What can we do to encourage to increase our healthcare workforce, and provide better training to improve the level of services provided? How can we make healthcare a more attractive profession for people, and can we make more efficient use of our healthcare workforce?? Do we need to adopt different strategies in advanced nations and in underprivileged and developing nations?
The World Health Organization (WHO) published a report entitled “A universal truth: No health without a workforce” in 2013. The report predicts that the world will be short of 12.9 million healthcare workers by 2035. The report warns that the findings – if not addressed now – will have serious implications for the health of billions of people across all regions of the world.
Additional studies support this shortage of healthcare professionals. A recent study by the American Association of Medical Colleges indicates that the USA will face a shortage of 100,000 physicians by 2030, fueled by population growth, an increase in the number of aging Americans, and retirement of practicing doctors.
While advanced nations such as the USA also face this problem, the WHO report indicates that the largest shortages in numerical terms are expected to be in parts of Asia, and it is in sub-Saharan Africa where the shortages will be especially acute. On education and training, for example, in the 47 countries of sub-Saharan Africa, just 168 medical schools exist. Of those countries, 11 have no medical schools, and 24 countries have only one medical school.
The report highlights some encouraging developments, for example, more countries have increased their health workforce, progressing towards the basic threshold of 23 skilled health professionals per 10,000 people, there are still 83 countries below this basic threshold. But it is the future projections that raise the loudest alarms. For example, in Israel they are piloting a program where they are converting EMT professional to PA in an expedited program to help cure the shortage. In the US NYU medical college recently announced that they will paying the tuition for all medical students to alleviate the stress of the overwhelming financial debt and perhaps make it a bit more attractive for them.
Additionally, we should note that the goals measured by the report are for providing the minimum essential level of healthcare services which can be achieved with 23 skilled professionals per 10,000 people as opposed to a desirable level of services, which will likely require a higher density of healthcare professionals.
In a stark assessment provided by future projections in the report, the current rate of training of new health professionals is falling well below current and projected demand. The result will be that in the future, the sick will find it even harder to get the essential services they need and preventive services will suffer.
This can lead to a dangerous healthcare crisis across the world. Demand is increasing with a growing world population, while we have an ageing health workforce with staff retiring or leaving for better paid jobs without being replaced, and inversely, not enough young people are entering the profession or being adequately trained.
What do we need to do to avert this crisis? How can we transform the training of healthcare professionals and the delivery of services to fight this trend and build a strong healthcare workforce to support our future?