Area hospitals, schools addressing healthcare labor shortage

LIMA — When it comes to today’s healthcare landscape, the Dickensian observation of being both the “best of times” and the “worst of times” could apply. According to Becker’s Hospital Review, the average salary for registered nurses increased 4 percent in 2021. This gain was even greater than the 3.3 percent increase in the prior year and the 2.6 percent gain in 2019.

While the increase in wages is helpful, insufficient staffing is raising the stress level of nurses, impacting job satisfaction and resulting in many nurses leaving the profession.

Patti Baucom, Senior Human Resources Business Partner at Lima Memorial Health System, notes that the higher acuity level of hospitalized patients creates a more demanding and stressful work environment for nurses, often contributing to “burn out.” To assist less experienced nurses, LMHS has an administrator on site and a clinical resource nurse available at all times to mentor newer nurses and to offer additional support when needed.

Many associates left their positions in the past two years as the job market became more competitive. Several nurses were lost to “travel nursing” positions, which often offer large sign-on bonuses, greater scheduling flexibility and higher hourly wages. Baucom has found that many newer associates are unwilling to work night shifts and weekends, contributing to the 100 vacancies currently posted at the hospital.

Dr. Matt Owens, COO at Mercy Health Bon Secours in Lima indicated that there are an inadequate number of healthcare providers in several medical specialties. The reasons for the shortage are multifactorial. Dr. Owens cited the COVID-19 pandemic as placing a strain on the healthcare system, with many healthcare providers in the Baby Boomer generation accelerating their retirement plans to avoid the increased stress and demands.

Dr. Owens pointed to the growth in the aging population as one of the factors that has placed a strain on the healthcare system. With older individuals typically having multiple chronic illnesses, there is an increased demand for healthcare, including specialty care. The training pace has not kept up with the demand.

Specialty shortages

While there is a shortage of oncologists, that deficit is not unique to Lima. Many areas of the country experience the same concern. One of the contributing factors is the “hyperspecialization” of the field. For example, some oncologists choose to specialize further into radiation oncology or surgical oncology. Fewer physicians select the “full spectrum” of oncology as a career choice. Providers that seek the expertise developed during hyperspecialization often select large medical centers as practice sites, further limiting recruitment to smaller hospitals and more rural areas.

For a long period of time, there has been a shortage of endocrinologists in the Lima area. Endocrinology deals with the endocrine system, which centers around hormones. Diabetes, thyroid dysfunction and adrenal abnormalities are among the conditions treated by endocrinologists. Statistics from the American Diabetes Association indicate that 1.4 million people are diagnosed with diabetes every year in the United States. Many of these individuals seek diabetes management from their primary care providers, rather than an endocrinologist.

There has also long been a shortage of oral surgeons in the Lima region. While the three oral surgeons in Lima did not provide a comment regarding the shortages, Dr. Philip Mikesell provided some insight into the issue. Dr. Mikesell is a practicing endodontist in Wapakoneta. He is also an assistant professor at Ohio State’s College of Dentistry in Columbus.

Two oral surgery residents per year graduate from the OSU program. Of the two most recent grads, one chose to practice in a metropolitan area and one chose a rural area. The selection of a practice area can be based on a variety of factors. Some residents join an established practice with another family member, some are looking for a specific type of practice and some choose to work in an academic setting. Ohio State’s applicant pool for oral surgery residency has remained large. The recent trend has been an increase in female applicants. Oral surgery, endodontics, pediatric dentistry and orthodontics are considered the four most desired specialties in dentistry, according to Mikesell.

Successful physician recruiting efforts

There has been greater recruitment success for some specialties in the region. For example, the Orthopedic Institute of Ohio has been successful in obtaining new providers. Owens attributes some of their recruitment success to the large volume of patients they see, providing a busy practice for the physicians and the ability to share calls among a larger number of physicians, which makes the call rotation less cumbersome.

Podiatry is another specialty that is well-served in our region. The Podiatric Medicine Residency, initiated approximately 15 years ago, was the first residency program at Mercy Health-St. Rita’s Medical Center.

