The coronavirus crisis has created a stratified impact on the healthcare workforce, with front-line doctors and nurses and select specialists in high demand, while others are finding demand for their jobs is dropping precipitously.
Temporary workers — such as traveling nurses — are in especially high demand, according to staffing firms.
And while most hospitals have canceled elective procedures to free up labor, executives say staffing shortage concerns are acute, as more physicians come down with the virus, especially those practicing certain specialties.
"Aside from talking about ICU beds and ventilator capacity, our No. 1 concern is staff," Kevin Ward, treasurer and CFO of New York Presbyterian/Queens Hospital, said during a call with Jefferies analysts Thursday. "We could have all the ventilators in the world, but we don't have respiratory therapists, and they're in very short supply."
Respiratory therapists are specifically trained to operate ventilators and intubate patients by placing a breathing tube in their airway. They're trained to manage six ventilator patients at a time, according to Tim Myers, chief business officer at the American Association for Respiratory Care.
While nurses and other physicians are able to manage and run ventilators, "by and large those people will tell you while they have the authority, it's not what they were trained to do," Myers said.
About 150,000 respiratory therapists are practicing right now in the country, although the profession has a high retirement rate, Myers said, and geographic distribution is uneven — especially in rural areas.
Richard Keenan, CFO of Valley Health System in Ridgewood, New Jersey, said he's worried about other trained specialists, such as CT and MRI techs working at the hospital.
"There are very, very few of them, if two or three get exposed and can't show up to work anymore, it really causes a bottleneck," Keenan said.
At the same time, Ward's New York Presbyterian Hospital network operates five freestanding imaging centers where he said appointments are down 80%.
"People are not going for diagnostic tests," Ward said. Radiology staff haven't been laid off completely, but furloughed to a part time, 50% pay schedule, he said.
Charles Fox, a gastroenterologist at Atlanta Gastroenterology Associates and assistant clinical professor at Emory University, said in a separate call with analysts the organization has furloughed about 300 of its more than 800 employees.
Offices now have a skeleton crew as patients who can be deferred are having procedures rescheduled until at least May, he said. As Atlanta emerges as a potential hotspot, he and colleagues are discharging anyone they can, to "prepare for this coming tsunami."
Michael Marzoug, vice chair of administration and finance at University of Florida Health in Gainesville, Florida, and Michael Ring, an interventional cardiologist at Providence Sacred Heart Medical Center in Spokane, Washington, told the Mizuho analysts their outpatient visits had dropped by about 80%.
Ring said his organization is keeping as many patients away as possible by postponing non-urgent visits. While that's needed currently, he worries about what that will mean as the crisis continues.
"You don't want to defer things indefinitely and try to play catch up," he said. "We were already at capacity previously, so you've got to be smart."
Fox said all the changes are likely to spur further adoption of telehealth by doctors, although buy-in from payers and patients is still unclear.
"I think this is going to be a paradigm shift within medicine, especially as we face the baby boomer generation growing older and retiring physicians," he said.
Marzoug agreed, saying he wouldn't be surprised if the pandemic "opened up the floodgates" for virtual visits.
Shannon Muchmore contributed reporting.