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PubMed2002

The health care workforce in Los Angeles County and New York City: a comparison and analysis.

New York City and Los Angeles County have the largest health systems in the United States, but they differ significantly in structure. This study compares and analyzes the structural and workforce differences between the two. The health system in New York City is centered around its large hospitals, and as a result New York employs many more health workers than Los Angeles County, where the health system is centered around physician groups. Health care is a significant contributor to the economy of both areas, but a larger contributor to the economy in New York City.

Adolescent↗
PubMed2005

Neurosurgical workforce trends in the United States.

OBJECT: The purpose of this study was to evaluate the US neurosurgery workforce by reviewing journal recruitment advertisements published during the past 10 years. METHODS: The number of available academic and private neurosurgical staff positions was determined based on recruitment advertisements in the Journal of Neurosurgery and Neurosurgery for the 10-year period from 1994 to 2003. Advertisements were evaluated for practice venue, subspecialization, and location. The numbers of active neurosurgeons and graduating residents also were reviewed. The number of advertised neurosurgical positions increased from 141.6 +/- 38.2 per year from 1994 through 1998 to 282.4 +/- 13.6 per year from 1999 through 2003 (mean +/- standard deviation, p < 0.05). The mean number of academic positions increased from 50.6 +/- 11.1 to 95 +/- 17.5 (p < 0.05), and the mean number of private positions rose from 91 +/- 30.4 to 187.4 +/- 6.8 (p < 0.05). Subspecialty positions represented a mean of only 15.6 +/- 5% per year during the first time period and 18.8 +/- 3% per year in the second period (p = 0.22), and therefore the majority of positions advertised continued to be those for generalists. The number of practicing neurosurgeons declined after 1998, and by 2002 it was less than it had been in 1991. The numbers of incoming and matriculating residents during the study period were static. CONCLUSIONS: The number of recruitment advertisements for neurosurgeons during the last 5 years has increased significantly, concomitant with a severe decline in the number of active neurosurgeons and a static supply of residents.

Advertising↗
PubMed2004

The evolution of the general practice workforce in Australia, 1991-2003.

OBJECTIVE: To examine changes between 1991 and 2003 in the characteristics of active recognised general practitioners in Australia. DESIGN: We compared self-reported GP characteristics from the 1990-91 Australian Morbidity and Treatment Survey (AMTS) with those from the 1999 and 2003 Bettering the Evaluation and Care of Health (BEACH) surveys, after standardisation for age and sex to the respective sample frames. AMTS and BEACH are cross-sectional, paper-based, national surveys. PARTICIPANTS: Three random samples of 473 (1990-91), 980 (1998-99) and 1008 (2002-03) GPs who had claimed at least 1500 A1 (ie, general practice) Medicare items in the preceding year (in the AMTS) or 375 general practice Medicare items in the preceding 3 months (in the BEACH surveys). MAIN OUTCOME MEASURES: Changes in distribution of GP sex, GP age, number of sessions per week, practice size and location, country of graduation, and postgraduate training. RESULTS: Between 1991 and 2003, the proportion of female GPs rose from 19.3% to 35.2%; GPs aged < 35 years dropped from 22.3% to 10.0%, and those aged >or= 55 years increased from 21.4% to 31.6%. Between 1999 and 2003, the proportion of male GPs working < 6 sessions/week increased from 6.1% to 11.4%, while the proportion working >or= 11 sessions/week fell from 23.8% to 17.1%. Between 1991 and 2003, the proportion of solo practitioners nearly halved (25.5% v 13.7%); the proportion of GPs in practices of >or= 4 partners increased from 34.3% to 59.8%; the proportion of Australian graduates fell from 81.4% to 72.2%; and the proportion of graduates from Asia and Africa increased. Over the same period, the proportion of GPs with Fellowship of the Royal Australian College of General Practitioners more than doubled (17.8% v 36.4%). All of these differences were statistically significant (P < 0.001). CONCLUSION: Changes in characteristics of the practising GP population will affect consultative services and the balance between supply and demand for these services. These changes should be considered in future workforce planning.

Adult↗
PubMed2006

A radical new treatment for the sick health workforce.

The health workforce crisis needs radical treatment; simply educating more health workers will be insufficient, and role substitution among existing health workers is untenable. We propose a new class of health worker who would take on single disease or single procedure responsibilities, working mostly to protocols; and be embedded within current structures. We also propose modular health education which has fewer entry points into the health system, allows transfer between different disciplines, and is based on modules that can be accumulated to allow progress through the system to gain more clinical responsibility.

Australia↗
PubMed1994

A new look at national medical workforce strategy.

The efforts of governments in medical workforce policy have been unimpressive, and this has had serious consequences. Political compromise, theoretical error and administrative laxity have all contributed. It is demonstrated that market evidence, viewed through the prism of orthodox price theory, allows useful prescriptions to be made. These can be implemented through vigorous continuing maintenance and adjustment work on the Commonwealth Medical Benefits Schedule, together with periodic adjustments to rates of undergraduate and specialist medical education and training.

Australia↗
PubMedDate not supplied

Understanding the demographics of the evolving workforce.

The author discusses the four age cohorts currently in the workplace and the fifth that will arrive by the year 2005: the Pre-Boomers, Boomers, Cuspers, Busters, and Netsters. She describes their workplace and lifestyle characteristics, their social values, and their communication styles. Strategies for motivating and communicating when managing a workforce of diverse ages also are included.

Age Factors↗
PubMed2000

Study predicts shortage of RNs as nursing workforce ages.

Data Benchmarks: A new study shows the decline in younger women choosing nursing as a career during the last 20 years has been a major factor in the aging of the RN workforce. The researchers predict a worsening shortage unless the trend is reversed.

