On a recent trip to Los Angeles, my plane circled out over the water to land from the west. There below was the picture behind the headlines – about 65-70 container ships anchored off the port, waiting to get waved in to unload. Thousands of stuffed animals from China and techno-gizmos from Taiwan, doing nothing but accumulating cost day by day.
Kids, unless you are getting some Bitcoin for Christmas (no, son, mom and I are not giving you a bitcoin in your stocking), inflation is going to take a bite out of what is under the tree this year.
It is not just consumer goods that are affected. In recent Q3 earnings calls, multiple healthcare equipment and device manufacturers cited ‘supply chain issues’ impacting the quarter and their future outlook.
But there is another part of the healthcare supply chain that is a bigger worry, one that is not going to get fixed anytime soon, even if the President magically kept the Port of LA open 30 hours a day.
We are about to experience a real and significant provider shortage…doctors and nurses. This type of thing has been forecasted for years based on simple demographics. This population, aging at this rate, needs that many providers and we just are not producing enough. And those we are pushing out of the educational and training pipeline are not properly distributed across specialties and geographies.
We have known that we are facing a large wave of coming nurse retirements. A young nurse who graduated in 1982 is now over 60. Yes, yes, I am good at easy math. But after the past two years, even the 40-somethings are fried. Many physicians feel the same way, contemplating hanging it up early out of sheer exhaustion. Thank you COVID.
The short-term solution to the problem is making the long-term problem worse. Many healthcare organizations, desperate for help, are turning to locum tenens physicians and traveling nurses. They have no choice – there is not a crate full of these folks off the coast of California that will be unloaded in a week or so. But the premium being paid to those who step in to help means that many providers are now signing up for the gig approach permanently.
One surgeon, on his way to cover the ER in a small town for a four-day weekend shift, told me he could do this twice a month and make what he made in his regular practice. Technically, he has not retired, but we lost 60% of his capacity. Traveling nurses are making the same calculation. Multiply that by several thousand providers – no shame on them for making their own best decision – and it starts to show up.
An argument against single-payer healthcare has been to point to the wait times in places like Canada. We are about to get to experience that directly.
Christmas greetings from Scrooge, huh?