Citing pressures that could lead to a "dissolution of the health professions," the National Academy of Medicine is calling for a comprehensive response to strengthen the well-being of the U.S. health care workforce. NAM lays out its vision for that response in a newly published plan that touches on everything from addressing overuse of prior authorization and burdensome productivity standards to destigmatizing mental health care and increasing racial and ethnic diversity among health care providers.
The National Plan for Health Workforce Well-Being is the product of an effort that began in 2017, when NAM convened what it calls an Action Collaborative on Clinician Well-Being and Resilience. According to the report, burnout and lack of support across the health care workforce were already alarmingly high when the collaborative began its work. The pandemic intensified the problem, the report states, introducing more intense levels of "extreme mental and physical fatigue, isolation, and moral and traumatic distress and injury."
"We cannot witness and not act, as our health workers continue to sound the alarm for reprieve from the multitude of stressors that have strained and drained our health workforce," NAM writes. "Immediate and sustained action to address health worker burnout and improve well-being is imperative to ensure that the United States has a health workforce that can support our population now and in the future."
The report is organized around seven calls to action:
- Create and sustain positive work and learning environments.
- Invest in measurement, assessment, strategies, and research.
- Support mental health and reduce stigma.
- Address compliance, regulatory, and policy barriers for daily work.
- Engage effective technology tools.
- Institutionalize well-being as a long-term value.
- Recruit and retain a diverse and inclusive health workforce.
NAM offers a list of issues that it believes should be addressed within each of the seven areas, with the needed actions often involving multiple players. Among the changes the report advocates: well-being onboarding programs for students in health professions education programs, "reasonable productivity expectations," reductions in non-patient-contact time, elimination of prior authorization requirements "if validated clinical decision support tools are used," and adequate time-off policies.
In many ways, the NAM report echoes an advisory issued by U.S. Surgeon General Vivek Murthy, MD, MBA, in the spring of 2022. Like the NAM plan, the advisory calls for a comprehensive strategy — what Murthy calls a "whole-of-society approach" — that involves payers, health care IT, education programs, health care workers, and communities.
Both reports are consistent with earlier APTA efforts. The association made provider self-care a central focus of its centennial programming in 2021 by way of its Fit for Practice initiative that offered free resources on movement, resiliency, restoration, and practice health.