Care delivery models of today rest on the idea that clinicians will continue to work as they have for generations — for long hours, often on call and unpaid for their documentation and for training new physicians and nurses. Meanwhile, health care workers have been raised on the idea that work-life balance is important. Often mission-driven, they want to see better outcomes and experience for their patients, and for themselves.
To better understand the drivers of health care workforce shortages, uncover leading practices and hear from frontline clinicians, EY teams conducted more than 100 in-depth interviews in 11 countries with health system executives and clinicians. The clinicians were health care workers who had daily responsibilities to care for patients, including physicians, nurses, nurse practitioners and allied health workers.
The clinicians interviewed for the EY Global Voices in Health Care Study 2023 (pdf) identified in detail the top factors causing them to consider leaving the profession: lack of autonomy or control (cited in 42% of responses), burden (38%) and moral injury and concerns about patient safety (27%).
A disconnect between clinician and health system perspectives
As they were confronting a crush of extremely ill patients, financial challenges and skyrocketing labor costs, health system executives tended to focus on pay in their response to the shortages (39% cited this approach), making sure clinicians were practicing at the top of what their license enabled (33%), providing education pipeline initiatives (33%) and wellness benefits (22%).
Some clinicians said in interviews they appreciated the increased focus on mindfulness and mental health, but when asked how the health system needs to change in the future, the top changes cited were: more preventative care, better staffing ratios and better flexibility.
Clinicians in several countries shared stories of not being able to get the care they believed their patients needed, and then seeing them cycle through the health system ineffectively, without addressing the root cause of disease or preventing crisis.