The times are a-changin' when it comes to human-resources management in Tennessee's rural hospitals. While the spotlight still shines on the problem of physician and nursing shortages, add to that the challenge of recruiting allied-health professionals to rural locales. "It's probably as great or greater an issue for our smaller, rural hospitals," said Bill Jolley, Tennessee Hospital Association assistant vice president for Rural Health Services and executive director of The Center for Health Workforce Development in Tennessee. The center was launched by THA in 2004 to address health workforce shortages, particularly in nursing. Now its advisory committee has broadened the focus to include physical and occupational therapists, radiology and laboratory technicians, respiratory therapists and other allied professionals in the hospital setting. Though not traditionally categorized as providers, a similar problem exists for pharmacists.

 

According to the U.S. Department of Labor, 60 percent of the American healthcare workforce is made up of allied-health professionals. The allied-health provider shortage is predicted to reach 1.6 million to 2.5 million workers by 2020. Thanks to a decade-long decrease in enrollment in allied-health schools and educational programs, the supply of such qualified providers is shrinking while, of course, the demand for healthcare is increasing.

 

Competing against urban areas with metropolitan amenities for these professionals is tough, said Charlotte Burns, CEO of Hardin County General Hospital. Burns has chaired the advisory committee of The Center for Health Workforce Development in Tennessee since its inception. Burns said her hospital offers tuition reimbursement to stay competitive. "We actually pay for their schooling if they will come back here," she said. In fact, the hospital recently agreed to do just that for a student accepted to physical therapy school. The hospital has done the same thing for nurses, from LPNs to RNs.

 

Jolley cited research which concludes that health professionals at all levels, including physicians, are very open to practicing at or near where they complete their training, "whether it's through a rural rotation or another experience that they've had practicing in a rural or underserved area." Thus, he encouraged rural hospitals to ensure they apply for opportunities to be included as residency sites.

Jolley also noted that there's another change in priorities when it comes to the rural hospital workforce – a move from recruitment to retention. Burns agreed. "Not to forget about the recruitment side, but now we've agreed that we need to focus on the retention side as well," she said.

 

While several state and federal programs are in place to help rural communities lure health professionals, and those programs are working to varying degrees, when it comes to retention, the onus is on hospital management. Burns said rural administrators across the state are sharing best practices, and she added, "If you want to retain employees, you reward and recognize your high performers. Let them know that their great work is not going unnoticed."

 

Burns expressed concern that the challenging economy has muffled the problem of employee retention. "Everybody is happy to have a job right now," she said. But that dynamic won't last forever. Right now, larger hospitals in more urban areas don't have jobs to offer, she said, because professionals are delaying retirement or because of decreased patient volumes (patients are eschewing elective surgeries or abandoning healthcare altogether). Burns urged rural administrators to ignore the comfort of fewer turnovers and to aggressively embrace retention initiatives to ensure professionals won't move on when the economic smoke clears.