Workforce

Can Veterans Fix the Health Care Workforce Shortage?

by Matt Gontarchick

Military servicemembers have stepped up throughout the course of the COVID-19 pandemic to care for a surge in patients, administer tests, and provide vaccinations.  Meanwhile, civilian health care professions like nurses and paramedics are facing severe workforce shortages for the foreseeable future. Therefore, it begs to ask the question: could military medical personnel transition to the civilian world to help address gaps in the health care workforce?

Military medical personnel, in brief: The US armed forces have over 73,000 enlisted medical personnel, including Army and Air Force medics and Navy corpsmen.  All medics and corpsmen receive three months of specialized medical training and have continuing education requirement throughout their enlistment.  Medics and corpsmen who specialize in physical therapy, dental care, radiology, and other specialties are required to complete additional training that can last up to one year. 

The issue – civilian shortages: Nearly all health care professions face staffing shortages that have been exacerbated by the COVID-19 pandemic.  As an example, the American Hospital Association (AHA) estimates that the US needs more than 200,000 new nurses each year to keep up with a rising population of seniors and replace nurses existing currently in the workforce.  Emergency medical services (EMS) agencies across the nation are also struggling to fill positions for emergency medical technicians (EMTs) and paramedics.   

Let’s jump into the discussion – can former medics and corpsmen be a solution to the care health care workforce shortage?  The closest equivalent civilian jobs where medics and corpsmen can apply their skills are as EMTs and paramedics, but many veterans find the transition challenging due to a lack of accreditation standards.

  • State EMS agencies have requirements that returning service members have difficulty meeting, like paying fees or undergoing background checks.  Some states have particularly onerous requirements, like requiring sponsorship from an EMS office before granting a license.
  • EMT certification usually has college coursework requirements, but many colleges don’t know how to interpret training and experience from military transcripts, meaning veterans usually have to spend time and money on repeat coursework.

Possible fixes: To help transition veterans into the health care workforce, specifically as EMTs or paramedics, advocates are calling on state EMT agencies to develop policies to apply military experience to licensing standards.  The Army has also been requiring its medics in recent years to maintain a National Registry of Emergency Medical Technicians (NREMT) certification, which can ease the transition to becoming a civilian EMT.  Furthermore, pilot programs such as program that the Lansing Community College currently offers,  which provides specialized training for former enlisted military medical personnel who wish to become paramedics, could serve as a national model for similar programs. 

Advocacy

HELP Hearing Explores Ways to Rebuild Public Health Workforce

by Matt Gontarchick

The COVID-19 pandemic represents an “unmitigated attack” on providers and first responders, which has left workers “fatigued emotionally and physically” according to public health experts at a March 9 hearing of the Senate Health, Education, Labor, and Pensions Committee on the COVID-19 response.

The nation’s public health system had been “hollowed out over the past 10 years” said Ashish Jha (Brown University) due to years of underinvestment and chronic personnel shortages.  

As a result, the challenges facing front-line health care workers according to Mary Ann Fuchs (Duke University) include a lack of access to personal protective equipment, confusion over changing policies, and exhaustion from surge staffing.  Fuchs also described the growing toll on health care workers’ emotional well-being due to fears of exposing family members to the virus and the trauma of constantly treating critically ill patients.  Washington State Secretary of Health Umair Shah similarly observed “compassion fatigue” among behavioral health providers as they face their own mental health pressures, and he noted outdated information technology systems such as faxes have complicated workers’ response efforts.  The result of these pressures, explained Fuchs, is the exacerbation of high rates of depression, burnout, addiction, and suicide among providers that existed before COVID-19.  As a consequence, Fuchs said the pandemic threatens to increase already-high turnover rates among health care workers.

To tackle stressors on the health workforce, the panelists recommended:

  • greater access to behavioral health resources that provide assessment and short-term counseling for providers
  • more support of workplace violence initiatives
  • new ways for paying primary care physicians
  • focus on diversity and equity to ensure workers represent the communities they serve
  • expansion of the public health workforce to include specialists and paraprofessionals

The panel underscored that rebuilding the nation’s public health system is essential to prepare for the next pandemic.  As described by Jha, economic development, climate change, and globalization are thrusting the world into a new “age of pandemics,” which underscores the need to continue to invest in the public health workforce even after the COVID-19 public health emergency ends.