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Academic Health Center CEOs Say W …
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Created: Mon Jul 9 13:31:55 2007
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Academic Health
Center CEOs Say
W
orsening faculty shortages in academic
Faculty Shortages health centers are threatening the
nation's health professions educational
Major Problem infrastructure, according to chief executives of
academic health centers nationwide. Academic
By Michal Cohen Moskowitz health centers train a major portion of the nation's
health workforce in professions including allied
health, dentistry, medicine, nursing, pharmacy,
public health, and veterinary medicine. A crisis
looms: without enough faculty members to teach
the next generation of health professionals, the
nation's health infrastructure is in jeopardy.
Faculty shortages are In response to a questionnaire from the
Association of Academic Health Centers (AAHC),
threatening the capacity
94 percent of the 31 responding CEOs declared
of the health professions faculty shortages to be a problem in at least one
educational infrastructure health professions school. Sixty-nine percent of
CEOs said that these shortages were a problem for
the entire institution. CEOs were asked to rank
shortages on a scale of 1 "not a problem at all"
to 5 "very much a problem," with a rating of at
least 3 being considered "a problem."
Several factors account for the widespread
faculty shortages, including low level of interest in
academic careers among those entering the health
professions; heavy faculty workloads; sharp
disparities in salaries between academe and private
practice or industry; the cost of education and high
incidence of debt among graduates; and in the case
of nursing, late point of entry into faculty careers
(typically after long periods of clinical practice).
The aging of the Baby Boomer generation is
producing the perfect storm, as surging demand for
health care services will coincide with a wave of
retirements among health professions faculty,
posing a major threat to the capacity of the U.S.
health system overall and health professions
education in particular.
SHORTAGES ACROSS HEALTH
PROFESSIONS SCHOOLS
Faculty shortages in nursing were rated as most
severe. Eighty-one percent of CEOs declared
ASSOCIATION OF ACADEMIC HEALTH CENTERS
nursing faculty shortages to be a problem at their "Half of CEOs reported the need to
institutions, while forty-five percent of CEOs rated enact some kind of institutional
nursing faculty shortages most severely, as "very change, such as cutting programs,
much a problem."
merging programs, limiting student
Allied health ranked second to nursing in
enrollment, or implementing other
intensity of faculty shortages, with 77 percent of
CEOs declaring shortages to be a problem. Allied
changes."
health is an umbrella term for the dozens of
professions who work alongside other health because only four CEOs had veterinary medicine at
professionals in performing or assisting with nearly their institution. Nevertheless, there is rising
every type of health care service. Most frequently concern given the increasing need for protection of
cited were faculty shortages for physical therapy, the animal food supply against disease and
radiologic science, and clinical laboratory science. bioterrorism.
CEOs also cited faculty shortages for programs in
occupational therapy, rehabilitory counseling,
speech and language pathology, dental hygiene,
INSTITUTIONAL RESPONSE
and physician assistants.
Institutional responses to faculty shortages varied.
Of the academic health centers with pharmacy
Most alarmingly, half of CEOs reported the need to
schools, 71 percent of responding CEOs declared
enact some kind of institutional change, such as
faculty shortages to be a problem. Notably, most
cutting programs, merging programs, limiting
pharmacy schools are not in academic health
student enrollment, or implementing other
centers, so this figure may not be an accurate
changes. Other institutional responses included
reflection of faculty shortages in pharmacy schools
providing more on-line instruction, adding adjunct
in general. Nonetheless, an aging population with
faculty, assigning additional responsibilities to
rising co-morbidity, increasing use of prescription
faculty members, or seeking assistance from the
drugs, and the expanding role of pharmacists
community. Of all strategies cited by CEOs,
portend a need for more pharmacists and, in turn,
"limiting student enrollment" was the most
more faculty to teach them.
commonly reported, and was always listed in the
For medicine, 70 percent of CEOs declared
context of nursing. Some institutions that limited
faculty shortages to be a problem. CEOs noted
nursing enrollment also were forced to do so in
shortages in several specialties, most frequently in
allied health or pharmacy.
