The wave of increasing hospital closures and service line cutbacks continues to sweep the U.S.
Explore This IssueACEP Now: Vol 42 – No 12 – December 2023
A recent article documents 56 additional U.S. hospitals that are closing clinical departments or ending or reducing services. Cited are issues of “shoring up finances,” “staffing shortages,” or “focusing on more in-demand services” as driving forces.1 This adds to the over 640 (mostly rural) hospitals that recently failed financial stress tests and are adjudged to be at imminent risk of closing.2
Of these 56 additional hospitals, many are not rural; thus, this specter is expanding. One of the chief reasons cited, again, is inability to obtain adequate numbers of doctors, nurses, and other health care workers to keep service lines open, and thus inability to generate adequate revenues to stay afloat.
Conditions in the Workplace
Over 20 percent of our health care workforce left health care in the last two years, and 10 percent of all practicing U.S. physicians quit in 2021 alone.3,4 This exodus is largely due to disintegrating conditions in many of our nation’s health care workplaces, conditions that include: marginalization, denigration, evolving oppositional attitudes that increasingly divide clinical workers and their administrations (“suits versus scrubs”), unobtainable and overwhelming workloads and administrative demands, increasing corporatization and private equity “sell-offs” of health care systems, increasing corporate boardroom isolation (by choice) from those who work clinically, almost no remaining health care corporate leaders with any clinical background, federal laws that increasingly prevent physicians and other clinically practicing leaders from participating in health care-system business decision-making, escalating moral injury, and accelerating unchecked violence against health care workers, all leading to increasingly toxic workplace conditions.5–13
Failures to Act
Health care has now been declared last for employee satisfaction among all U.S. industries, and the most dangerous of all U.S. workplace professions.14,15 There are pathways available to repair and correct these workplace issues, but our leaders have so far failed to act.
Thus unchecked, health care workplaces will continue to remain toxic, and more doctors, nurses and other health care workers will continue to exit, leading to increasing numbers of hospitals and facilities closing or cutting back on critical services, thus expanding the disintegration of health care delivery and the further decline of our whole health care system.
Disclaimer: Opinions expressed are the author’s alone, and do not necessarily represent views or opinions of the author’s employers or affiliates.
Dr. Severance is a clinically practicing physician, an educator, and researcher. He is a published author and national speaker on health care issues including pandemic and overall preparedness, healthcare workplace violence, and workplace/workforce disruptors. He provides advice and ‘mentoring’ to those facing issues and hardships within their healthcare workplaces.