The capacity and well-being of the U.S. health workforce has been under threat for years by an epidemic of burnout, and two years of the COVID-19 pandemic has further exacerbated this systems issue. Now at least 40% of nurses, 20% of physicians, and more than 25% of state and local public health department employees are considering leaving their professions. Recognizing that the function of the U.S. health system is at stake due to dangerously mounting health care system pressures, the NAM’s National Plan for Health Workforce Well-Being calls for immediate action to safeguard this precious national resource dedicated to protecting the nation’s health.
The NAM National Plan complements the May 2022 Surgeon General’s Advisory on Addressing Health Worker Burnout, which called attention to on-the-job harassment, bullying, and threats faced by health workers during the COVID-19 pandemic. These factors eroded the trust and relationship between the public and health workers. The current severe health workforce shortage places enormous burden on the health workers remaining and jeopardizes the health of the nation. The NAM National Plan will build on the Surgeon General’s Advisory as well as related bipartisan policy efforts, such as the Dr. Lorna Breen Health Care Provider Protection Act, which begins to support the mental and behavioral health of health workers.
Drawing on the energy of these and other recent steps taken across the U.S. health system to support health workers, in addition to six years of research and collaboration through the NAM Action Collaborative on Clinician Well-Being and Resilience, the National Plan calls on multiple actors to work together to drive policy and systems change to better support the health workforce and the health of all communities – including health care and public health leaders, government, payers, industry, educators, and leaders in other sectors. A draft of the National Plan was made available for public feedback and received nearly 2,000 constructive comments, and to date the final Plan has received endorsements from over 30 organizations representing the diverse organizational membership of the Clinician Well-Being Collaborative and the various actors needed to collectively advance the practical strategies laid out in the Plan.
NAM President Victor Dzau, co-chair of the Clinician Well-Being Collaborative, said, “There is an urgent need for a longer-term plan for the nation to stem this crisis. This NAM National Plan provides a roadmap for the nation to set forth the priority areas, action steps, and actors who must work collectively to achieve a system where the health workforce is thriving in an environment that fosters their well-being. Like the path-breaking national movement initiated by Institute of Medicine (now the NAM) to improve the safety and quality of health care over the past 20 years, we must mobilize all those impacted and invested to act together and build a major social movement to respond to the burnout crisis.”
The National Plan demonstrates that investment in health worker well-being must come from multiple levels. Health leaders and other key decision-makers across sectors – with support from frontline workers and the public – must collectively support a new social contract that begins with a coordinated national movement and system of evaluation and accountability. The National Plan visualizes that, when all actors take responsibility, we can create a health system in which care is delivered joyfully and with meaning, by a committed care team, in partnership with engaged patients and communities.
The National Plan identifies specific, near-term actions to achieve the following priorities, clearly naming associated goals and responsible actors:
- Create and sustain positive work and learning environments and culture
- 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
Darrell Kirch, President Emeritus of the Association of American Medical Colleges, and co-chair of the Clinician Well-Being Collaborative, commented, “By advancing the priority areas of the National Plan, we can help ensure the health and longevity of those who care for us and train, hire, and retain a health workforce that reflects the diversity of the U.S. population. We must support a thriving health workforce to deliver safe, high-quality, patient-centered care.”
U.S. Surgeon General Vivek Murthy, co-chair of the Clinician Well-Being Collaborative, said, “Even before the COVID-19 crisis began, our health workforce had to meet extraordinary and overwhelming challenges. As we now rebuild and recover from the pandemic, we owe health workers a debt of action. I’m grateful to the National Academy of Medicine for recognizing this, and for their leadership through the National Plan for our health workforce, because if we fail to address burnout and ensure health workers have the support and resources they need, then the consequences will be felt by everyone who relies on the health care system.”
Thomas Nasca, President and CEO of the Accreditation Council for Graduate Medical Education, and co-chair of the Clinician Well-Being Collaborative, said, “By actors stepping up as champions through committing to the actions in the National Plan, and acting based on the evidence on behalf of all health professions, we can ensure a strong and interconnected health care ecosystem. We’re proud to support these leaders in spreading change to benefit their health workers and the communities they serve.”
Access the full National Plan at nam.edu/NationalPlan.
The National Plan is the next step in the work of the Clinician Well-Being Collaborative, a network of expert volunteers and leaders committed to reversing trends in health worker burnout, and an expansion on the foundation of the 2019 NAM report, Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. For more information on the Clinician Well-Being Collaborative, visit nam.edu/CW. For questions, contact ClinicianWellBeing@nas.edu.