Category Archives: Healthcare Workforce

3 Medical Specialties That Need Trained Providers

Nationally, there is a practitioner shortage and healthcare needs are increasing.  Between 2014 and 2024, the need for physicians and surgeons is projected to rise 14%.  The need for physician assistants will grow 30%, and nurse practitioners will increase 31%.  Simultaneously, almost 40% of the American population (i.e. the Baby Boomer generation) is aging and increasing the demand on the current healthcare system.  Political uncertainty about the future of the Affordable Care Act and a future replacement are beginning to drive changes within the industry.

Empty Hospital

Demand for trained medical providers has always been high, and continues to increase.  While specific demands will vary by region, here are some medical specialties that need providers in nearly every community.

Primary Care (including family medicine, internal medicine, and pediatrics)
Today’s healthcare system increasingly relies on the primary care provider to coordinate a patient’s care.  These providers write referrals to specialty care, and help patients navigate a complex healthcare system.  While the primary care provider role is critically important, communities in every state do not have enough providers.

According to information from the Health Professional Shortage Areas website, over 8,000 more primary care providers are needed to resolve the healthcare shortage areas in states across the country.   Some states have a greater need for primary care providers while other (smaller states) have a diminished need.  Primary care providers routinely take the first place title for the most important and sought after provider type.

Today, the demand for psychiatrists is huge.  Some experts suggest that psychiatry is the second biggest provider need behind primary care.  Other sources state that it’s the third biggest need.  Regardless, the shortage of (and demand for) trained psychiatrists is significant.

Although distressing now, the psychiatrist shortage will become more severe over the next decade. One study quoted in Forbes revealed that 60% of psychiatrists engaged in active patient care are ages 55 or older.  With many of these providers nearing retirement, needs in this field is projected to increase substantially.

Hospitalists are medical doctors who care for patients who are currently hospitalized.  They are aware of the unique aspects of a hospitalized patient’s stay, and are often more available than doctors who have other areas of practice.

With increasing demands on the healthcare system, the need for trained medical providers spans all specialties.  Although each source ranks the most in-demand roles differently, primary care providers, psychiatrists, and hospitalists are routinely needed throughout the system.

Continue reading >

Practitioner Shortages and Demand: a Summary

Today, some communities are already feeling the effects of the national shortage of trained medical providers. For example, in Josephine County, Oregon, there is only 1 doctor per 486 people. While most communities don’t have such dire numbers, many patients have to wait longer or travel further to get medical care. Regionally and nationally, communities and healthcare organizations are partnering together to take steps to ensure local access to care.

These six interesting facts begin to explain the complexities of provider shortages.

  • Fluctuating costs, technological advances, legislative changes, and an aging population all impact today’s healthcare system.Costs are frequently connected to advances in technology, insurance requirements, and legislative changes.As the Baby Boomer generation ages, the needs and demands placed on the healthcare system are systemically increasing.All of these factors have shaped today’s healthcare industry and impact the discussion of provider demands and shortages.
  • The Bureau of Labor Statistics projects that the need for physicians and surgeons will grow 14% percent between 2014 and 2024.
  • Between 2014 and 2024, the need for physician assistants will increase 30% and the need for nurse practitioners will grow 31%.
  • The United States Department of Health and Human Services tracks the provider shortage areas using the Health Professional Shortage Area (HPSA) database.This database tracks provider shortages in primary care, dental care, and mental health on a scale of 0-26.Lower scores indicate fewer shortages.Higher scores indicate increased shortages.
  • Some counties in Washington rank as high as 25 out of 26 on the HPSA scales.Most communities and states need more trained healthcare providers.
  • Primary care providers are routinely needed in every area of the country. Using HPSA data, the Kaiser Family Foundation identified primary care needs by state. Delaware had the fewest primary care HPSA areas with 9.California had the most with 607 primary care HPSA areas.Washington has 155 primary care HPSA areas.

