Natalie EilbertMilwaukee Journal Sentinel
A workforce shortage is continuing to deeply rattle Wisconsin hospitals as demand for care increases, the number of providers thins, and the "silver tsunami" of aging baby boomers looms.
That's the primary takeaway of the 2024 Wisconsin Health Care Workforce Report, which noted that nationally, every baby boomer will be older than 65 by 2030. Wisconsin's population already skews older than most states, with future retirees outnumbering young people by about 10%, according to the report. As those people age, their health care needs will likely rise.
Even with increased hiring in the medical field, the report — with data through 2022 — found high vacancy rates among hospital professionals, especially registered nurses, who make up half of the hospital workforce. In Wisconsin, it typically took 100 days to fill one opening.
None of this has been helped by the fallout from February's announcement that Prevea Health and Hospital Sisters Health System were exiting western Wisconsin, shuttering Sacred Heart Hospital in Eau Claire, St. Joseph’s Hospital in Chippewa Falls and all Prevea locations across the Chippewa Valley.
The report described these events as "unthinkable," and the first Wisconsin hospital closures in more than a decade.
Related: They stayed in nursing after COVID. But these Wisconsin nurses will never be the same.
The report calls for some general actions: more ways to enter health care; fewer regulatory hurdles; streamlining reimbursem*nt; improving technology.
The report also offered a note of encouragement that educators, policy makers and health care leaders can meet the challenges of urgent and longer-term workforce needs if they work together on solutions.
But it's a small glimmer in an otherwise grim assessment.
Here's what you need to know.
New health care employment isn't moving fast enough
Vacancies may be affecting every job sector across the country, but unlike other industries, where economic forces dictate the future, demographics are the primary driver of health care demands, meaning it's largely outside the industry's control, said Ann Zenk, senior vice president of workforce and clinical practice at Wisconsin Hospital Association.
"Our workforce is shrinking. At the same time, demand is increasing. The biggest issues are the higher and higher (job) vacancy rates that have at least stabilized since last year, but are still quite bad," Zenk said.
The report noted that workforce shortages are critical but stable following peak years of the pandemic, but, as Zenk alluded to, the vacancy rate of 9.9% is still very bad. One silver lining, Zenk said, is that many of the vacancies are entry-level positions, meaning they require shorter-term education and the state can grow those positions faster.
Wisconsin's registered nurses, who make up the largest group of medical professionals and can bridge many gaps with their expertise, are contending with a 10% vacancy rate.
According to the Bureau of Labor Statistics Occupational Outlook Handbook Employment Projections 2021-2031, Wisconsin must hire 4,000 nurses annually over the next decade to keep pace with demand.
Since 2020, Wisconsin nursing schools have graduated more than 3,500 pre-licensed graduates per year, up from the 3,061 graduations reported in the 2018-19 school year.
Still, the nursing workforce isn't growing fast enough.
"Even with that, we're over 1,000 new nurses short every year and demand is only going to get greater," Zenk said, noting that a dearth in nurse educators means only so many opportunities for student nurses to get experience.
The state could be short 3,000 physicians by 2035
The last two decades have also seen a dramatic dip in working physicians. A 2023 national study from Kaufman Hall revealed that 63% of clinics and health care systems are struggling to meet patient demands, with patients waiting 25% longer to see primary care providers.
Compounding physician shortages is the length of time it takes for a student to obtain all the education needed to practice. And, in keeping with the aging theme, there's also another problem: Of the medical professionals currently working, physicians tend to be the oldest, Zenk said. In fact, one in five working physicians is already 65 or older.
The Wisconsin Council on Medical Education and Workforce projected that the state will need 2,500 more physicians than the current number to meet increased demands. It also predicts that the state could face a shortage of 3,000 physicians by 2035.
Research shows that people who grow up and train in a particular state are more likely to stay working there. Wisconsin Hospital Association's grant program "Grow Your Own" follows a simple but challenging equation: If you put students in Wisconsin medical schools and then Wisconsin residency programs, 86% of graduates end up in the Wisconsin's health care workforce.
Since the creation of Wisconsin Graduate Medical Education's "Grow Your Own" grants in 2013, there are now 18 new Wisconsin Graduate Medical Education programs and 153 additional residency positions. Zenk noted that localized residencies increase the chances of talent staying in state by 40%. Each year, 60 new physicians will graduate from the clinical training pipeline.
Additionally, more than 100 other "Grow Your Own" grants are helping to fuel the numbers of other crucial hospital professionals, including nurse practitioners, physician assistants, psychologists, addiction medicine and obstetrics-gynecology, among others.
Related: Amid physician shortage, 60% of Medical College of Wisconsin-Green Bay students stay in Wisconsin
The workforce is not diverse enough
Leveraging diversity in the health care workforce, whether racial and ethnic diversity or the many options within the health care field, can play an important role, the report finds.
Wisconsin Hospital Association's digital media campaign "So Many Options," highlights the many career paths hospitals and health care settings can provide.
Meanwhile, the report notes the power of health care institutions to reflect the diversity of the state. While 80% of Wisconsin's population is white, 91% of the registered nurses in the state are white. While people of color make up nearly 20% of the state's population, they make up less than 10% of the nursing workforce.
"Growing a more diverse workforce in health professions targeted to the needs of Wisconsin's citizens will benefit the health of the state's overall population," the report read. "Tapping into a talent pool that includes underrepresented groups will help grow Wisconsin's health care workforce faster."
One of the ways to grow this underrepresented group is through a new registered nurse apprenticeship, the first of its kind in the country. Established in 2023, the RN apprenticeship, in partnership with UW Health, the Wisconsin Department of Workforce Development and Madison College, allows diverse health care personnel to start working in the health care workforce one year into a four-year program.
The future of health care: flexibility, work-life balance and better financial incentives
Baby boomers once dominated the workforce, and with that came a boomer's world. Now that baby boomers are retiring at a rate of 100,000 per day, workplace expectations have changed, Zenk said.
Now that the workforce has a multigenerational demographic, from the Silent Generation to Gen Z, employers are hearing the need for two things: flexibility in the workplace and a need to care for themselves and their loved ones.
New technology is allowing medical professionals to select their shifts and block off time for themselves and their families, but regulatory burdens remain a constant problem. Physicians are spending more than half of their work days, nearly six hours, interacting with electronic health records, during and after clinic hours.
It's a daunting task, one that Zenk said can leave medical professionals across the health care sector feeling burned out.
To keep this new multigenerational workforce in the field means changing workloads, adding more paid time off, and offering competitive annual bonus and financial incentives.
"We're really proud of the high-quality of care we provide in the state, so we have to get ahead of this silver tsunami so that we ensure we have the workforce in place to sustain that care," Zenk said. "We need to make sure people can get access. Because that's not always easy. We want that care to be there."
Natalie Eilbert covers mental health issues for the Milwaukee Journal Sentinel. Shewelcomes story tips and feedback. You can reach her atneilbert@gannett.comor view her Twitter profile at@natalie_eilbert.
