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  • Writer's pictureAlan Shoebridge

Healthcare at the halfway point: What’s going well – and not so well – in 2023

Updated: Jul 5, 2023

Each July we face an uncomfortable truth. Summer has arrived and the current year is more than half over! Time flies when you’re having fun – or something like that.

The last three years have been incredibly challenging for those working in healthcare. COVID disrupted healthcare in so many ways, and returning to how things were in 2019 seems impossible. That’s certainly true for frontline care providers. It’s also the reality for all of us.

An expected “recovery” for hospitals and health systems never materialized in 2022, and it’s clear that many of the challenges that COVID exacerbated are just going to be with us for the foreseeable future. Maybe forever.

As we get ready to tackle the second half of 2023, it feels like a good time to review where things stand relative to how many of us thought the year would go. Let’s start with the positives.

During the past three years, the summer months have been a dangerous time with travel and gatherings fueling COVID-19 surges. This year marks the first summer of the post-emergency phase of the pandemic.

2023: Better than expected

COVID: Although the threat of COVID is not fully over and risks remain, we’ve avoided the crushing case surges that hit several times during 2021 and 2022. Day to day, society feels almost back to normal. That’s allowed most hospitals and healthcare systems to better manage volumes and work through backlogs of delayed care.

The virus still is out there, but deaths and hospitalizations are thankfully much lower than last summer. In addition, variants will be an ongoing threat and we’re likely to need annual vaccinations to deal with COVID. None of that is great news, but the situation could be so much worse.

Resiliency. Burnout, stress and workload reached almost unprecedented levels over the last three years. However, I’ve been impressed with the attitude people – especially leaders – have adopted so far in 2023. There is a strong passion for investing in our workforces, re-establishing human connections, leveraging technology to solve problems and planning for the future. Overall, it feels like the continual “crisis mode” of the pandemic has finally shifted a bit. There is a better balance of proactive to reactive work. Optimism is building for the future. A recent survey confirms this feeling:

"Nearly 3 in 5 healthcare workers said they are optimistic about the future of the medical industry.
3 in 5 said they have been mostly able to handle the stressors of work in the past six months.
About 3 in 5 healthcare workers said their facilities are capable of moving beyond the end of the public health emergency declaration."

2023: About what we expected

Staffing: The staggering worldwide shortfall of nurses, doctors and support staff is a problem that cannot be solved without embracing new ways of working. There are simply not enough people to address staffing needs. Many health systems like Providence, where I work, are taking steps to make hiring and onboarding simpler and faster. That’s a good step, but it won’t solve the entire problem. That’s why the work itself is being examined. For example, a virtual nursing program pilot called “co-caring” has delivered amazing results for caregivers and patients. At Lubbock, Texas-based Covenant Medical Center, first-year turnover rates fell by 73 percent for registered nurses who took part in the pilot.

Nurses protest in front of Austin's Ascension Seton Medical Center during a one-day strike.

Labor unrest: Union activity is picking up in healthcare. Organizing activity is increasing. Nursing strikes – even where they haven’t occurred in decades – are happening. At least 30,000 healthcare workers went on strike in 2022, according to data compiled by Healthcare Dive. We’re likely to see this activity continue to intensify, which will bring a myriad of operational and reputational challenges to address.

2023: Worse than expected

Financial recovery. According to data from Kaufman Hall, hospitals barely broke out of the red for the first time in April with an average net profit margin of 0.0%. Although breaking even is better than losing money, that path isn’t sustainable for supporting future growth or making up for several years of losses. So, what's slowing the recovery? High expenses for staffing and supplies, inflation, the unwinding of the Medicaid continuous coverage requirement of the COVID-19 public health emergency, increases in bad debt and charity care, and increasing hospital length of stays are the biggest causes. Similar to how leaders are approaching the staffing crisis, it’s clear that innovative thinking will be needed to make do with less net revenue.

Politicization of healthcare. Even as the prevalence of COVID has receded, we are still dealing with distrust of healthcare professionals, scientists and other experts. Anti-vaccine sentiment remains strong in many parts of the country. Confidence in the scientific community declined among U.S. adults in 2022:

"Overall, 39% of U.S. adults said they had “a great deal of confidence” in the scientific community, down from 48% in 2018 and 2021. That’s according to the General Social Survey, a long-running poll conducted by NORC at the University of Chicago that has monitored Americans’ opinions on key topics since 1972."

Furthermore, transgender care, abortion and other issues are not only hotly debated by certain aspects of the public, but are the focus of legislation, protests and calls for action from employees. Hospitals and healthcare providers are often caught in the middle. It’s impossible to keep everyone happy and the heat just keeps getting turned up.

Setting a plan of action for the rest of 2023

Much of what I explored above are situations we cannot control on a personal level. However, there is good news. You can still approach the rest of this year in a positive, proactive way.

I suggest dividing the year into quarters where you set a specific focus for each quarter. With two quarters coming up, think about doing this:

  • Q3: July – September: Assess the impact of your work so far. Knowing whether what you’re doing is working or not is the key to good planning for the upcoming year. The third quarter of the year is the perfect time to gather information from your business partners.

  • Q4: October – December: Plan for the year ahead. If you don’t have a plan in place – or at least a strong outline of what you want to do when you hit 2024 – you will be behind from day one. That’s not a place you want to find yourself in.

Right now, I would also advise that you look at trends that are likely to impact the future of what you do. I know many of you feel overwhelmed by the hype around AI, but it’s really something you should investigate. This recent blog post covers some of the reasons why.

Overall, the "easy" times for healthcare are gone - if they ever really existed at all. It's important that we stay connected, focus on learning and set goals that will help us make an impact.

2023: healthcare at the halfway point.

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