“Individual commitment to a group effort – that is what makes a team work, a company work, a society work, a civilization work.” — Vince Lombardi
Talent acquisition is always top of mind for all business leaders. Demand for workers now outpaces supply throughout the U.S., but particularly here in Michigan due to our demographic realities, including an aging baby-boom generation entering retirement in significant numbers. A recent presentation by Michigan Senate Fiscal Agency Chief Economist David Zin summarizes these challenges, as Michigan has the eleventh highest median age in the country, a metric which has been increasing rapidly in recent years.
This challenge is clearly felt by Michigan hospitals and health systems, as many retirement decisions made by healthcare workers accelerated during and because of the pandemic. The use of contract agencies for nurses exploded while hospitals also reduced the number of staffed beds in their facilities due to worker shortages. The financial repercussions of these shortages had Michigan hospitals spending more than $1 billion more on contract labor and recruitment and retention expenses in 2022 than in 2020, according to a MHA workforce report.
Although current staffing levels have stabilized somewhat in the state, the demand remains high. According to a March 2023 survey of 95% of the MHA membership, there were over 27,000 job openings in Michigan hospitals, including nearly 8,500 open nursing positions.
While the number of open positions may be surprising, healthcare is historically the largest private-sector employer in Michigan. The next iteration of the Economic Impact of Healthcare in Michigan report publishes May 2, which demonstrates the massive role healthcare plays in the state. Michigan healthcare organizations provided nearly 568,000 direct healthcare jobs in fiscal year 2021, with Michigan hospitals providing roughly 219,000 – or nearly 40% – of those jobs. Once wages, salaries and benefits and tax revenue are factored in, healthcare contributes nearly $100 billion to the state’s economy each year.
The value that our hospitals provide to the health and wellness of a community is obvious and is reason enough to warrant our strong support. But in addition, the magnitude to which our Michigan economy depends on healthcare can easily be overlooked. Hospitals are often the largest employer in their respective communities and serve as critical lynchpins of economic vibrancy. This is why it is so important for hospitals to engage with business and policy leaders to ensure alignment across the state in our efforts to attract and retain talent.
Healthcare careers are not only stable and well compensated, but also provide a set of transferrable skills which rarely become obsolete. We recognize that healthcare careers, particularly clinical positions, can be stressful and emotionally draining. We can’t sugarcoat the challenges associated with caring for all types of patients in organizations that operate 24/7/365.
But the MHA is here to help. In an effort to support the emotional well-being of healthcare workers, in 2021 the MHA Keystone Center launched a partnership with the Duke Center for Healthcare Safety and Quality team led by Bryan Sexton, PhD. More than 5,000 clinical and non-clinical staff from 144 organizations joined in the first 10-week Well-being Essentials for Learning Life-Balance cohort, and our work here is ongoing. We are also advocating for policy change at the state and federal level that would increase the penalties for those who commit acts of violence against our caregivers.
Through our successful advocacy work, the Michigan Legislature appropriated $75 million in funding for the recruitment, retention and training of hospital workers in Public Act 5 of 2023. This funding supplements an earlier $225 million appropriation made in Public Act 9 of 2022 and has played a large part in minimizing further losses to the healthcare workforce. The MHA was named as the fiduciary for both of these funding pools – evidence of the strong bipartisan trust in our association.
Allowing clinicians to work at the top of their license and removing administrative work is another tactic that can help attract healthcare talent. Enacting policy change that reduces rates of healthcare worker violence and expands access to behavioral health treatment are others. The work of the MHA and our members is to make sure healthcare workers have all the tools available to do their work improving and saving lives without unnecessary mandates and other interference that contributes to the challenges healthcare professionals experience.
These workforce challenges and the need for more workers also illustrates the need for local control for hospitals to determine staffing models that best represent the needs of their patients and communities. A one-size-fits-all approach doesn’t work when comparing a rural critical access hospital to an urban Level I trauma center. Successful staffing models incorporate input and feedback from nursing teams and the unique needs of the local community.
There are also a variety of other approaches the MHA and our partners at the American Hospital Association are advocating for to attract healthcare talent. This ranges from increased investment in nursing schools, nurse faculty salaries and hospital training time; enacting protections for healthcare workers against violence and intimidation; supporting apprenticeship programs for nursing assistants; and supporting expedition of visas for foreign-trained nurses.
There is no silver bullet that will fix workforce shortages. The current issue facing hospitals, as well as many other industries, is the reality that the available supply of workers simply doesn’t meet the demand. Michigan continues to be aggressive in efforts to attract businesses to the state. We must recognize our state is in competition with others for a finite amount of available healthcare workers.
Yet things can be done to grow the pie and attract more students into the healthcare talent pipeline. For example, the MHA will be focused this summer on raising awareness about the variety of jobs and career pathways that exist within health systems, and encouraging future and existing workers to consider a career in healthcare where they can truly change lives, whether they’re at the bedside or behind a computer screen.
Healthcare is the ultimate team sport, with the utmost objective – saving lives, and preserving the health and welfare of people. I hope you will join us in this endeavor and invite as many people as you can to the party.
As always, I welcome your thoughts.