Labor shortage or opportunity surplus?

As computers replace paper in the health care system, hospitals and physician groups are having a hard time recruiting skilled technical staff. From today’s Boston Globe (Hospitals’ move to e-files spurs a labor shortage)

[S]hortages of qualified personnel in healthcare information technology, [said Massachusetts eHealth Collaborative CEO, Micky] Tripathi, “are acute at almost every level.”

John Glaser, vice president and chief information officer for Partners HealthCare, the largest hospital network in the state and the parent corporation for big Harvard Medical School teaching institutions, said the lack of skilled people is slowing projects and forcing Partners to turn to expensive outside consultants.

Northeastern University is launching a graduate program in clinical IT. Framingham State College is considering offering a certificate program.

It’s a bit ironic that the bottleneck for automation is labor.

My economics training taught me to be suspicious of the term “shortage.” There’s no doubt that health care providers are having trouble filling their open positions and that demand is growing, but there can be other explanations for this besides the absence of qualified people.

Think of it from the perspective of a job candidate who has all the qualifications an employer seeks. Rather than taking a hospital job, he (or in rare cases she) may prefer:

  • Working for a private company that provides financial upside through stock options
  • Being an “expensive outside consultant” who enjoys the variety of moving from job to job

Instead of a shortage, the candidate may see a variety of opportunities, some of which are more compelling than others.

The situation as Glaser and Tripathi describe it is likely to persist, regardless of what Northeastern and Framingham State do. So what are the implications for talent seekers?

  • We advise our provider clients to work with IT vendors that are successful and growing. Those vendors are in a good position to hire and retain highly qualified and motivated technical staff. In negotiating contracts, it’s also important to devote ample time to working out the support arrangements and naming specific individuals where feasible. It’s more important than squeezing out the last financial concession
  • Hospitals and other providers can emphasize the benefits of working for them compared to private industry. This may include less travel, a more predictable schedule, and a more family-friendly environment
  • When embarking on IT programs, place a strong emphasis on solutions that require less technical support. It’s easier said than done but not impossible
  • Be open to off-shoring of technical skills, and working with an organization that is able to provide training to its employees to help them understand the US health care context

From a public policy standpoint, it also makes sense to support liberal immigration laws.

May 14, 2007

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