BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Morgan Stanley named Eli Gross and Simon Smith as new global co-heads of investment banking, as part of a leadership shakeup at the top of one of Wall Street’s most powerful deals advisory group. The current investment banking heads, Mark Eichorn and Susie Huang were elevated to executive chairs of the division to lead a newly formed group of senior bankers, according to an internal memo seen by Reuters.
The U.S. Bureau of Labor Statistics will release June data from the closely watched Consumer Price Index (CPI) today, which tracks the prices of a basket of daily goods and services. Investors use the CPI as one way to measure inflation, which has hit a 40-year high this year and forced the Federal Reserve to become increasingly hawkish in terms of monetary policy. While CPI data comes out every month, the reading will be watched more closely than normal, as are the current high levels of inflation.
America has decided the pandemic is over. The corona virus has other ideas. The latestomicron offshoot, BA.5, has quickly become dominant in the United States, and thanks to its elusiveness when encountering the human immune system, is driving a wave of cases across the country. The size of that wave is unclear because most people are testing at home or not testing at all. The Centers for Disease Control and Prevention in the past week has reported a little more than 100,000 new cases a day on average. But infectious-disease experts know that wildly underestimates the true number, which may be as many as a million, said Eric Topol, a professor at Scripps Research who closely tracks pandemic trends. Antibodies from vaccines and previous coronavirus infections offer limited protection against BA.5, leading Topol to call it “the worst version of the virus that we’ve seen.”
This “Guide to Travel Nursing Jobs” presents data obtained from a nationwide information database of travel nurses including motivational factors in choosing a travel nurse career, age demographics, benefits information, and social media usage.
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In addition, the guide highlights the salary info for travel RNs as well as a timeline of the travel nursing process.
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Conclusion
My how things have changed post pandemic. Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
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“Uberization” is a catchphrase that has quickly become part of common parlance in discussions about the pandemic-induced economy. Uberization is the movement by organizations to “replace fixed wage contracts with ‘dynamic pricing’ for labor” (Davis, & Sinha, 2021). It is transforming many elements of the economy and replacing employees employed by the organization with a type of self-employed or contract employee. In essence, it allows businesses to “recruit labour at a large scale in new ways” (Davis, & Sinha, 2021).
The global business community has had a range of responses to the trend of uberization (Babali, 2019), as has the healthcare industry in particular. Yet as health systems emerge from the pandemic, Bloomberg reports that “the ongoing elevated costs of [healthcare] workers are causing profit warnings” (KHN, 2022; Court, & Coleman-Lochner, 2022). Regardless of one’s resistance or acceptance of uberization, healthcare employment is in crisis. Change must occur to keep health systems from financial disaster.
It seems that the tide of uberization in the healthcare industry is already rising. An increasing number of employees are contracting with hospitals and health systems via a staffing agency. This trend is likely to evolve, with a portion of staff employed directly by the hospital, and the remaining employees self-contracting with hospitals or health systems with short-term or even daily contracts. In fact, hospitals are reporting that rather than temporary “travel nurses” coming from other states to work on a contract basis, nurses are taking short-term contract work at hospitals a short drive from their own homes rather than pursue permanent employment with these organizations. We are witnessing the uberization of nursing, which will eventually extend to other healthcare occupations.
Why uberization?
The healthcare workforce shouldered the heavy burden of fighting the COVID-19 pandemic. Yet a collaborative study from Indiana University, the nonprofit Rand Corp., and the University of Michigan that analyzed the changes in the U.S. healthcare workforce during the COVID-19 pandemic found that “the average wages for U.S. healthcare workers rose less than wages in other industries during 2020 and the first six months of 2021” (Toler, 2022; Cantor, Whaley, Kosali, & Nguyen, 2022). According to a February 2022 report by the U.S. Bureau of Labor Statistics, only about 35 percent of healthcare and social assistance organizations “increased wages and salaries, paid wage premiums, or provided bonuses because of the COVID-19 pandemic” (U.S. Bureau of Labor Statistics, 2022).
Due to the media attention the “Great Resignation” has received, it is common knowledge that workers across industries have been leaving their jobs at higher rates than before the pandemic (Parker, & Horowitz, 2022). Yet by October 2021, when the “quit rates” were at their highest recorded levels, healthcare and social assistance job resignations had increased to 35% higher than they had been before the pandemic, slightly higher than the increase of resignations among all workers in the same period (29%) (Wager, Amin, Cox, & Hughes-Cromwick, 2021).
Over the last ten years, “the salary of registered nurses increased by 1.67 percent in the United States” (Michas, 2021). Whereas healthcare executives make on average eight times more than their hourly employees (Saini, Garber, & Brownlee, 2022). The pandemic has rebalanced the scales in favor of those underpaid for many years. The salary landscape has changed, and in response many hospital systems blindly grasp to the pre-pandemic state of agency staffing. This, combined with near flat salary increases, contribute to the uberization of healthcare.
