Perspectives on Minnesotas Health Industry Workforce

1
Perspectives on Minnesotas Health Industry
Workforce
Minnesota Rural Health Conference July 19,
2005 Duluth, MN
Jay Fonkert Office of Rural Health and Primary
Care MN Department of Health
2
Opinions expressed in this presentation are the
sole responsibility of the author and do not
represent opinions or positions of the Minnesota
Department of Health or the State of Minnesota.
3
Workforce Analysis Program Office of Rural Health
and Primary Care
Annual surveys of licensed health professionals
to better understand workforce demographics and
disparities in health care access
4
Health care industry accounts for 11 percent of
all private sector employee compensation in
Minnesota.
Health Services
Other private nonfarm industries
Source Bureau of Economic Analysis, regional
accounts, 2003
5
Ambulatory Care employees receive more than half
of all health care compensation in Minnesota.
Nursing and residential care facilities
Ambulatory Care
Hospitals
Source Bureau of Economic Analysis, regional
accounts, 2003
6
Some counties with high dependence of health care
employment
Health care and social services employment as
of wage and salary employment
Olmsted (Rochester) 37 Wilkin
(Breckenridge) 25 Chisago 22 Grant 21 Mil
le Lacs 20 St. Louis (Duluth) 20
Statewide 13
Source U. S. Bureau of Economic Analysis,
Regional accounts, 2002
7
Minnesotas Healthcare Workforce
Estimated active at MN sites, 2004
8
Minnesotas Healthcare Workforce
Estimated active at MN sites, 2004
9
Largest Minnesota health occupations
Source Minnesota Department of Employment and
Economic Development, 2nd Quarter 2004.
10
Half of Minnesota health care workers work
outside hospitals or physician offices.
Hospitals
All other sites
Physician and dentist offices
Nursing care facilities
Source U.S. Census Bureau, County Business
Patterns, 2002.
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Male Female Composition of Workforce
Physicians
Physician assistants
RNs
LPNs
RCPs
Physical therapists
Dentists
Dental assistants
Dental hygienists
Source MDH, Office of Rural Health and Primary
Care, 2004 survey data.
12
Dentists, physicians and RNs are older than other
practitioners.
Median age of MN practitioners
Physicians
Physician assistants
RNs
Respiratory care practitioners
Physical therapists
Dentists
Dental assistants
Dental hygienists
Source MDH, Office of Rural Health and Primary
Care, 2004 survey data.
13
Age composition of workforce
Physician assistants are significantly younger
than physicians or RNs.

55 yr.

Source MDH, Office of Rural Health and Primary
Care, 2004 survey data.
14
The retirement crunch may be more serious for
dentists than for physicians.
Dentists enter workforce at slightly younger age
than physicians, but may stay in part-time
practice a bit longer.
Source MDH, Office of Rural Health and Primary
Care, 2004 survey data.
15
Retirement is more imminent for dentists in the
most rural areas.
DENTISTS BY AGE

55 yrs.
16
Rural practitioners tend to be a year or two
older than urban practitioners.
Median age comparisons
Source MDH, Office of Rural Health and Primary
Care, 2004 survey data.
17
Dentists are more geographically dispersed than
physicians.
Dentists
Dentists
Physicians
Physicians
Population 41 rural
RNs 26 LPNs 52 RCPs 19
Physical therapists 29 Dental assistants 34 Den
tal hygienists 33 Physician assistants 31
Source MDH, Office of Rural Health and Primary
Care, 2004 survey data.
18
Specialist physicians are more concentrated in
urban areas than primary care physicians.
Primary care physicians
Other specialties
Source MDH, Office of Rural Health and Primary
Care, 2004 survey data.
Urban Anoka, Carver, Dakota, Hennepin, Ramsey,
Scott and Washington counties, plus Rochester,
St. Cloud and Duluth.
19
Per 100,000 Population (2000)
Patient care physicians
Source HRSA , State Health workforce Profiles.
20
Per 100,000 Population (2000)
Patient care physicians
Source HRSA , State Health workforce Profiles.
21
Minnesota Workforce Mix Ratios
2000 data, HRSA Health Workforce Profiles
22
Minnesota is

• AVERAGE in number of PHYSICIANS.

• ABOVE AVERAGE in number of RNs and Dentists.

• MUCH ABOVE AVERAGE in number of LPNs and Dental
  hygienists.

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Minnesota has

• high ratio of RNs to physicians

• high ratio of RNs to LPNs

What are the implications?
What changes can be expected?
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Primary Work Sites of MN LPNS
MDH ORHPC 2004 Licensing Survey
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What kind of problem is it?
Workforce Supply?
Grow Workforce
Weak Market Demand?
Strengthen Markets
Weak Demand Low Need
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Hospitals and clinics, doctors and dentists
Arent that much different from
Other professionals or firms.
They set up business where there are enough
paying customers to pay the bills.
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DISTANCE TIME
The Rural Health Care Access Challenge
Get the person to where the health care is or
get the health care to where the person is and
find a way to pay for the care.
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All occupations face shortages
ISSUE How will health care attract its needed
share of a limited supply of workers?

• Challenges
• Finding enough employees
• with appropriate education and skills

Critical importance of K-12 Education we will
need young people prepared to acquire the
KNOWLEDGE, SKILLS and ETHICS necessary for health
careers.
29
As workers become scarce and expensive
Incentives to
1. Use technology to reduce labor need. 2.
Redesign way services are delivered to use labor
more efficiently. 3. Use different mixes of
occupations.
Improve labor productivity
30
For more information
Workforce Analysis Program Office of Rural Health
and Primary Care Minnesota Department of Health
Jay Fonkert 651-282-5642 Jay.fonkert_at_state.mn.us
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THE END
Following slides are held in reserve.
32
Vacancy rates in nursing occupations have been
quite high, but generally declined.
33
Vacancy rates in other health occupation vary
widely, and sometimes are erratic.
34
Workforce stories
Its physician specialists that help draw
patients into your facility.
Hospital CEO, Marshall MN Pop 12,788 Marshall
Independent, March 1, 2005
COMMENT Critical mass affects economic
viability. Regional centers will be higher level
health care centers.
35
Workforce stories
Going to a small town and having an abundance of
patients that you are going to lose money on when
you have 180,000 of debt doesnt make it.
Rural MN Dentist Northwest Dentistry January-Febru
ary, 2005
COMMENT Providers need paying customers
whether they be private sector or government.
36
Workforce stories
When those ambulance people come up to your
side you want them to be the best.
Supporter of higher national EMT standards
These guys have jobs. They work at the Cenex
store, they work at the butcher shop. Theyre
farmers trying to get their crops in.
Director of North Dakota EMS Association
COMMENT Higher professional standards, advanced
training requirements and expensive technology
tend to favor concentration of health care
services in regional centers.
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Health Care in the Minnesota Economy
Share of personal income 9.3 Share of wages
and salaries 10.0 Percent of employment 10.4
The health care industry creates jobs and buying
power in communities with hospitals, clinics and
care facilities.
Source Bureau of Economic Analysis, regional
accounts, 2003. All data reported by place of
work.
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Minnesota Health Care Employment By type of
business
Offices of physicians and dentists 44,091 15 Out
patient care centers 32,513 11 Home health
services 17,855 6 Other ambulatory care
services 14,207 5 Hospitals 99,990 35 Nu
rsing care facilities 42,940 15 Residential
MR/MH/substance abuse fac. 22,495 8 Other
residential facilities 15,371 5
Source U.S. Census Bureau, County Business
Patterns, 2002.