THE HEALTH WORKFORCE: AN IMPLICIT ASSUMPTION

Whenever major health legislation becomes law, such as the Patient Protection and Affordable Care Act of 2010, all too frequently the focus almost exclusively is on providing health insurance coverage and slowing the rate of increase in health care expenditures. An implicit assumption is that if every individual in the U.S. population was given a health insurance card, major health problems essentially might disappear. Unfortunately, provision of health care requires the presence of a sufficient cadre of competent practitioners. This fact is an important element in the overall equation that does not always receive the amount of attention warranted.

sine qua non of sound policymaking is the existence of high quality data. Pockets of relevant health information exist, but they may be restricted to professions, such as medicine and what is obtainable in certain states. For example, since 2015 the Association of American Medical Colleges (AAMC) has commissioned annual reports of national physician workforce projections prepared by independent experts. The purpose of doing so is threefold: update and improve workforce projections; present new analyses that reflect physicians and key issues, such as the evolving health care system and the changing demographic composition of the workforce; and identify future directions for research. Not many other kinds of health professions are able to capitalize on having information of this nature.

At the state level, data derived from decennial censuses by the U.S. Census Bureau make it possible to determine demographic shifts. State out-migration patterns may result from the flight of youth seeking improved employment prospects elsewhere, while leaving behind jurisdictions that have a growing proportion of older persons characterized by experiencing one or more chronic health problems. Few states are capable, however, of tracking increases or declines in the number of different health professional groups that provide clinical services for patients needing care. The Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill serves as an example of an academic resource that benefits state legislators and health department officials in addressing workforce concerns.

Some contributors to ASAHP’s Journal of Allied Health occasionally may be searching for suitable topics for the submission of articles. Suggestions of possible future manuscripts that might be of interest to the journal’s readership are: issues involving recruitment and retention of both faculty and students; supply and distribution of selected health professionals in rural areas; roles filled by various personnel in the provision of healthcare services; identification of gaps in workforce data availability by profession and projected time periods needed to promote improved data collection and reporting; how roles have adapted to fewer in-person visits and more use of distance technology and ways in which changes are being influenced by regulatory and payment policies; redeployments, furloughs, and layoffs, among other work status changes for health care personnel across different settings during a pandemic and other emergency situations; and skills needed to use telehealth by the health workforce effectively in primary care.

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