Healthcare is rapidly changing and growing. Eventually, each community will need to address the issue of practitioner shortages. While there are national trends, each region will have a unique experience based on their individual factors. Understanding the shortages is an important first step to address provider demand and how organizations can recruit trained healthcare providers. Continue reading >

What Sets Correctional Medicine Apart

Correctional medicine staff provide medically necessary care to some of America’s nearly 2 million incarcerated people. This non-traditional health care environment has unique challenges that teach important lessons

The Patients Don’t Leave, So You Improve Communication Skills  
In traditional health care environments, patients and providers fire each other. Firings can happen for a number of reasons.  Maybe the patient disagrees with the provider’s recommendations.  Or perhaps the patient violated a care plan, and the provider announces that the patient needs to seek care elsewhere.  Regardless of the reason, patients in the outside world can often find new providers. In correctional medicine, patients are not free to seek care elsewhere.
Patients and providers will continue to disagree.  In correctional medicine settings, both parties need to find a way to move past it.  Providers will need to maintain boundaries while providing medically necessary care.  These are difficult conversations with a variety of factors to consider.  Yet these discussions will teach (and solidify) valuable de-escalation skills.

All the Patients Know Each Other, So You Practice Fairness  
In traditional health care environments, patients do not know each other.  There is no opportunity for patients to discuss their clinical experiences.  In correctional medicine, all patients share the same providers.  Given that, there is a much greater opportunity for patients to discuss their clinical experiences with each other.  Any provider that is perceived as doing a favor for one patient will be asked to do the same for others.  Correctional medicine providers need to ensure that they are treating all of their patients similarly.
Providers in correctional medicine have the chance to provide medical care to their patients without considering the person’s financial status (or their ability to pay.)  The opportunity to provide fair care is unique to correctional medicine because providers in traditional health care environments consider the impact and the importance of insurance payments dramatically.

Your Patients Are Always Around, So You Can Witness Daily Life and Disease Progression
A fascinating part of medicine is watching a patient’s daily life, and how their disease progresses. Often, health care providers in traditional settings only get to see snapshots of the patient’s progression.  So they mark the changes between today and the patient’s last appointment.  Although providers can surmise about what the patient experienced between appointments—they don’t know for sure.
Correctional medicine providers do not have to surmise.  Instead they get to witness aspects of their patients in daily life.  A few providers note that the correctional medicine environment gives them much more exposure to witness disease progression than they did in traditional settings.

Working in correctional medicine has a unique set of challenges and learning opportunities.  Correctional medicine may not be the right fit for everybody.

Correctional Facility Nursing. Minority Nurse, 7 February 2016, Accessed February 9, 2017.
Correctional medicine. Wikipedia, 2 June 2016, Accessed February 7, 2017.
Giang, Vivian. Jailhouse Doctor Shares What It’s Like To Care For The Most Dangerous People In the World. Business Insider, 20 March 2013, Accessed January 31, 2017.
Keller, Jeffrey. Correctional Medicine is Different: Our Patients Don’t Go Home!, Accessed February 7, 2017.
Keller, Jeffrey.  Correctional Medicine: The Principles of Fairness.,  Accessed February 7, 2017.
Keller, Jeffrey. Correctional Medicine is Different: All Clinical Encounters are Discussed in the Dorm., Accessed February 7, 2017.
Keller, Jeffrey. Correctional Medicine is Different: We Can’t Fire Our Patients-and They Can’t Fire Us!, Accessed February 7, 2017.

What is a Medical Assistant?

Throughout the healthcare industry, staff and providers rely on medical assistants for their versatile knowledge and skills.  Found in both inpatient and outpatient settings, medical assistants support patient care clinically and administratively.

Medical AssistantWhat is the role of a Medical Assistant?
Medical assistants are an important part of the healthcare team.  They work closely with providers to complete assigned patient care tasks, and responsibilities vary depending on organizational needs.  In smaller healthcare offices, medical assistants schedule patient appointments, coordinate referrals, obtain insurance authorizations, room patients, request medical records, and assist in recording patient information into charts.  In larger organizations, medical assistants may have a more narrow scope of responsibilities.  Specialized clinics may require that a staff member focuses on a specific skill set.

Medical assistants work in a fluid environment, and staff must quickly adapt to changing needs. Even if there are multiple medical assistants, they may have separate responsibilities. Some staff may be expected to master a complex set of circumstances—like working on a procedure team.  Other staff may be responsible for making sure that patients are promptly roomed and paperwork is completed.  All medical assistants are available to assist patients by answering questions and solving problems.

