Healthcare Labor Trends in 2023: Increased Executive Burnout, Stress

The nation’s health care workforce is still trying to recover from the COVID-19 pandemic nearly three years after it began as labor shortages stress hospitals and clinicians, spurring increased burnout among staff ranging from nurses to executives.

In addition, health care workers across the country are striking for higher pay and better staffing conditions in labor contracts, while local doctors are increasingly getting involved in labor organizing.

Those labor trends will continue to pose challenges for health systems this year as facilities work to return to pre-pandemic operations and stem labor costs that rose last year, experts say.

Continued staff shortages and use of temporary labour

Staffing shortages are expected to continue this year, particularly among nurses, as widespread burnout and increased turnover affect the sector. The shortage has led to the continued use of expensive contract labor to fill workforce gaps, even as severe hospitalization rates due to COVID-19 have declined.

In December, the national average weekly pay for travel nurses was $3,173, according to data from nursing platform Vivian Health. This is an increase from $1,894 in January 2020.

High rates are expected to remain fairly static this year, said Tim Needham, senior vice president of revenue at Vivian Health.

Without another wave of COVID, demand for contract labor costs this year should normalize to about 60% higher than 2019 levels, Jefferies analysts said in a January healthcare stocks brief.

Persistently high labor costs pose financial challenges to the systems. Although some are raising wages for permanent staff to attract the workers they need, many are still doing so unable to contain rising labor costs.

“The cost differential between full-time staff and then contract staff continues to put pressure on health systems to reevaluate their compensation packages for full-time employees,” Needham said.

Increasing organization among residents and interns

Health workers in all roles have been active on the labor front during the pandemic in an effort to improve working conditions.

While nurses have long been the face of union activity, resident physician organizing has grown in recent years, according to the Residents and Trainees Committee, an affiliate of the Service Employees International Union.

The fast-growing union representing physicians-in-training has five election wins in 2022, four in 2021, one in 2020 and two in 2019, according to CIR-SEIU. It currently represents around 25,000 members.

The organizing of trainee doctors is expected to continue into the new year, with residents at Montefiore Medical Center in New York and Lifelong Medical Care in San Francisco currently entering union representation elections, according to the union.

Last year, residents at three Los Angeles County hospitals and one Oakland, Calif.-based hospital authorized strikes, even though both groups reached agreements with the systems in advance and averted work stoppages.

Strike threats from resident physicians are particularly difficult for hospitals because residents are harder to replace than nurses. Also, doctors are on strike threaten the facility’s ability to maintain surface operations in the event of a breakout, he said John Augustus, director of health care labor relations at Cornell’s School of Industrial and Labor Relations.

Like nurses and other health care workers, unionized residents are demanding better pay and adequate job support.

“Doctors think they’ve kind of turned a corner for many years they felt that their power and influence was waning because of the consolidation of health care systems and reimbursement systems and technology,” August said.

Burnout, turnover hits executives

Reports first indicated a burn nurses and doctors such as healthcare workers reporting feeling stressed and emotionally drained.

Now even health executives are reporting symptoms of burnout, which is causing some to think twice career changes.

A December survey by a consulting firm WittKieffer found that nearly 75% of healthcare executives surveyed reported feeling burned out in the last six months of 2022, compared to 60% of respondents who reported symptoms of burnout in 2018.

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