Introduction to Rural Hospital Staffing Challenges
By Natalie Krebs, Iowa Public Radio, KFF Health News
Even by rural hospital standards, Keokuk County Hospital and Clinics in southeastern Iowa is small. The 14-bed hospital, in Sigourney, doesn’t do surgeries or deliver babies. The small 24-hour emergency room is overseen by two full-time doctors. CEO Matt Ives wants to hire a third doctor, but he said finding physicians for a rural area has been challenging since the COVID-19 pandemic. He said several physicians at his hospital have retired since the start of the pandemic, and others have decided to stop practicing certain types of care, particularly emergency care.
The Pandemic’s Impact on Healthcare Workforce
Another rural hospital is down the road, about a 40-minute drive east. Washington County Hospital and Clinics has 22 beds and is experiencing similar staffing struggles. “Over the course of the last few years, we’ve had not only the pandemic, but we’ve had kind of an aging physician workforce that has been retiring,” said Todd Patterson, CEO. The pandemic was difficult for health workers. Many endured long hours, and the stresses on the nation’s health care system prompted more workers than usual to quit or retire.
Shortage of Medical Providers
“There’s a chunk of workers that were lost and won’t come back,” said Joanne Spetz, who directs the Institute for Health Policy Studies at the University of California-San Francisco. “For a lot of the clinicians that decided and were able to stick it out and work through the pandemic, they have burned out,” Spetz said. Five years after the World Health Organization declared COVID a global pandemic and the first Trump administration announced a national emergency, the United States faces a crucial shortage of medical providers, below the projected need for an aging population. That could have lasting effects on care, particularly in states like Iowa with significant rural populations.
Physician Shortage in Iowa
Keokuk County Hospital has 14 beds, which makes it one of Iowa’s smaller hospitals. (Natalie Krebs/KFF Health News/TNS) “Some of them made it through COVID like ‘Let’s get us through this public health crisis,’ and then they came out of it saying, ‘OK, and now? Now I’m exhausted,’” said Christina Taylor, president of the Iowa Medical Society. “Iowa is absolutely in the middle of a physician shortage,” Taylor said. “It’s a true crisis for us. We’re actually 44th in the country in terms of patient-to-physician ratio.”
Burnout and Nursing Shortages
A 2022 survey by the Centers for Disease Control and Prevention found a significant jump in health workers who reported feeling burned out and wanting a new job, compared with 2018. The number of people in health care has grown since the start of the pandemic, said Janette Dill, an associate professor at the University of Minnesota’s School of Public Health, but the growth has not happened fast enough. Keokuk County Hospital needs three physicians to staff its emergency room but has just two. (Natalie Krebs/KFF Health News/TNS) Some of that can be traced to the pandemic, said Sara Bruns, nurse manager at Keokuk County Hospital and Clinics.
Retaining Healthcare Workers
Policymakers and health care organizations can’t focus only on recruiting workers, according to Janette Dill at the University of Minnesota. “You also have to retain workers,” she said. “You can’t just recruit new people and then have them be miserable.” Dill said workers report feeling that patients have been more disrespectful and challenging since the pandemic, and sometimes workers feel unsafe at work. Research has shown health workers reporting higher levels of burnout and poor mental health since the pandemic — though the risks decreased if workers felt supported by their managers.
Conclusion
The COVID-19 pandemic has exacerbated the shortage of doctors and nurses in rural hospitals, particularly in states like Iowa with significant rural populations. The shortage of medical providers could have lasting effects on care, and policymakers must address the issue by investing in training doctors and retaining healthcare workers. It is crucial to support healthcare workers to prevent burnout and ensure they can provide quality care to patients.
FAQs
Q: What is the main challenge faced by rural hospitals in Iowa?
A: The main challenge faced by rural hospitals in Iowa is the shortage of doctors and nurses, particularly after the COVID-19 pandemic.
Q: How has the pandemic affected healthcare workers?
A: The pandemic has caused burnout, stress, and fatigue among healthcare workers, leading to early retirement or a change in career.
Q: What is being done to address the shortage of medical providers?
A: Policymakers are introducing bills to increase medical student loan forgiveness and requesting federal help to add residency training slots for medical students.
Q: How can healthcare workers be retained?
A: Healthcare workers can be retained by providing a supportive work environment, addressing burnout, and ensuring their safety at work.
Q: What is the projected outlook for the nursing workforce?
A: The projected national outlook for the nursing workforce is not as dire as in recent years, but getting nurses to move to rural areas remains a challenge.