Generally, medical assistants can room patients, take vital signs, record patient history, prepare samples for the lab, and record medical information into charts.  As appropriate, medical assistants also help physicians with appointments.  These staff members are also usually responsible for communicating updates after the patient has been roomed.

What are the Washington State Requirements?
Medical assistants in Washington must be licensed through the Washington State Department of Health. To be eligible for licensure, applicants need to complete a medical assistant training program.  Candidates should have completed a program that is offered or accredited by the Accrediting Bureau of Health Education Schools (ABHES) or the Commission on Accreditation of Allied Health Education Programs (CAAHEP.)  Programs with local or regional accreditations can be counted as long as the accrediting organization is recognized by the U.S. Department of Education.  Candidates can also be eligible if they have completed an apprenticeship program administered by the state.
Candidates who have completed an appropriate program are eligible to sit for one of four certifying exams.

  • Certified Medical Assistant Exam through the American Association of Medical Assistants
  • Registered Medical Assistant Exam through American Medical Technologists
  • Clinical Medical Assistant Exam through National Health Career Association
  • National Certified Medical Assistant Exam through the National Center for Competency Testing

Additionally, candidates must also have completed high school, have proficiency in English, and complete HIV/AIDS training. Candidates must submit all required materials for review by the Washington State Department of Health.  After review, the department will follow up with the candidate about the status of their application.

How to Become a Medical Assistant. United States Department of Labor: Bureau of Labor Statistics: Occupational Outlook Handbook, 17 December 2015,  Accessed February 27, 2017.
Medical Assistants. United States Department of Labor: Bureau of Labor Statistics: Occupational Outlook Handbook, 17 December 2015,  Accessed February 27, 2017.
Medical Assistant—Certified or Interim Certification Requirements. Washington State Department of Health, Accessed February 27, 2017.

8 Simple Ways To Recognize Your Employees

Employee recognition programs are designed to make it easier for managers to acknowledge staff successes. By praising accomplishments, these programs aim to retain employees. When someone leaves a job, it costs the business between 16-200% of the employee’s salary to fill the vacancy.  These replacement costs are tied to the employee’s salary, which means that the highest earners are harder to replace.  Since recognition is a helpful way to minimize turnover, here are some ideas to help managers recognize their employees.

  1. Ask new employees how they prefer to be recognized and what they like to do outside of work. Record this information in their employee file.When it is time to recognize this employee, choose a method that’s consistent with what they originally told you.Other options—while appreciated—may be less impactful.
  2. Verbal recognition:  Simply saying thank you is a great start.  Then take the time to specifically describe the positive impact of their work.
  3. Verbal recognition with an audience:  If an employee’s actions positively impacted the larger organization, announce their success at a meeting.
  4. Written recognition:  Writing a card or email to an employee gives them the opportunity to revisit the kind words later.
  5. Gift:  There are a lot of possibilities here.  Some managers have gift cards and movie tickets.  Other organizations offer branded items (like reusable shopping bags and water bottles) for managers to give away for recognition reasons. If recognition items are not provided by an employee recognition program, there may be room in the budget to purchase items to have on hand.
  6. Time off: People love getting extra time off, whether it’s the day or simply the afternoon.
  7. Free meal:  Everyone loves a free meal.  Before offering this option, determine the employee has any dietary restrictions.  Pick an appropriate place and take your employee to lunch.
  8. Meetings with executive level managers: This option can only be offered if the organization’s highest leaders are dedicated to spending time with employees.  Since this is not true for many leaders, it is important to determine this prior to offering to an employee.

Recognition programs were created to foster an appreciative workplace that celebrates successes.  After all, retaining employees is easier than replacing them.  There are countless ways to recognize employees.  Use these 8 ideas as inspiration.  Take what works, and feel free to leave disregard the rest.

Merhar, Christina.  Employee Retention: The Real Cost of Losing An Employee. Zane Benefits, 2016 February 4, Accessed March 25, 2017.
Recognizing And Rewarding Your Staff. Harvard University Faculty of Arts & Sciences Human Resources Department, Accessed March 25, 2017.

