After all, to say that we’ll have a supply shortage is to say that wait times will be longer; with a workforce oversupply, wait times will be shorter. If APPs increase our productivity, we’ll have shorter wait times. More burnout? More time. Technological disruption? Less time. Generational shifts toward more work–life balance? More time. Increasing costs and HDHPs? Less time.
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June 2022We can also judge wait time across time periods: A two-week wait now is the same as a two-week wait 10 years from now. We can define time from the perspective of quality by more specific metrics of new patient availability or surgical wait times. We can assess time differences across regions and by practice type, thereby showing where job needs exist. Wait time allows for a clearer understanding of oversupply or undersupply. It means something on ground level; supply and demand metrics of 3.61 and 3.11 do not.
Wait time, however, speaks to only one quality of a workforce: access. Skillset use points to a different quality, that of bringing optimal care to the patient. If we’re training too many fellows, we’ll see this play out by declining skillset use by indicator cases over time. The ultimate prize for society would be transparent, uniform outcome data, with appropriate controls. Nothing, in my opinion, would inspire more quality improvement projects than that. But despite being armed with better metrics, we still need to think about how to bring these analyses together and also how to craft a more dynamic future workforce. And aside from my training and fellowship growth concerns, we should discuss another uncomfortable factor that molds our workforce in serious ways: competition.
Dr. Tompkins is a private practice otolaryngologist in Columbus, Ohio.