- The Washington Times - Friday, July 27, 2007

Emergency rooms closing down, patients not receiving timely critical care, surgeries delayed. This isn’t a stereotypical potshot at national health programs but a grim depiction of what the U.S. health care system might look like in the not-too-distant future as nursing and physician shortages take hold.

The urgent need for nurses in this country should come as no surprise. The numbers began to drop in the 1970s, when women started going into careers other than nursing and teaching. The federal government estimates the shortage will peak around 2020.

The U.S. Health Resources and Services Administration reports there will be 1 million nurse staffing vacancies across the country by 2020.

The latest study to remind us of this looming crisis was released this month by PricewaterhouseCoopers’ Health Research Institute. Its report, “What Works: Healing the Healthcare Staffing Shortage,” notes that because baby boomers make up a big chunk of today’s physician and nursing work force, retirements are likely to thin the ranks significantly beginning in the next three to five years.


The report predicts that the United States could face a shortage of 24,000 doctors and nearly 1 million nurses by 2020, a double whammy “that may be more than the industry can bear.” In addition, the shortages would come at a time when an aging population will need more care.

Specifically, the report points out that while the total number of registered nurses has increased by 75 percent since 1980, it will begin to decline in 2010. The number of physicians also has increased steadily over the years, but the report finds alarming distributions of doctors by specialty and geography. For instance, only 20 percent of internal medicine residents are now choosing primary care internal medicine, the rest are pursuing higher-paying specialties.

Meanwhile, 20 percent of Americans live in areas with a shortage of primary medical care doctors.

Hospitals stand to be most dramatically affected by the coming shortages as nurses are moving to away to retail health clinics. Two-thirds of hospital executives surveyed by PricewaterhouseCoopers said their physicians now want to be employed by the hospital but the percentage of nurses working in hospitals has been dropping steadily. Nurse vacancy rates are running between 7 percent and 10 percent, according to the report, and hospitals are now regularly turning to temporary workers to fill nursing slots.

One of the report’s key conclusions is that the process of educating clinicians, particularly nurses, must change. The number of denied applicants for nursing schools is at its highest level ever, increasing more than sixfold since 2002. PricewaterhouseCoopers cites several reasons for this, including a shortage of qualified nursing faculty, financial disincentives to offer nursing education, particularly among state schools, and a scarcity of clinical training sites.

“Despite the growing importance of nurses in the health care continuum, there is a lack of broad-reaching financial incentives to bolster nursing education,” said Bill Dracos, director in PricewaterhouseCoopers’ Health Advisory Practice. Nursing programs can lose money for colleges, limiting willingness to expand and raise faculty salaries, he said.

c Health Care runs on Fridays. Contact Gregory Lopes at 202/636-4892 or glopes@washingtontimes.com.