While 66% of survey respondents say improved wages for experienced and entry level workers are the top solutions, experts fully agree that good pay certainly doesn’t hurt.
“It’s important that we seek to pay competitively—that’s one of our solutions,” Carlson says. “That said, in every clinical aspect, we don’t necessarily lead the pay scale, but it’s important if you want good clinicians that you help them grow and continue to learn.”
She believes good leadership also makes a difference in retaining employees. More workers leave their jobs because they don’t care for the managers than those who leave because they don’t care for the job itself, she says.
Quamme says the rise in private, for-profit treatment centers has caused a noticeable shift of workers away from the traditional not-for-profit agency setting. Part of the attraction is likely higher pay.
“The industry does have a hard time keeping people,” he says. “Workers will jump for that one job with that $1 dollar per hour more.”
Of the survey respondents with some knowledge on the subject, more than half report that their organization has seen a staff reduction at some point in the past two years attributed to financial strains. Even with its long established programs, Hazelden Betty Ford has had to cut staff in the past, according to Carlson.
“Healthcare as an industry is in such a state of change continuously, it’s challenging to be able to set the right levels of staff and be able to provide excellent care when margins are reducing,” Carlson says.
Policy enhances service
While some solutions can be implemented at the organization level, broader strategies might be needed to extend the reach of the workforce. For example, Beck says clinical professionals could have more impact right now if policies were in place to allow them to leverage all of their practice skills.
“It’s an area where legislators can get involved to address capacity issues in their states by ensuring the workforce they have is working up to the full scope of their practice,” she says. “It’s an issue of how you best utilize the staff you have.”
For example, a nurse might be limited by state restrictions, causing a physician’s time to get tied up in delivering services that the nurse otherwise is trained for and capable of providing.
Additionally, telehealth has been held up as a tool that could extend the workforce. Digital visits could solve some access issues, connecting more patients with behavioral health services, especially in rural areas. However, barriers to adoption—such as licensing requirements when patients and providers aren’t located in the same state—continue to drag down telehealth’s progress.
Beck says telehealth providers need to know who they can treat and where, taking licensing and reciprocity into account. Meanwhile, providers that are philosophically open to the idea of conducting telehealth visits might decide against it if they’re already overbooked with office visits.
“And there are still the questions about alleviating perceptions about the quality of care with telehealth: Can you treat someone as sufficiently as with in-person care?” says Beck.
According to Quamme, clinical competency has evolved in behavioral health. While its origin might be one of fellowship or spiritual support, system pressures today increasingly call for evidence-based practice that has the science to back up its efficacy. However, there’s room for both, he says.
“I’d like to see the field put certification in higher esteem because we are the ones who guarantee competence, as opposed to permission to practice,” says Quamme. “I think they go hand-in-hand.”
In the future, as the healthcare system at large seeks greater integration, clinicians might also find themselves on large care teams. And how the teams are comprised matters, according to Beck. Sometimes it’s difficult to ensure that behavioral health professionals are equitably included in a team-based care provision—and equitably reimbursed.
Not all numbers add up to 100% due to rounding.
“I don’t know” and “N/A” responses were excluded from data calculations. Total respondents ranged from 605 to 721.
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