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Why Financial Incentives Are Not Enough to Address Health Worker Shortages

As many states and territories deal with shortages of health care workers and overcrowded emergency departments, politicians are turning to financial incentives to retain or recruit staff. I'm pointing 

In the past seven months, at least five states have announced tens of thousands of retention bonuses or other recruitment perks to retain or attract doctors and nurses.

But is financial compensation an appropriate recruitment tool?

Some researchers and recruiters believe, based on research and their own experience, that one-off financial incentives are not effective enough to keep health care workers on the job. says. 

"Financial incentives have been and will continue to be her solution to band-aids," says Maria Matthews, professor of family medicine at Western University in London, Ontario. says.

Nurses' unions and national health leaders say that financial incentives are just one piece of the ongoing puzzle needed to solve the healthcare burden.

Working conditions, wages and long hours are all issues that need to be addressed.They said 

``What's important to these doctors?'' In 2022, it's quality of life said David Este, emeritus professor of social work at the University of Calgary, who has researched the issue.

"When they work in chronically understaffed hospitals and their working conditions are maintained over a long period of time, financial incentives may not have the ability to address the nature of the working environment.

Why financial incentives count?

State governments have relied on financial incentives for decades Matthews co-authored. These incentives vary from state to state and also depend on specific roles and local needs. 

Ontario, Alberta, Newfoundland, Nova Scotia, P. E. I. is the latest state to announce some type of financial compensation for new or existing family physicians or nurses.

Health- Healthcare workers threaten the entire

sector as they leave the system due to burnout and shortages. Burned-out and overworked nurses are quitting one after the other, while jurisdictions struggle to persuade them to stay. Healthcare workers share the changes they say will help them keep going.

This is a move Mathews has seen many times before, and the reason politicians are turning to financial incentives is that it can be done relatively quickly. Because it is given, he added.

"Just giving people financial incentives won't solve the problem, because then we won't lose nurses," Este added. 

There are also notable differences between taxpayer-funded compensation initiatives recently announced by state governments. 

Earlier this month, the Registered Nurses Union N. L. President Yvette Coffey and Newfoundland and Labrador Prime Minister Andrew Fury announced new measures aimed at keeping nurses. (Ted Dillon/CBC)

Ontario and Newfoundland and Labrador Retention BonusesIt was announced that nurses would retain existing staff. This is the Alberta, P. E. I. and Nova Scotia 

need to be resolved immediately, as it is needed immediately." said Dr. Vesta Michelle Warren, President of the Alberta Medical Association and Family Physician in Sandre, Alta.

Are financial incentives helpful?

There are many reasons why hospitals are feeling the additional strain, with hospitals closing and patients waiting hours. Experts say one of these reasons is that people without a family doctor are adding to long wait times in hospitals across the country. 

About 25% of patients who visited the emergency rooms of Richmond Hill and Cotelucci Vaughan hospitals in north Toronto last month did not have a primary care physician.According to Mackenzie Health Emergency Department Medical Director David Rauchwerger, PhD.

This is well above his pre-pandemic figure of 5%, he said. 

By providing a better work-life balance and helping employees feel connected to their communities, Healthcare workers often rank high in deciding whether to stay or retire, a study across Canada shows. (Nathan Denette/The Canadian Press)

Politicians in Alberta and Nova Scotia see newly-announced bonuses and other recruiting efforts pushing doctors and professionals I hope to work in rural and underserved areas. P. E. I. Officials have expanded incentives to include family doctors and other professionals working anywhere in the state. 

Studies conducted in Canada since the 1990s often cite that hiring bonuses are not as important to physicians as they are to other fields.

In a 2019 study, researchers interviewed 91 Alberta physicians, administrators, community members, and spouses,It is only "somewhat important" for recruitment and not at all important for keeping doctors in the community.   

Almost 5 million Canadians do not have a family doctor. This is one of the factors that strain emergency rooms. (David Donnelly/Radio-Canada)

In contrast, her members of the community ranked incentives as highly rated for attracting doctors. 

This mirrors the findings of the1999 study, which found that despite "widespread deployment", financial-based approach is particularly effective.

Another common practice in many states and territories is that they are usually offered to recent graduates and internationally trained doctors, and are part of training and other costs. It's called a return-to-service agreement or grant that is offered to offset the division. Said. 

This is often the time an individual signs an agreement that in most states he will go and work in the community for one to her three years, Matthews said. says. 

She looked at data from re-service agreements in Newfoundland and Labrador and found that these agreements kept people well-served. It says it might take people to areas that don't have them, but the pact is "don't keep people in those communities."

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In some cases, doctors paid contracts and left the community. Another team of researchers found what happened in 1999 in other states such as Saskatchewan and Quebec.

"Financial incentives will be limited to recruiting and retaining talent," Matthews said.

Keeping doctors and other health care workers in the community is something Craig Copeland, mayor of Cold Lake, Alberta, knows all too well. 

Since he was elected in 2007, communities northeast of Edmonton have struggled to recruit doctors to the area. The area will need about five to six doctors in the next few years, he said. 

To get them involved in the community, the city currently offers $20,000 and pays interest on a $50,000 line of credit if the doctor agrees to work for Cold His Lake. increase.

"Unfortunately, you have to pay to play," said Copeland.

Access to data on economic incentives and retention programs should be better shared with researchers and those studying the issue, Matthews said. 

Brian McLean, who recruited physicians for Northern Medical Services at the University of Saskatchewan and has been a recruiter for years, said he and his colleagues were "siloed" about recruitment and retention programs. "We are trying to gather information," he said. Better access to data.

But based on what he saw, the doctor worked in the community, fulfilled his commitment to service, and moved on. 

"There needs to be more emphasis on the issue of government retention," he said. 

Dr. Vesta Michelle Warren is president of the Alberta Medical Association. She says it was the lifestyle and working conditions of the community, not her contract bonuses, that allowed her to stay in Sandre, Alberta. (Alberta Medical Association)

Warren said the bonus would help. But the president of the Alberta Medical Association says she and her colleagues often weigh other factors. For example, community fit, whether your spouse can find a job, and whether you have a good work environment and team. 

"I stayed at the center not because of her three-year bonus, but because it was a perfect fit for my family, my children, and me professionally." said Warren. 

Ontario's nurse made a similar statement after the Ford government announced her $5,000 salary bonus earlier this year. Many nurses and trade union representatives said it was not enough to keep their jobs. 

Health professionals planning to come to Canada can use pre-arrival services to begin the accreditation process before coming to the country. says Queenie Chu. She is a UK-trained former nurse who now runs an organization that helps newcomers.

"You promise nurses up to [$5,000], but what they really want is support to do their job well and safely. Four unions at the time

Other solutions

Health guidance Nurses, nurses, and doctors are calling for specific changes to address what's happening in hospitals, clinics, and GP offices. 

Many said it was essential to have more medical staff, including family doctors, nurses and other workers. 

MacLean and Warren agree that introducing more Physician Assistants and Nurse Her Practitioners can create more team-based care. 

Warren also said it would be another option to consider bringing back Canadian students trained at international medical schools. 

And if governments are serious about retention bonuses, they should also offer them to other healthcare workers, Matthew said. 

"Without clerks, without good laboratory technicians, we cannot provide care," she said.