An area’s appeal to a physician can also be related to ties with the community, including having family members in the region or a spouse who has been recruited to the region. Dr. Owens, a native of Middle Point, is one of those physicians who desired to return to serve the residents in the area. He enjoys the interactions with those he knows not only as patients but also as neighbors and friends.

Benefits of Residency Programs

Educational programs produce a larger pool of providers. It is estimated that approximately 30 percent of physicians who train in the area will remain in the area. The podiatric medicine program is one example of residents who were successfully recruited, at least in part, due to their affiliation with the local residency program. With the anticipation that many residents will remain in the region, St. Rita’s invested in the Graduate Medical Education program. The program includes internal medicine, family medicine and emergency medicine residents.

Physicians, oral surgeons and nurses are not the only healthcare positions with increased needs. Shannon Williams, the Director of Mercy Health Talent Acquisition, has been using creative ways to recruit healthcare workers to fill technical roles. She cited imaging (CT scan, ultrasound and radiology), physical and occupational therapy and respiratory therapy as areas where there are shortages. Williams indicated that fewer programs in schools across the country are graduating medical technologists and certified surgical technicians and enrollment in the programs has declined. She attributes the “changing healthcare landscape” to the COVID-19 pandemic.

Baucom is excited about the new Surgical Technician program beginning this fall at the Borra Center for Health Sciences in Lima. Students will be able to train in a simulated operating room suite. Baucom is hopeful that many of the students from the program will remain in the area to fill the current surgical technician vacancies.

Dr. J.J. Sreenan, a retired pathologist and current director of Graduate Medical Education at Mercy Health-St. Rita’s is very concerned about the shortage of medical laboratory technicians. He noted that the two medical technology programs in the region, one at Ohio Northern University and the other at Bowling Green State University, do not have enough applicants to fill their current vacancies.

According to Sreenan, professional pathology societies identified a potential shortage of medical technologies as long as 20 years ago. With the average Medical Technologist greater than 60 years of age, the shortage may reach a crisis state in the next five to 10 years. Currently, there are fewer lab technicians in the 40 to 60 age range and this leads to what Sreenan refers to as a “knowledge gap” to train younger associates.

People interested in working as laboratory technicians have the option of two educational tracks. The two-year track leads to certification as a medical lab technician. To become a medical technologist (soon to be known as a medical lab scientist) requires four years of college coursework plus a one-year internship. Salaries for both positions have improved recently due to demand.

Creative Recruiting Strategies

While it is estimated that 1.2 million new registered nurses will be needed in the United States by 2030, Mercy Health has modified its recruiting efforts in an attempt to fill the 266 vacancies they are currently experiencing. Among the recruiting efforts are “walk-in” days for interviews, where candidates can walk into the facility, meet with a recruiter then be escorted to a clinical manager for a unit-specific interview. St. Rita’s has also offered complimentary continuing education programs (CNEs) for nurses. With nurses on campus for the educational programs, recruiters take the opportunity to make the nurses aware of available vacancies. For some positions, there is a “robust” referral bonus. St. Rita’s has also been working to recruit certified phlebotomists and state-tested nursing assistants (STNAs) upon their graduation from vocational schools, such as Apollo Career Center.

Lima Memorial adjusted base wages for their associates to attempt to recruit and retain skilled employees. They also have an internship program at Bath and Wapakoneta High Schools, where students are hired while still in high school and then receive tuition assistance to further their education in healthcare. Currently, two students from the internship program are enrolled in classes to become registered nurses.

Baucom feels that the Rural Healthcare Grant provided by the U.S. Department of Labor has been helpful for the community. Funds are available for those associates who are interested in advancing their education, allowing them to move from entry-level positions to technical and professional roles. The funding is administered through OhioMeansJobs Allen County. Recipients of the grant can receive up to two years of educational assistance to cover the cost of tuition, books, uniforms and certification fees.

Guild education

Within the past year, Mercy Health partnered with Guild Education to offer an innovative education program for eligible Mercy Health Associates. The collaboration with Guild Education enables associates to obtain advanced education without incurring a financial burden. While tuition allowance varies, it can be fully funded for some select clinical positions.

Associates have an opportunity to advance in the organization from entry-level positions to professional-level positions while maintaining employment and thereby maintaining their seniority. Williams indicated that associates can have “a lifetime of careers within our organization.”