anesthesiology, internal medicine specialties A fifth of CEOs reported being forced to make
(particularly gastroenterology, oncology, and changes in the school of medicine due to faculty
rheumatology/geriatrics), pediatrics and pediatric shortages. Responses included cutting programs (in
subspecialties, radiology and radiological radiology or graduate medical education), merging
subspecialties, and surgery and surgical programs (including rehabilitory medicine;
subspecialties. Critically, most of those specialties pediatric pulmonary, allergy, and cystic fibrosis; and
provide services that are high in demand by older pharmacy and anatomy); and delaying expansion
patients, who will utilize the health system in of medical school class size and residencies.
higher numbers as the population ages. Faculty
shortages were least frequently cited in anatomy,
dermatology, otolaryngology, orthopedics, GOVERNMENT AWARENESS AND
pathology, psychiatry, rehabilitory medicine, and ACTION
urology.
Sixty-seven percent of CEOs with dental In light of the inextricable relationship between
schools and 55 percent of CEOs with public health faculty shortages and the health workforce, the
schools rated faculty shortages as a problem in AAHC asked its CEOs about government
FACULTY
those disciplines. This questionnaire could not engagement in these issues. CEOs expressed the
SHORTAGES
MAJOR accurately discern the prevalence of faculty need for greater government involvement in health
PROBLEM shortages among veterinary medical schools, workforce issues despite state governments' relative
2
ASSOCIATION OF ACADEMIC HEALTH CENTERS
lack of knowledge about the critical forces at play. urging heightened awareness and involvement
Fifty-four percent of CEOs rated governors as being from political leaders. Health workforce issues,
aware or very aware of health workforce issues, and including faculty shortages, pose a major societal
46 percent of CEOs rated state legislatures as being problem that should be given a higher priority on
aware or very aware. CEOs' rating of governors' the political agenda. More communication and
and legislatures' awareness of faculty shortages was collaboration between governmental and academic
even lower: 33 percent of CEOs rated governors as leaders will be needed in order to develop policies
being aware or very aware, and only 26 percent and programs that promote the development of a
rated state legislatures as being aware or very aware. pipeline of new health professions faculty and
Even as state governments lack sufficient sustain the educational infrastructure.
awareness of these problems, academic health The AAHC is a national, non-profit
center CEOs are seeking increased action by state organization dedicated to improving the nation's
and federal government leaders to address health health care system by mobilizing and enhancing
workforce concerns. Asked how much the the strengths and resources of the academic health
government should take action to help on center enterprise in health professions education,
workforce issues, 81 percent said that the state patient care, and research.
should take "much" or "very much" action, and 84
percent said that the federal government should Michal Cohen Moskowitz is a program associate at the
take "much" or "very much" action. Association of Academic Health Centers.
CONCLUSION
The responses of academic health center CEOs shed
light on an emerging national crisis. Faculty
shortages are already manifesting themselves as
visible crises across the health professions schools,
in allied health, dentistry, medicine, nursing,
pharmacy, and public health. As demonstrated by
widespread institutional responses to faculty
shortages, such as cutting programs or limiting
enrollment, the educational infrastructure for
health professions is being threatened. By
hampering the ability of academic health centers to
train a workforce that serves the country's health
needs, faculty shortages threaten to further
perpetuate looming shortages throughout the
health workforce, in both the private and public
sectors.
Academic health center CEOs perceive that
state governments are not yet fully aware of faculty
shortages and general health workforce issues, even
as the vast majority of those same CEOs desire
much or very much governmental action on the
health workforce. By their responses, CEOs are
"Academic health center CEOs are
seeking increased action by state and FACULTY
federal government leaders to address SHORTAGES
MAJOR
health workforce concerns." PROBLEM
3
VISION
To advance the nation's well-being
through the vigorous leadership of
academic health centers.
MISSION
To improve the nation's health care
system by mobilizing and enhancing the
strengths and resources of the academic
health center enterprise in health
professions education, patient care,
and research.
1400 Sixteenth Street, NW Suite 720
,
Washington, DC 20036
202.265.9600
202.265.7514 fax
www.aahcdc.org
For more information, contact
Michal Cohen Moskowitz
mcohen@aahcdc.org
© 2007 by the Association of Academic Health Centers