Perspective from Andrew Limouris, President & CEO, Medix
What is the worst thing that can happen when staffing shortages delay preventive care? Before you answer, think about four healthcare services that live under the umbrella of “preventive:”
- Elective surgeries
- Well-child visits
- Vaccinations
- Emergent surgeries for medical issues such as appendicitis, cardiac events, and traumatic injuries
You probably knew the answer as soon as you read the question: Preventive treatment delayed for any reason can cause serious harm, even death.
Major Contributors to Staffing Shortages and Preventive Care Delays
The lingering effects of COVID-19 are a major force behind current delays in preventive healthcare. The reason for this is the massive federal government-mandated shutdown of preventive care that was necessary to maximize COVID response and curb viral spread. Even people with serious health conditions and/or in need of surgery had their procedures postponed. Already lower nurse staffing levels complicated matters further. Now that preventive care services have resumed, the healthcare system is scrambling to catch up and keep up.
Those pre-pandemic nurse shortages already challenging healthcare readiness due to factors that included burnout, were driven through the roof by COVID. This 2023 study shared by the National Institutes of Health (NIH) showed that 91.1 percent of nurses experienced “high levels of burnout.” Physicians were and are affected by burnout, too. Surgeons, for instance, still face backlogs of deferred procedures.
Another 2023 study shared by NIH, concluded that COVID raised burnout among surgical residents and cited the administrative burdens of workflows, documentation and challenges of electronic health records (EHR) as key stressors.
Preventive Care Delays Affect Children Too
The American Academy of Pediatrics (AAP) reported that the pandemic caused marked drops in well-child visits, sparking delays in preventive pediatric care such as well-child visits and the services typically included during them.
Identification of health conditions where early intervention is advised was drastically impeded by COVID and staff shortages. In May 2023, the Centers for Disease Control warned that “these disruptions may have long-lasting effects due to delays in identification and initiation of services.”
Here are some health issues that qualify children for early intervention services:
- Autism
- Blindness or vision trouble
- Cerebral palsy
- Delayed movement skills
- Deafness or hearing trouble
- Down syndrome
- Sensory and behavioral delays
- Speech/language delays
Just What Does Elective Mean?
Determining if a surgery qualifies as elective is generally the job of the patient’s physician. According to Johns Hopkins Hospital, “An elective surgery does not always mean it is optional. It simply means that the surgery can be scheduled in advance. It may be a surgery you choose to have for a better quality of life, but not for a life-threatening condition. But in some cases, it may be for a serious condition such as cancer.”
A post on the Susan G. Komen website, which offers information about breast cancer, explains it this way, “Surgery (in the form of lumpectomy or mastectomy, and often with lymph node surgery as well) remains an important component of breast cancer treatment.
However, it can often be postponed without compromising the patient’s outcome. One strategy to safely postpone surgery involves treatment with chemotherapy and/or special breast cancer-fighting pills, which can be delivered for several months prior to the surgical management.”
Preventive Healthcare Delays Can Hurt Some People More Than Others
Many people, including medical sociologists, express concern that women, the uninsured, people with chronic illnesses, the LGBTQIA+ community, and others are more likely to have their healthcare needs wrongly deemed elective. This can impact many aspects of their health, perpetuate stigmas, and marginalize them further.
Delayed preventive care can dramatically lessen quality of life, as some patients continue living with pain, discomfort, and stress until their conditions can be more fully addressed.
Reducing the Impact
The pandemic and staffing shortages make it imperative to remove obstacles to preventive care wherever possible. A new system is needed to prioritize medical procedures, eliminate confusion over words like “elective,” and tear down care inequities that compromise the health and dignity of people from underrepresented groups.
A Vox article by medical sociologist Andréa Becker describes a proposed change that would determine patient care priority by levels, calling it “…a tiered framework, which would group different types of care based on varying degrees of urgency.” The article listed those tiers as “emergency, intermediate urgency, and routine.”
Staffing organizations like Medix can join arms with healthcare systems to bolster staffing. Placing local nurses who already know the community into long term roles where they can adapt to policies, procedures and other characteristics of individual hospitals, will combat the high costs of travel nurse agencies and lighten the physical, mental, and emotional burnout that is so prevalent right now.
And still we can do more, including adopting more of the technologies that lighten nurse workloads and streamlining nursing education, making the process faster without compromising standards.
Of course, it’s vital that we make work environments safer through concerted efforts to improve our mental health system and by passing laws to better protect hospital workers from violence. We must do everything possible to incentivize healthcare professionals through signing bonuses and compensation packages that better reflect the effort, thought, and heart demanded of these professionals, and we need to find fresh approaches to scheduling and task assignments.
Healthcare staff shortages will likely worsen before they improve, but I believe that innovative approaches like these will curb that trend and set our healthcare system on a path to readiness and sustainability.
