"In healthcare we do this to ourselves. We create this bubble and think that no other logic applies to us, but anytime you have mass change to an industry you are going to get a reaction. And the first reaction you are going to get is around labor because it is the largest cost. So, I am not sure what people expected if they expected the healthcare job growth to keep pace, that was an unrealistic expectation, certainly when you look year-over-year."
Hospitals created only 300 new jobs in September and 8,600 new jobs so far in 2013, compared with 53,200 new jobs in the first nine months of 2013. Job growth in the volatile residential and nursing home sector was even worse, recording a net loss of 1,600 jobs in September. The sector has created 15,100 new jobs so far this year, compared with 25,900 new jobs for the same period in 2012.
So far, the job growth figures have yet to reflect any slowing demand for physicians, clinicians, and executives. Merritt Hawkins saw its physician and advanced practice recruiting assignments increase by 14% from 2012 to 2013. Singleton says he doesn't expect the demand for clinicians will abate any time soon.
"You won't see for at least the next couple of years cuts to providers. In fact, you are going to still see a pretty robust increase in providers and physicians by a large part because they hold up the walls as far as revenues," he says.
"But it doesn't stop there. It also goes to physician extenders and nursing. I expect to see huge increases in nursing over the next couple of years, primarily because of the changes they've made to quality and readmissions. So many people now have studies that directly tie a nurse-to-patient ratio with readmissions and quality components. At the end of the day they can't afford to cut in those areas. That kind of leads you back to, 'OK what can you do?' And unfortunately that gets to the support staff. So it is a right-sizing more than anything."