Nurses Needed In These 5 Health Care Settings


Employment for these nursing roles is projected to grow much faster than average until the mid-2020s. In addition to inpatient roles, nurses can work in outpatient clinics, schools, community health centers, nursing homes, home health options, palliative care, and correctional centers.

Outpatient clinics allow nurses to work deeply in a specific specialty.  Nurses who already have (or who want to build) in-depth knowledge about medical specialty will be attracted to these roles.

Schools also need nurses to care for ill students. Job requirements will vary.  Some school nurses work full time; some work part time.  They may work in one location or rotate between neighboring schools.  In these environments, nurses will typically work with pediatric or adolescent patients.

Nursing homes offer the opportunity to work with patients who need varying levels of care.  Some patients may be long-term residents who need assistance with all of their activities of daily living.  Others may be short-term residents who are recovering from an injury or illness.  Since many patients are elderly, nurses interested in geriatric care may gravitate toward these roles.

Home health nurses travel to patient’s homes to assist them on a temporary or permanent basis. Some patients may need short-term care while recovering from an injury or acute illness.  Others may need ongoing care to help with chronic conditions or disabilities.  Since they visit patient’s homes, palliative care nurses are also considered home health nurses.

Correctional center nurses are responsible for intake screenings and medical care for inmates.  Within correctional centers, nurses see patients who have acute and chronic medical conditions.  Due to the close proximity of inmates, outbreaks of disease are common.  On a daily basis, nurses may also be responsible for administering medications as needed.  Care coordination between providers is another part of the nursing role, particularly when someone is being released.

Nurses fill a range of roles in any setting.  Inpatient nurses help patients who are currently admitted to the hospital.  Outpatient nurses get to work in-depth within a particular medical specialty.  School nurses typically work with pediatric populations in one or more locations.  Nursing home nurses care for patients who need varying levels of assistance.  Home health nurses visit patients in their homes on a temporary or ongoing basis.  Correctional center nurses care for incarcerated patients and help coordinate their care. Each setting offers a different set of challenges for nurses to conquer as they care for specific patient populations.

Correctional Facility Nursing. Minority Nurse, 7 February 2016, Accessed January 31, 2017.
Giang, Vivian. Jailhouse Doctor Shares What It’s Like To Care For The Most Dangerous People In the World. Business Insider, 20 March 2013, Accessed January 31, 2017.
Registered Nurses. United States Department of Labor. Bureau of Labor Statistics. Occupational Outlook Handbook, 17 December 2015, Accessed January 31, 2017.

What Sets Correctional Medicine Apart?

Staff working in correctional medicine provide health care to almost 2 million Americans who are currently incarcerated in jails, prisons, and detention centers. There are differences between correctional and traditional medicine environments.

Different Environment
Correctional medicine has rules to protect the safety and privacy. For example, staff need to routinely assess what items they leave out in an unattended exam room. As a safety precaution, certain items should never be left unattended. There may also be restrictions on items (like cell phones) that can be brought into the care environment. On a broader scale, staff may be asked to limit their sharing personal experiences with patients. These restrictions are meant to help maintain a safe health care environment. Despite the restrictions, workers in correctional medicine benefit from its unique environment.

Staff in traditional health care settings spend a chunk of time worrying about health insurances, contracts, and billing. Different doctors accept separate insurances. Some patients who lack (or have undesirable) insurances are barred from seeking care at certain offices. In correctional medicine, staff do not worry about billing or insurances. Instead, providers in correctional medicine are bound to provide medically necessary care to their entire patient population.

Better Follow-Up Care and Routine Screenings
In traditional health care environments, patients go home. In correctional medicine environments, patients do not leave. The patients are always nearby, which simplifies follow up care. Additionally, many correctional medical facilities have higher percentages of compliance with recommended screenings than their traditional medicine counterparts. Again, this is because the patient population is always nearby.

Treating Chronic and Acute Conditions
Similar to the larger population, patients have chronic medical conditions that need care. While some medications can be given to the patient. Guards or correctional medicine staff need to distribute other prescriptions. Due to the close living quarters, acute infections (if not caught quickly) can spread throughout the entire population. If an infection spreads, providers often work with epidemiologists to determine cause and next steps. Due to changing needs, most correctional medicine providers are generalists who can quickly respond to a patient’s needs.

