For several years the impetus of the hospital and healthcare industry has been to shed labor. The dictates of the market and the tightening of the financial screws have meant that the institution's biggest budget line had to take a hit to keep the ship afloat.
With about 60% of the typical hospital's cost structure being labor, lots of bodies have been dumped overboard.
So it may come as something of a shock to hear that shortages of skilled labor could be on the horizon in 1998. We could be in for a repeat of the nurses shortage, and even scarier things besides . . . like anesthesiologists.
In many markets, especially those where unemployment is at 30-year lows, hospitals are scratching at the ground to find and retain low-skilled labor to work in laundry rooms, cafeterias and maintenance. Some hospitals are boosting wages and plumping up benefits to keep these positions filled.
On the registered nurse level, several years of layoffs and substitutions should be producing a glut of experienced, unemployed caregivers.
Not so, reports Geraldine Marullo, outgoing executive director of the American Nurses Association, who's sniffing the telltale signs of an impending shortage.
"I'm feeling those symptoms again," she says. "I've been in the business long enough; this is the third time I've been through it." Hospitals in the San Francisco Bay Area, the Twin Cities, Houston and San Antonio are hurting for the kinds of nurses they need. In New York and Washington, shortages are cropping up.
The unfolding shortage of anesthesiologists stands recent conventional wisdom on its head. About 1993 or so, it began to be perceived that the country had far more of these doctors than it needed. The word quickly filtered through the academic medical community to slow down the assembly line. Graduating medical students heeded the call and turned to other specialties for their residencies.
What all this means for hospital executives and human resources managers is chilling to contemplate. Reimbursements from payers are basically frozen and may even be headed down slightly in some markets. The supply and demand curves in the labor market are shifting. Wage demands could escalate across the board>