The nation’s health care workforce, stretched to breaking point by the pandemic, is in crisis –at all levels. One study published in March 2022 revealed that one in five physicians intends to leave practice from heightened stress, with higher levels among primary care physicians, and that 44 percent of facilities had open positions for clinicians. The Association of Ameri-can Medical Colleges (AAMC) projects a shortfall of up to 139,000 physicians by 2033. The overall health care workforce has declined from its 2019 level. As of December 2022, physi-cians’ offices, outpatient care centers, home health services, and hospitals employed more people than in February 2020; however, given pre-pandemic trends, employment in these in-dustries is still below expected levels. Turnover is high in many health care jobs, from physi-cians to health aides, with health care workforce shortages peaking during the Omicron surge in January 2022 when 22 percent of all US hospitals reported critical staffing short-ages. As The Conference Board notes, among the sectors still suffering from labor short-ages, they remain particularly severe in the health care sector. The US recruits many nurses from abroad; yet the global shortage of nurses could reach 13 million by 2030.

All this is not surprising given the daily pressures health care workers have faced with little relief over the past two years. In the worst-case scenario, as health care workforce scholar and roundtable participant Dr. Bianca Frogner noted, as aides and assistants leave the health care sector due to competition from other industries, problems will “bubble up” to higher level workers; in particular, Registered Nurses, who will suffer without nursing assis-tants available to them, will act as a “canary in the coal mine” to the system.1 However, shortages and maldistribution of health care workers existed prior to the pandemic, for instance in primary care, psychiatry, and behavioral health, as well as in certain regional geographies. Nursing provides an illustrative case. One study from 2016 forecasted a short-age of 154,000 Registered Nurses (RNs) by 2020 and of 510,000 by 2030, with states in the South and West facing higher risk than those in the Northeast and Midwest—one important driver of the shortages—expected retirements of nurses.

Similar shortages are estimated for physicians, with pre-pandemic estimates pointing to a gap of up to 124,000 physicians by 2033, split between shortfalls of between 17,800 and 48,000 primary care physicians and between 21,000 and 71,100 specialty physicians. A more recent 2021 report focused on lower-wage critical health care occupations—medical assistants, home health aides, and nursing assistants—estimated the total shortage among those workers in 2026 to be up to 3.2 million. Limitations on the availability of training have constricted the pipeline for health workers, particularly in nursing. In 2020, the American As-sociation of Colleges of Nursing reported that more than 80,000 qualified applicants were not accepted at nursing schools, due to shortfalls in clinical sites and faculty.