Clinical doctors smiled (actually, they grimaced) while reading two recent headlines. The first was “Wyden, Blackburn Introduce Bipartisan Legislation to Tackle Health Care Workforce Shortages.” This is one more demonstration of Ronald Reagan’s prescience when he said in his 1981 Inaugural Address, “Government is not the solution to our problem; government is the problem.”
Every direct care provider understands from painful daily experience that government regulations stemming from federal legislation are the real reason for shortages.
The shortage of nurses, therapists, and physicians is undeniable and getting worse. Understanding why people are leaving helps to know why they became care providers, especially doctors, given the time, stress, and cost necessary to become one.
The answer is the psychic reward, what Maslow called self-actualization. As a nurse shared one day, “When my [patients] do well, it feeds my soul.” Care providers prove their self-worth to themselves when they help heal a sick person through their personal efforts. The number of Washington advisories, guidelines, prohibitions, clinical algorithms, crisis standards, and clinical mandates is literally uncountable. These federal commandments effectively take care decisions out of clinicians’ hands.
As the number of regulations goes up, the psychic reward shrinks until it is gone. And when the psychic reward goes, so go the care providers.
Federal health care regulations make it harder for caregivers to do their jobs, not easier. The security elements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) obstruct communication between clinicians, frustrating them and increasing the likelihood of medical errors. Workers everywhere rightly expect their employers to help
