To meet patient needs now and in the future, the United States health care industry must build a larger, more diverse health care workforce with the right experiences, skills, and linguistic capabilities. Kaiser Permanente is committed to working with policymakers to build that workforce.

The COVID-19 pandemic has put a spotlight on structural challenges facing America's health care system, especially employee shortages and a lack of racial and ethnic diversity. While these challenges existed prior to the pandemic, they have intensified during the global health emergency and are expected to grow significantly if unaddressed.

In 2020, 19.5% of hospital employees and 18.7% of staff registered nurses left their jobs, with many of those nurses completely leaving that field. These resignations came at a time when the health care workforce was already struggling to meet the demand for care. In 2022, approximately 200,000 new nurses are necessary to meet demand nationwide. There is also a critical need for additional physicians, physician assistants, behavioral health practitioners, and other key health care providers.

Over the coming years, the demand for care will only increase. Researchers at the U.S. Census Bureau predict that the nation’s population will grow by almost 80 million people over the next 4 decades. By 2030 more than one-fifth of the American population will be over the age of 65. These trends will require the health care workforce to grow and adapt to ensure all patients receive high-quality care.

As the U.S. population is growing, it is also becoming more racially and ethnically diverse. While some health care professions reflect the diversity of the communities they serve, certain roles, especially physicians, do not reflect the composition of the general population. A comprehensive analysis by the Association of American Medical Colleges reveals that only 10.8% of physicians identified as Black or Hispanic in 2018. This percentage is a third of what is reflected in the general population.

The health care workforce's limited diversity creates challenges for patients and workers. For patients, having a provider from their community or who shares their background can be critical to building trust and maintaining or improving health. For workers, a lack of diversity can lead to feelings of isolation, misunderstanding, and burnout.
 

To strengthen the health care workforce, Kaiser Permanente believes public policy should:

• Increase funding for residency and other clinical training programs
• Promote the use of telehealth and technology to enable more flexible care and scheduling
• Rationalize training requirements to minimize economic burden and enable more people from diverse backgrounds to enter the health professions
• Make it easier for practitioners to get licensed in multiple states through interstate compacts
• Ensure that the diversity of the health care workforce reflects the populations served
• Explore more adaptable and inclusive work schedules
• Bolster the health care workforce pipeline by expanding education, training, and fellowship opportunities

¹ Health Affairs, 2018
² Medscape, 2020
³ AAMC, 2019