our staff to support those with more complex scheduling needs.”

Matsinger sees these kinds of advances as tools to make Virtua even more patient- and employee-friendly. “AI can augment the work of clinical and nursing staff, but it will not replace them,” he said. “However, I’ve heard it said that physicians and nurses who embrace AI will replace those who do not.”

According to AtlantiCare President and CEO Michael Charlton, “Attracting and retaining staff – especially in the current health care environment – can be challenging, and at AtlantiCare we’ve found that it’s important to focus on a combination of strategies that go beyond competitive compensation and benefits, and address not only professional capabilities and compensation but support personal and lifestyle needs as well.”

He noted that AtlantiCare prioritizes “patient-centered care so that our clinicians and health care professionals can have the job experience that originally led them to the field. We embrace advancements in medicine and operations so that our team has the state-of-the-art medical technology and resources they need to provide the best care. “

The system also strives “for work-life harmony so that our team can do their jobs without sacrificing their personal lives,” Charlton added, offering such opportunities as “professional development opportunities for all levels throughout the organization. This not only provides paths to career advancement, but it also keeps our team engaged in their work. By focusing on these elements, AtlantiCare has not only made a positive impact on the health and well-being of our community but has cultivated a strong team of clinical caregivers and other health care professionals.”

Technology can help in a number of ways, he noted. “Technology should make the job easier, not provide more levels of frustration. I’m focused on creating systems that remove the burden of business tasks from our clinical teams so that they can prioritize the care that called them to this career. Maintaining the well-being of our team not only ensures their health but also paves the way for the well-being of our patients and community.”

Every aspect of health care is dependent on some form of technology, including AI, observed Charlton. “This was intensified during the COVID pandemic as patients relied on telehealth services and apps to chat with their doctors. However, there is no replacement for the human connection of bedside care. While AI plays a crucial role in supplementing and enhancing health care practices – with services such as telehealth, remote monitoring, virtual health assistants, and automated administrative responsibilities – I don’t believe it will replace the invaluable contributions of doctors and nurses. The expertise, experience and compassion that health care professionals provide on a daily basis is vital to overall patient-centered care.”