Partnership with Other Staff
Security guards help maintain a safe environment. Sometimes guards provide extra support when a provider needs help with an escalated patient. Often, security guards recognize and report unusual appearance or behavior to correctional medicine providers. This early recognition helps providers to begin early treatment—if necessary.


Correctional medicine has different restrictions and freedoms than traditional health care environments. While the work is challenging, it is worth considering for those health care staff who want the opportunity to stop worrying about insurance and treat their patients.

Correctional Facility Nursing. Minority Nurse, 7 February 2016, Accessed February 9, 2017.
Correctional medicine. Wikipedia, 2 June 2016, Accessed February 7, 2017.
Giang, Vivian. Jailhouse Doctor Shares What It’s Like To Care For The Most Dangerous People In the World. Business Insider, 20 March 2013, Accessed January 31, 2017.
Keller, Jeffrey. Correctional Medicine is Different: Our Patients Don’t Go Home!, Accessed February 7, 2017.
Keller, Jeffrey. Correctional Medicine: The Principles of Fairness., Accessed February 7, 2017.
Keller, Jeffrey. Correctional Medicine is Different: All Clinical Encounters are Discussed in the Dorm., Accessed February 7, 2017.
Keller, Jeffrey. Correctional Medicine is Different: We Can’t Fire Our Patients-and They Can’t Fire Us!, Accessed February 7, 2017.

The Role of the Social Worker

See Social Worker Openings Here!

Social workers play an important role on care teams, because they can do psychosocial assessments for patients.  Often these assessments identify outstanding challenges that a patient is facing.  Then social workers can work collaboratively with the patient and provider to provide guidance and education to improve patient experience and outcome. For those who do not regularly work with medical social workers, here is an overview of their role.

Social Worker

What Settings Do They Work In?
Depending on the organization, social workers can be found in outpatient and inpatient settings.  One social worker may be on staff at a clinic with a vulnerable population.  Other social workers may work with a variety clinics to support patients as they move between departments.  Precise staffing of social workers depends on the needs throughout the individual health care organization.  Nursing homes also have social workers who support the facility residents and their families throughout their stay.

What Do They Do?
Usually, social workers only see the patients who have been referred to them.  During the first conversation with a patient, a social worker typically does a psychosocial assessment.  The results of this assessment help to determine what support the patient needs from the social worker.  Although patients will need different levels of support, social workers will usually assist with care coordination and behavioral health services.

Care coordination needs vary.  Some patients will seek continuing care within the same organization.  Others will return to their established provider.  Another group of patients will need to identify new providers to transition care to.  While specifics differ, social workers can help coordinate a patient’s care in each of these scenarios.  When needed, they will guide the patient through the organization’s medical records release process.  Additionally social workers may contact outside organizations to discuss a patient’s medical care or identify appropriate providers to transition care to.

After an initial assessment, a social worker may offer continuing behavioral health services to a patient depending on their needs.  As a part of an interdisciplinary medical team, social workers will work collaboratively with other providers to identify and address issues that need continuing support.

What’s Their Educational Background?
Social workers in health care settings typically have a master’s degree in social work.  To provide clinical care, they must be licensed with the state’s department of health.


By providing psychosocial assessments, social workers can identify challenges and support a patient as they navigate the health care system.  The insights from a medical social worker can help patients achieve better outcomes.

Healthcare Social Workers. United States Department of Labor: Bureau of Labor Statistics, 30 March 2016, Accessed February 10, 2017.
Medical Social Work. Wikipedia, 7 December 2016, Accessed February 11, 2017.
Social Workers. United States Department of Labor: Bureau of Labor Statistics, 17 December 2015, Accessed February 11, 2017.
Social Work Profession. National Association of Social Workers, Accessed February 11, 2017.

Streamline Your Referral Process

Effective patient care relies on a patient’s referrals between primary and specialty care. Primary care Photo credit www.ccPix.comproviders refer patients out to specialists for their help identifying an appropriate care plan. Specialists may refer patients between disciplines for further assistance with the patient’s care. Since referrals between providers facilitate a patient moving between medical disciplines, healthcare organizations should have strong referral process. Below are some broad questions to help create a referral process that will work well for your organization.

