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November 15, 2023
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David Burda
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Economics Outcomes System Dynamics
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Healthcare’s ‘Good Resignation’

We all know people who always have it worse than you. If you have a lot to rake in the yard, they have more leaves and lawn bags than you. If you had a cold or sore throat, they suffered much longer. If your mail was late, theirs never came.

Healthcare is a lot like those people you know. No matter what negative economic trend befalls all industries across the board, healthcare always had it worse. Just ask any administrator, doctor or nurse.

An example is the Great Resignation fueled by the COVID-19 pandemic. Workers left healthcare more than any other industry, pushing healthcare employment down to dangerously low levels, according to healthcare executives and their trade associations.

That’s why I had to laugh at a two-page research letter published earlier this month in the Journal of the American Medical Association. Four researchers from Michigan, Brown and Indiana universities and the Rand Corp. looked at quarterly changes in healthcare employment before and after the pandemic.

The researchers defined the pre-pandemic period as Jan. 1, 2016, through Dec. 31, 2019, and the pandemic period as Jan. 1, 2020, through Dec. 31, 2022. The researchers used data from the U.S. Bureau of Labor Statistics to compare changes in healthcare employment with changes in non-healthcare employment. They also broke down changes in healthcare employment by three sectors: hospitals, medical practices and skilled nursing facilities (SNFs).

Here’s what they found:

  • During the four-year pre-pandemic period, healthcare employment rose an average of 0.6% per quarter compared with 0.4% in other industries. In other words, healthcare employment was growing faster than everyone else.
  • During the three-year pandemic period, healthcare employment rose an average of 0.1% per quarter compared with 0.3% in other industries. In other words, healthcare employment was still growing but slower than everyone else.
  • In 2020 alone, when the pandemic hit and the Great Resignation began, healthcare employment dropped an average of 4.3% per quarter compared with 7.2% in other industries. In other words, healthcare lost people but not as fast as everyone else.
  • Within healthcare, employment at hospitals rose an average of 0.4% per quarter during the four-year pre-pandemic period compared with 0.03% during the three-year pandemic period. In other words, hospitals added people after the pandemic hit but not at the same pace as before.
  • Employment in medical practices barely changed — from a 0.6% average increase per quarter to a 0.5% average increase per quarter.
  • Employment at SNFs did take a hit — from dropping an average of 0.2% per quarter prepandemic to dropping an average of 1.1% per quarter during the pandemic. In other words, the pandemic accelerated an existing employment decline at SNFs.

In sum, healthcare employment growth slowed after the pandemic hit. Healthcare employment didn’t drop after the pandemic.

That’s a much different story than we typically hear from healthcare executives who want payers and patients to pay for their rising labor costs. They’re not rising because of any Great Resignation. They’re rising because most providers continue to hire more people despite the pandemic. Those people cost more money.

Maybe healthcare executives do have more leaves to rake in their front yards.

Thanks for reading.

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About the Author

David Burda

David Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personnel experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 40 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 40 years and his three children, none of whom want to be journalists or lobster fishermen.

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