The Great Resignation's Toll on Healthcare

In this three-part series, HealthLeaders looks at the significant loss of workers in the healthcare industry and how it will impact quality care and finances.

The healthcare field has lost an estimated 20% of its workforce over the past two years, including 30% of nurses, according to several recent studies. By any account, those statistics are staggering.

Healthcare is not alone. The so-called Great Resignation has gripped several industries. Millions of U.S. workers have left their jobs, and in many cases their field of work entirely. The reasons cited for doing so are many.

In this three-part series, HealthLeaders examines what is happening in the healthcare sector regarding job resignations, the reasons for them, the implications for the quality of care being provided, and the potential impact on the CFO role at hospitals and healthcare systems now and in the future.

Sharing their views on these issues are Terry Lutz, CFO at Scheurer Hospital in Pigeon, Michigan; Carlos Bohorquez, CFO at El Camino Health in Mountain View, California; and Dr. Gail Gazelle, MD, assistant professor of medicine at Harvard University in Massachusetts and a master certified coach for physicians.

How the Great Resignation impacts the healthcare industry

Recent job tracking numbers reveal that an estimated 5 million U.S. workers overall have decided to quit their jobs without having a replacement employer. In many cases, workers are deciding to leave their career fields entirely.

"The Great Resignation is occurring for a variety of reasons and the pandemic has played a large role," stresses Harvard's Dr. Gail Gazelle. "After the flexibility of working at home, many people don't want to return to the constraints that a workplace involves. Others have reconsidered their goals and priorities, leading them to try something new or move to a new organization."

Perhaps more important, especially in the healthcare space, is the toll of job burnout, caused by working endless long hours with little relief in sight.

"The levels of burnout are high in healthcare and in many other fields, so many people are leaving in an effort to focus on their mental health. Whatever the reason, the level of disruption throughout the economy is high," Gazelle says.

Gazelle says that she has spoken with several professionals in the medical field, who have all confirmed that the pandemic has left them feeling exhausted, past their breaking points, and in some cases, resentful. That is especially true for those working in COVID-19 units, where doctors and, especially nurses, have often been on their feet for 12–13 hours with only two breaks to use the bathroom, eat, and take care of other business.

"Add on the fact that the full personal protection equipment that they use is not very breathable, causing heavy sweating, and you have a recipe for disaster," Gazelle says. 

The reasons healthcare workers are leaving their jobs or the industry

Carlos Bohorquez can confirm the toll that job burnout is having in the healthcare field. As CFO at El Camino Health, he says there was already a staffing shortage at the healthcare system before the pandemic, and that forces each worker to put in a bit more effort. But when the pandemic hit, and many healthcare workers were forced to do double shifts or work without days off, some quickly reevaluated their commitment to the profession. Then, as healthcare workers started quitting, things got especially bad.

"Even before COVID, there was always a shortage of licensed nurses and other clinical staff. But the COVID pandemic has stretched the workforce to the limit," Bohorquez confirms. El Camino Health includes two nonprofit hospitals: Mountain View Hospital and Los Gatos Hospital, as well as urgent care, multispecialty care, and primary care facilities. Mountain View and Los Gatos, California, have a combined population of 116,000.

It is a similar tale at Scheurer Hospital, a 25-bed critical access hospital located in rural Michigan in an area on the east side of the state called "The Thumb." Scheurer Hospital serves a community of approximately 18,000 in its primary market and another 7,000 in its secondary region. 

"There appears to be a group of people who have reflected on their lives during COVID and realized that they didn't need to continue working since they were in good shape financially," Lutz explains. "As a result, they stopped working instead of earning additional wages at the end of their careers. This was more prevalent with the registered nurses." 

Another group at Scheurer Hospital took new jobs at Walmart or Meijer (a regional store like Walmart), since both retailers increased their wages in the competition to lure workers. The result was that healthcare workers could now earn nearly the same pay by leaving their healthcare jobs, where the risk of contracting COVID was perceived to be higher.  This group included medical assistants, receptionists, and housekeepers, Lutz says.

"A few left because they didn't want to be mandated to get vaccinated," Lutz adds. "We were required to either have our workforce vaccinated or get a medical or religious exemption from those that weren't. If we didn't comply, then we would lose payments from Medicare and Medicaid, which is about 65% of our revenue. That would effectively close our doors," Lutz says.

The specific job roles that have been hardest hit

Ask Lutz which job roles have experienced the greatest losses from the Great Resignation and he is quick to confirm those of registered nurses and medical assistants, "which have each accounted for about 25% of our open positions," Lutz says.

Scheurer has also struggled to fill lab tech positions over the past two years, and the hospital has depended on agency help as well as asking staff to work extra shifts to make up the difference.

The experience at Scheurer is also happening at hospitals and healthcare systems across the country.

"Nurses are leaving in large numbers, and we have a national shortage of nurses that was predicted before the pandemic started," Gazelle says. "The pandemic has made the worst of a bad situation."

Contributing to the large-scale exodus of nurses at hospitals and healthcare systems is the growing trend of traveling nurses.

"Nurses can now leave their own home institution and do what's called traveling nursing and get paid a lot more," Gazelle says.

"Economics are a big driver for all of us. One can appreciate that nurses who have a family to feed and debts to pay will jump at the chance to move on, even if their personal allegiance is to their own community. But this has caused a great deal of disruption in the healthcare landscape," Gazelle says.

That disruption is also being keenly felt at the physician level.

"There is great concern about the numbers of resignations by physicians," Gazelle explains. "The levels of burnout in physicians was already extraordinarily high before the pandemic. With the incredible new demands and pressures of taking care of seriously ill and often dying patients with COVID, they want change."

For many physicians, that means looking elsewhere, Gazelle acknowledges.

"They're thinking, 'Maybe the grass is greener if I move to a different hospital or healthcare system. Maybe things will be better.' And sadly, they are not better. In addition, some physicians are just throwing in the towel on this career that they have invested so much in, and leaving the field completely," Gazelle says.

Editor's note: In part two of this series, we will look at how the Great Resignation is impacting the quality of care, and how it is changing recruiting, staffing, retention, and rewards strategies. In part three, we will explore how this trend impacts the role of the CFO, what are the expected long-term impacts, and what steps CFOs can take to combat or ease the effects of the Great Resignation in healthcare.