Technology Versus Human Workforce

By Eric Rodgers, Director of Respiratory Care, WVU Medicine Princeton Community Hospital

Healthcare continues to evolve daily. Technology continues to make the lives of healthcare workers and patients feel better about the testing process. Technology has given doctors, nurses, and other healthcare technologists the opportunity to better diagnose patients correctly. However, profitability has created a training rut. Healthcare systems rely on profits to continue to provide care for patients, purchase equipment for a more complex healthcare system, and rely on those employees to optimize that equipment. Many healthcare equipment providers are providing equipment that require teaching and training. When that equipment is purchased initial training is provided and sometimes, they will return to continue training to assure that everyone is fully operating the equipment. There are possibly two problems with that type of organization. First, with the shortage of educated and licensed staff, hospitals rely on people to work a lot of overtime or utilize travelers. Travelers are expensive and administration want to minimize their use due to it not be a successful business plan. Second, hospitals often do not have the financial resources to continue to train staff annually.

Finding the budget to include annual training has become a hard sell for department directors with administration. Budget lines have become hard to achieve the goals that financial departments often set without including the directors who manage those areas. Part of this issue revolves around reimbursement for the testing. Today, many companies who are providing new equipment with improved technology do not work with hospitals to provide updated CPT numbers to receive reimbursement. Like many things that are phased out in healthcare because it has become too expensive to justify, healthcare equipment companies want to entice directors with purchasing the equipment without any relationship to reimbursement for testing. This did not happen quickly but slowly over time. There was a time that no department director would contemplate purchasing new equipment without understanding the reimbursement to pay for that equipment. Now many hospitals are implementing that equipment and wondering how to implement a new CPT through CMS. I recently purchased a new equipment that has had amazing results. The equipment has improved patient outcomes drastically and shortened the length patients must stay in the hospital. These are the fundamental outcomes that CMS looks for when reimbursement is requested. When articles get published and trash how hospitals react to the complexity of today’s healthcare, they never look at the companies that provide that very expensive equipment and little support to reimbursement. The administration team still need to manage healthcare like a business because it is a business.

It is impossible to list all the issues with healthcare. Healthcare is a complex business with many moving parts and is designed to not be profitable.

I generally do not hear people complaining about purchasing the latest cellular device or upgraded computer or video gaming device. The people who create those video games or write the code to drive different programs within the cell phone or computer get paid very well. Salaries in healthcare have not kept up with inflationary demand annually. I worked at a hospital system and did not receive a raise for over three years, and last year I received a meager 3% raise despite inflation increased over 3.5% from 2023 to 2024 depending on your resource. With that salary structure why would anyone want to be eager to join healthcare. Maybe we could look at the nursing, respiratory, and radiology shortage centered around salaries. I have a difficult time blaming administration at every hospital with this issue. Instead, we should look at this staffing difficulty as a system issue. Recently, healthcare professionals have been enjoying increasing salaries by working with traveling companies. I do not blame these healthcare professionals by enjoying this opportunity that COVID created and does not appear to be changing soon. Healthcare professionals want to be trained and challenged to provide improved diagnosing and outcomes for patients. Doctors are being asked to diagnose and treat more complex patients daily, and without the professionals to provide that testing for them to evaluate eventually makes healthcare more expensive for everyone. Healthcare systems cannot effectively manage budgets under traveling healthcare professionals increasingly growing salaries without effective reimbursement. Without effective reimbursement there will not be a budget for effective training those professionals annually. When testing does not get performed correctly the first time and must be repeated, healthcare cost rise to the patient and insurance companies. The overall structure of healthcare needs a revival and a significant change.

It is impossible to list all the issues with healthcare. Healthcare is a complex business with many moving parts and is designed to not be profitable. Healthcare is also one of the most government regulated business in the country. Prioritizing what needs to be fixed first and how to improve the situation could be debated for years. Once those people in place figure out how to fix that problem, the complexity of that problem has changed, and their suggestion will no longer be the answer. Instead, hospital administrators will continue to try to survive the complexity of healthcare while answering to communities wanting to see positive change for patients. The shortage of healthcare professionals will continue to grow, and patient outcomes will possibly suffer under this crisis. Insurance companies who operate under a “for profit” business plan will continue to trade well under the stock market and those company employees will enjoy good salary and annual bonus. Doctors, nurses, and other healthcare professionals’ national shortage will continue to be a crisis. Rural community hospitals will need to continue to rely on paying these professionals through traveling contracts. Further reducing budgets that could be used for training and new equipment. Healthcare will always be a people business. The darkness of COVID revealed that investing into training and paying healthcare workers should be at the top of any list when it comes to healthcare. Recruiting talented people to operate complex equipment and manage the needs for patients should be the number one priority in healthcare.