The healthcare workforce crisis is not new, but its root causes may be less understood than its symptoms. At Becker’s 16th Annual Meeting, a group of health system and academic leaders gathered for an executive roundtable hosted by ECG Management Consultants to examine an underaddressed lever in workforce strategy: the relationship between academic institutions and health systems.
ECG representatives leading the discussion included Jessica Wells, PhD, principal in ECG’s academic healthcare and health systems alignment practice; Asif Shah Mohammed, partner and leader of ECG’s digital and innovation practice; and Katherine Hines, senior manager.
Here are three key takeaways from the discussion.
Note: Quotes have been edited lightly for length and clarity.
1. Siloed data between academic and clinical environments is fueling the pipeline problem
Many health systems and their academic partners are operating with fundamentally separate data environments — one for clinical operations, one for academic programs — with little visibility across either. The result is a planning and operational blind spot: leaders often don’t know how many learners are in their system, where they’re placed, whether they’ve completed rotations or how their experiences correlate with hiring and retention outcomes.
“Learners are part of our workforce,” Dr. Wells said. “They shouldn’t be considered as a transient part of our environment.”
Mr. Shah Mohammed described a recent ECG engagement with an academic medical center in New Jersey that has more than 6,500 clinical learners annually and was unable to track basic placement data — including where learners were placed, whether they had completed rotations or whether they were in compliance. To address this, ECG is working with the organization to implement a clinical learner placement system: a single source of truth spanning program, site and preceptor data that enables real-time capacity management, predictive analytics and strategic workforce modeling.
2. Preceptor burden is a structural problem, and layering teaching on top of clinical work makes it worse
Across the room, leaders identified preceptor availability and burnout as a critical bottleneck. The conventional approach — asking experienced clinicians to take on students in addition to their regular workload — is failing. “When we take a traditional clinical environment and then we layer teaching on top, we’ve now just added another job hindrance,” Dr. Wells said. “We have to design teaching into the work environment.”
A nursing leader in the room noted that the acute care workforce dynamic has fundamentally shifted: new graduates who once expected to start on medical-surgical floors working nights and weekends are now entering on very different terms.
“New grads are coming out with an expectation that for all intents and purposes is not sustainable,” the leader said, noting that health systems are paying premium rates for contract staff on weekends while struggling to attract and retain new graduates in a way that is financially viable for the organization.
3. The pipeline starts at recruitment — and culture is the closing argument for retention
Dr. Wells emphasized that the “recruit, train, retain” pipeline is a continuous strategy, not three separate functions. Clinical experiences during training act as “imprinting”; how learners train shapes how they will practice for years afterward, making rotations in rural or underserved settings among the strongest predictors of eventual practice location.
But financial incentives alone are not sufficient. Retention rates can be less than 50% for providers recruited primarily by compensation after their initial two years for some locations, Dr. Wells noted. Leaders from academic medical centers echoed the challenge, describing competitive pressure from community health systems that can offer double the compensation for specialists.
Another leader in the room observed that culture, often cited as the primary reason clinicians stay, has received less attention recently than in prior years, even as workforce pressures have intensified. Dr. Wells agreed, noting that a learner’s earliest experiences on the clinical floor — whether they felt welcomed, known and prepared — shape their long-term employment decisions.
“Every learner and everyone in your organizations wants to truly walk away and say, ‘I matter. My work matters. I’m growing and capable. And this is where I feel like I belong,'” she said.
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