What are the limitations around referrals?

Start with the first step of the process. Identify how your organization can receive referrals. Many organizations accept faxed or mailed referrals. Some also accept referrals within a shared electronic medical records system.

Clinically, identify which conditions your providers can see and which ones they cannot. While this is a simple step, it helps staff identify misdirected or inappropriate referrals. Also consider any exclusions to receiving care in your clinic. Does the patient need to meet any clinical standards to be seen by one of your providers? Also, consider if there are any questionnaires, tests, or imaging that a patient needs to complete before being scheduled.

What information do we need about the patient in order to process this referral?

When a referral has complete information, staff can better triage the referral and contact the patient.

Obtaining required private health information helps to ensure that the patient’s first appointment is beneficial. Recognizing these requirements early in the referral process will help clinical staff explain what information is needed prior to beginning of their care.

What about insurance?

Insurance is a tricky topic. After all, each healthcare organization negotiates their own contracts with different insurance companies. To avoid future complications, it is important that a patient’s insurance be identified during the referral process. Including this information will help staff identify if the patient’s insurance is contracted—or what additional payment options are. Staff should be aware of all potential payment options so that they can give patients correct information while scheduling.

Healthcare leaders can strengthen their organizational referral process by identifying referral limitations, information, and insurance requirements. Then leaders should share it with their front line staff. Specific answers will vary depending on organizational needs. Yet considering and sharing these answers will help staff quickly triage the referral and contact the patient.


Beginners Guide to Burien, Washington

Mount Rainier High School in Burien

Nestled on the shores of Puget Sound, Burien, Washington is a medium sized city that is 11 miles south of Seattle and 285 miles east of Spokane.  Officially incorporated in 1993, Burien is a comparatively young city.  Although young as a city, Burien shares a rich community history as part of the historic Highline area of Washington state. Today, Burien’s vibrant community offers a mild climate, a medium-sized population, an intriguing history, a thriving public education system, and a variety of activities.


Check out our openings in Burien!

Burien has a mild climate.  Average summer temperatures range between the high 40s and the high 70s.  Average winter temperatures range from the mid-30s to the mid-50s.  Monthly precipitation peaks at 6 inches during some winter months.  Precipitation dips to below 1 inch (of precipitation) per month in some summer months.

The April 2010 U.S. Census listed Burien with 33,313 residents.  Another census was taken in 2010 after Burien successfully annexed a nearby unincorporated area. This second census stated that Burien’s population increased to 49,858.  2015 population estimates list Burien’s population as 50,467.

For generations, the Duwamish, Suquamish, Muckleshoot and Puyallup tribes lived in the greater Burien area.  Settlers first arrived in the 1860s and 1870s, and immediately named the town Sunnydale.  The unincorporated town began to grow and change with the times.  After several attempts at incorporation (in 1954, 1960, 1961, and 1984) the city was formally incorporated in 1993 with the name Burien.

The Highline School District operates 18 elementary schools, 4 middle schools, and 12 high schools in Burien and surrounding areas. The district also has a variety of alternative education options. Nearby Seattle has several 2 and 4 year colleges and universities.

Burien and its surrounding areas offer a variety of things to do.  For those who look to explore the outdoors, visit Seahurst Park.  The park offers picnic areas, trails, a playground, and more.  For those who want to learn something new, visit the Museum of Flight or the Hydroplane & Raceboat Museum.  The city’s downtown area also offers a lot of different opportunities that can be found through exploration.

Since the 1860s, Burien has grown by meeting the needs of its population. Naturally, this has changed as the area and population have changed.  Today’s Burien is focused on the future, and many will be watching as the city plans its path forward.  Make the time to enjoy the mild climate while learning about Burien’s rich history or trying one of many available activities.  See what captures your imagination first.

Burien, WA.  “About Burien.” ( retrieved October 22, 2016.Burien, WA. “Seahurst Park.” ( retrieved October 23, 2016. “Burien, Washington.” ( retrieved October 22, 2016.
DeCoster, Dotty. “Burien-Thumbnail History.” May 28, 2013. ( retrieved October 23, 2016.
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