For many healthcare professionals, the combination of work-related stress and incommensurate compensation was the final straw. However, in addition to fair salary, flexibility has become a top demand of employees—even in healthcare. “Gone are the days when job security or pay was everything. Workers now are giving more thought to how their jobs fit into their lives. Ambition for ambition’s sake is being reassessed” (Buckingham, & Richardson, 2022).
A recent survey articulated “higher pay and dissatisfaction with management were also key drivers of nurses changing work settings in 2020 or 2021,” with 28% of respondents saying they’ve changed work settings (Lagasse, 2022). The percentage of nurses considering changing employers increased by 6% from 2020 to 2021, with 17% saying they are contemplating making an employment change. The percentage of nurses who are “passive job seekers – not actively looking for a new job but open to new opportunities – also increased, from 38% in 2020 to 47% in the current survey” (Lagasse, 2022).
The moment: contractor or non-contractor
As the trend of uberization continues to spread beyond the transportation industry, the global business community should be watchful of challenges that the trendsetter Uber is facing to understand future implications of this movement in their own industry. For example, recent legal battles regarding the employment status of Uber drivers will likely impact the cost-benefit analysis of those considering traditional employment or independent contracting. While an independent contractor is free to offer services to anyone and doesn’t have the limits on their freedom that comes with being an employee of a single organization, the U.S. National Labor Relations Board decision that Uber drivers are independent contractors means that drivers have no federal right to unionize (HyreCar, 2021; Fishman, 2020). In Europe, however, Uber drivers are considered employees and not independent, which could mean that unionization could occur en masse.
The future
The future of healthcare employment could be via an app on smart phones. Imagine: daily staffing supplemented by workers employed and credentialed through the app. The healthcare worker could choose their rate and shifts, and the hospital could determine the desired experience, quality, and patient experience reviews for the open position. It could shift the future of employment healthcare significantly.
The rate of change in today’s workplace is accelerating whether it is through the uberization of healthcare workers or advancements in workers’ rights. A recent New York Times article entitled “The Revolt of the College-Educated Working Class” states: “The support for labor unions among college graduates has increased from 55 percent in the late 1990s to around 70 percent in the last few years, and is even higher among younger college graduates” (Scheiber, 2022).
This may have a ripple effect on the healthcare workforce. Years of stagnating salaries and organizations’ undefined workforce vision has primed the industry for action with record job-quits within healthcare. This has proven especially true in rural markets where recruitment of permanent and agency staff has posed numerous challenges. Our current climate potentially opens the door for workers to leverage themselves via the advocacy of a union.
Summary
The labor supply and demand are out of balance. The long-term effects on the health sector labor market from the pandemic are unknown, but changes in healthcare delivery (such as the growth of telehealth) may lead to lasting shifts in the healthcare industry. Fierce competition for healthcare workers means that employers must go beyond good pay and benefits to attract the best candidates. Healthcare recruitment is a zero-sum game. There isn’t a pool of healthcare workers lying idle, and so recruitment is often at the cost of a competitor. The employee knows that this demand exists, and this could further drive the uberization of healthcare workers. However, there is potential for this new movement to benefit both parties. As limited number of employees equates to skill scarcity which drives salaries, hospitals could utilize their skilled workforce based on need and demand.
Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group”. It is an approach to health that aims to improve the health of an entire human population or cohort. http://www.HealthDictionarySeries.org
History
In fact, the nominal “father of population health” is colleague and Dean David B. Nash MD MBA of Jefferson Medical School in Philadelphia. And, although I attended Temple University down the street, David still wrote the Foreword to my textbook years later; Financial Management Strategies for Hospitals and Healthcare Organizations [Tools, Techniques, Checklists and Case Studies].
Now age, income, location, race, gender and education are just a few characteristics that differentiate the world’s population. These are called ”disparities” and they have a major impact on people’s lives; especially their healthcare. And, I’ve written about them before. Perform a ME-P “search” for more.
So, it’s only natural that we’re keeping an eye on two major demographic trends: aging baby boomers and maturing Millennials [1982-2002 approximately].
Why it’s important
The impact of large population shifts propagate throughout an economy benefitting certain sectors more than others and influencing a country’s growth prospects; tantalizing investing ideas?
Example:
For example, as baby boomers retire, we’ll likely see higher spending on health care, but less on education and raising children. Likewise, tech-savvy Millennials will likely prioritize consumption on experiences over cars and houses [leading economic indicator].
So, can we profit from these trends?
Assessment
Well maybe – maybe not! Overall economic prospects may not be completely affected by these trends. Spending habits on combined goods and services will shift, rather than rise or decline.
So, be careful. What matters most for your investment success is your demographics and investing according to your personal circumstances and goals [paradox-of-thrift].
Conclusion
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
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Due to the media attention the “Great Resignation” has received, it is common knowledge that workers across industries have been leaving their jobs at higher rates than before the pandemic (Parker, & Horowitz, 2022). Yet by October 2021, when the “quit rates” were at their highest recorded levels, healthcare and social assistance job resignations had increased to 35% higher than they had been before the pandemic, slightly higher than the increase of resignations among all workers in the same period (29%) (Wager, Amin, Cox, & Hughes-Cromwick, 2021). 
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