Out of Order, Out of Time: The State of the Nation’s Health Workforce

Source: Association of Academic Health, 2008

Out of Order, Out of Time: The State of the Nation’s Health Workforce is a report undertaken by the Association of Academic Health Centers (AAHC) to focus attention on the critical need for a new, collaborative, coordinated, national health workforce planning initiative. The report’s seven chapters include more than 40 findings that document what is “out of order” with respect to the nation’s health workforce, as well as the looming social and economic forces that leave no time for further delay before the problems get dramatically worse.

The report draws several broad conclusions from the detailed findings including:

• A broader, more integrated national strategic vision than our historic approach to health workforce policymaking and planning is needed if complex and urgent health workforce issues are to be addressed effectively.
• A new mechanism is needed to serve the currently unfilled integrative role that existing health workforce policymaking and planning processes are not designed, and are ill-equipped, to serve.
• It is critically important to act immediately to develop and implement an integrated, comprehensive national health workforce policy before intensifying health workforce needs outpace available resources, putting the U.S. at risk of losing its status as the global health care leader.

The report’s findings and conclusions offer compelling arguments that we are out of time to address what is out of order in our health workforce. Therefore, the report recommends that all public and private stakeholders work together to:

• Make the U.S. health workforce a priority domestic policy issue;
• Begin addressing national health workforce issues immediately to avert crises in national workforce capacity and infrastructure;
• Develop an integrated, comprehensive national health workforce policy that recognizes and compensates for the inherent weaknesses and vulnerabilities of current decentralized multi-stakeholder decision-making; and
• Create a national health workforce planning body that engages diverse federal, state, public and private stakeholders with a mission to:
• Articulate a national workforce agenda;
• Promote harmonization in public and private standards, requirements and prevailing practices across jurisdictions;
• Address access to the health professions and the ability of educational institutions to respond to economic, social, and environmental factors that impact the workforce; and
• Identify and address unintended adverse interactions among public and private policies, standards, and requirements.

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