Adult↗
PubMed2001

The state of the health care workforce.

The shortage of health care workers has emerged as one of the field's biggest long-term challenges. The number of nurses, technicians, pharmacists and even housekeeping staff is on the way down, and worker dissatisfaction is on the way up. The health care workforce is slowly vanishing, and those workers who remain are unhappy. In this special fold-out section, Hospitals & Health Networks looks at this complex problem by analyzing how serious it really is and how bad it's going to get, taking a look at workers' frustration, and offering tips and resources to start to fix it.

Data Collection↗
PubMed2001

Workforce planning. Of one mind.

The NHS is heavily reliant on locum doctors, many of whom trained overseas. It is important they are appropriately trained so they can be integrated into the workforce. A pilot nine-session course for consultant locum psychiatrists was well received by participants. Medical directors have expressed willingness to pay for locums to attend such courses.

Clinical Competence↗
PubMed2002

Kidney disease physician workforce: where is the emerging pipeline?

A predicted increase in the number of patients with end-stage renal disease in coming years, coupled with significant numbers of qualified nephrologists reaching retirement age, will place great demands on the renal physician workforce. Action is required on several fronts to combat the predicted shortfall in full-time nephrologists. Of particular importance is the need to recruit and train greater numbers of physicians from ethnic minority groups. Changes in the demographics of kidney disease make it increasingly a disease of ethnic minorities and the poor. These demographic changes, together with the existing racial disparities in the diagnosis and treatment of kidney disease, highlight the specific need for nephrologists who are cognizant of the issues and barriers that prevent optimal care of high-risk minority populations. The current lack of academic role models and the drive by medical schools and residency programs to encourage minority group physicians to become primary care providers, rather than specialists, are issues that must be urgently addressed. Equally, changes in the training of renal fellows are required to merge the critical need for cutting edge research activity in renal science and with the insights and sensitivity to equip clinicians with the necessary skills for the team-based approach to patient care that increasingly characterizes the management and care of the patient with chronic kidney disease.

Humans↗
PubMed2002

The health care workforce. State-by-state numbers and initiatives.

As the shortage of health care workers intensifies, its impact is becoming more and more obvious. From overcrowded emergency departments to the cancellation of elective surgeries, providers and others are starting to recognize the effect on patient care, and to realize that the situation is likely to get worse before it gets better. H&HN examines the distribution of the health care workforce throughout the United States, the extent of the shortage in certain professions and how some states are responding.

Allied Health Personnel↗
PubMed2003

Workforce planning. A force for good.

A workforce development confederation facing a shortage of 2,000 clinical staff by 2004 has initiated a programme to train assistant practitioners. The programme is aimed at drawing workers into the NHS who have some care experience but not the educational requirements for traditional professional courses. The project, which involves 14 organisations across health and social care, has attracted 216 entrants. The course takes two years full time, or three years part time.

Health Workforce↗
PubMed2003

[Forecast of physician workforce in the 22 French regions (1998-2013)].

The first chapter provides detailed information on the methodology and data used. As were the other projections carried out in the past by the Centre de sociologie et de démographie médicales, the present work is basically a demographic projection. Whereas a projection of national workforce uses the total number of annual new graduates as inflow, a regional projection has to collect other types of data, as new graduates move freely from one region to another. This fundamental difference implies the use of more complex models for predicting the flows of newcomers at regional level. As concerns the outflow, a single table covering retirement and death is used for all regions. The medical profession is a homogeneous group and such a decision is not irrelevant. The second chapter presents briefly the results of the work as concerns one region. In the high variant, the regional number of physicians will continue to increase from 1998 to 2007 or 2008, then it will decrease. In the low variant, the growth will end in 2004 or 2005, followed by a stronger decreasing process. The decrease is caused by the "graduate boom" cohorts (doctors graduated during the 70's and 80's) reaching retirement age. Given the duration of medical training, the decrease will take place even if the numerous clausus (at the start of medical training) rises steadily right now. The decrease in the number of physicians will be accompanied by an aging process: the proportion of senior active doctors will raise and that of junior doctors will diminish. The third chapter evidences the diversity of the various regional trends.

Adult↗
PubMed2003

Operational and design strategies for a reduced workforce.

In response to continuing workforce shortages, healthcare financial executives should encourage workflow processes and facility designs that promote staff productivity. The physical layout of care-delivery areas can affect efficiency. Facility planners should investigate opportunities to improve efficiency through consolidation of functions. Adequate staff amenities and support space can foster increased staff satisfaction and thus lead to higher retention and recruitment rates.

Efficiency↗
PubMed2003

Transdisciplinary approaches to building the capacity of the public health workforce.

The thesis of this article is that public health professionals working across disciplines can have a greater impact on the health of the public than they can working independently. A conceptual model, the HERP (Health Care Services, Education, Research, Policy) Transdisciplinary Model, is proposed to support the thesis. The model differentiates transdisciplinary approaches from multidisciplinary, interdisciplinary, and other similar efforts. Methods for strengthening the public health workforce through application of the transdisciplinary approach to research, professional education, and practice are discussed. The key roles played by epidemiological research, the cardiovascular disease (CVD) care team, and health education/health promotion in CVD prevention in developing countries are highlighted. CVD prevention in sub-Saharan Africa is used as an example in discussing the model and the transdisciplinary approach.

Africa South of the Sahara↗
PubMed2003

The U.S. primary care physician workforce: minimal growth 1980-1999.

Growth in the primary care physician workforce (physicians per capita) in the United States has trailed the growth of the specialist physician population in recent years. This has occurred despite calls during the same period for increased production of primary care physicians and educational reforms focusing on primary care.

Career Choice↗