Editor’s Note: This is part of a series of articles on “The Big Shortage” in California’s health care workforce. Watch The CHCF Blog for more discussions of how the workforce is changing in response to care innovations and demographic trends.
Every day, the women and men charged with providing health care to California’s 40 million residents work heroically. In helping people in California achieve healthier lives, this network of health professionals not only upholds the highest ideals of human care, it constitutes a formidable economic force that accounts for over 7% of the state’s total employment.
Yet in the next decade the health care workforce will face unprecedented challenges. The state’s population is growing and becoming more diverse. The number of older Californians is projected to increase dramatically. Meanwhile, the cost of health care continues to rise faster than inflation. One of the biggest reasons these costs are so high and rising so fast is that we rely on a health care workforce that does not fit our needs.
To ensure that all who need care can get it in the future, California must cultivate a workforce that delivers smarter, more affordable care. That will require a new generation of health professionals with roles, skills, and workflows that match our latest understanding of how best to deliver high-quality, high-value care. We need a workforce that can function in sophisticated teams and coordinate a broad array of services with patients. We also need a workforce that focuses not only on the body, but the mind and socioeconomic circumstance of each patient.
Of course, we can’t responsibly prepare for a health care future without considering how technology allows providers to work more efficiently, overcome barriers of time and distance, and lift the skills and knowledge of practitioners at all levels. We ought to prepare our workforce to take advantage of these opportunities — and we need a payment system that makes them viable.
We expect a lot from our health care providers, but the reality is that California’s health care system will not have the workforce it needs unless leaders take smart steps to prepare for it. Today, the California Health Care Foundation (CHCF) is proud to join just such an effort — the California Future Health Workforce Commission, an unprecedented opportunity to ensure that the talent we have matches the care we need.
The 24-member commission, co-chaired by University of California President Janet Napolitano and Dignity Health President and CEO Lloyd Dean, is composed of top leaders in California health care, higher education, and business. This extraordinary group of commissioners has the vision, expertise, experience, and position to not only deliver a comprehensive, statewide plan but to help implement it after the commission completes its work.
The California physician workforce was among the oldest in the nation in 2014. One-third of physicians in California are over 60.
While Latinos account for 38% of the population, they represent only 5% of active physicians. Latinos are underrepresented in the physician population in all regions of California, particularly in those with the highest proportions of Latinos: the Inland Empire, Los Angeles, and the San Joaquin Valley.
While the Affordable Care Act has expanded health coverage among people who were previously uninsured, these populations are more likely to live in areas where primary care doctors are spread across great distances.
Over the next 12 months, Future Health Commission members will develop a master plan addressing these and other pressing workforce issues. Their work will guide the state, educational institutions, employers, and other stakeholders for years to come.
We at CHCF could not be more enthusiastic about supporting a project that builds on so much of our past and current work to strengthen California’s health workforce. We are excited to be joined by our colleagues at Blue Shield of California Foundation, The California Endowment, and The California Wellness Foundation in backing this effort.
Ultimately, it will take more than 24 commissioners to modernize our health care workforce and to meet the health needs of the 21st century. The people involved in hiring, training, connecting, and researching California health professionals will have to approach their jobs in whole new ways. They will have to account for new technologies, new ways of working together, and new ways of developing and distributing talent. The Future Health Commission gives us an opportunity to accelerate that transformation. You can follow their work in the coming months by signing up to receive regular updates.
Good health isn’t something that just happens to you — it’s something you have to plan for. That’s true for people. It’s true for communities. And it’s true for California’s health workforce.
The 24 members of the California Future Health Workforce Commission
Janet Napolitano, President, University of California (co-chair)
Lloyd Dean, President/CEO, Dignity Health (co-chair)
Anne Bakar, President and CEO, Telecare
America Bracho, Executive Director, Latino Health Access
Linda Burnes Bolton, Vice President for Nursing, Chief Nursing Officer, Cedars-Sinai
David Carlisle, President and CEO, Charles R. Drew University of Medicine and Science
Joseph Castro, President, California State University, Fresno
Diana Dooley, Secretary, California Health and Human Services Agency
Hector Flores, Chair, Family Practice Department, White Memorial Medical Center
Jane Garcia, President and CEO, La Clínica de la Raza
C. Dean Germano, CEO, Shasta Community Health Center
Liz Gibboney, CEO, Partnership HealthPlan
Alma Hernandez, Executive Director, SEIU California
Sen. Ed Hernandez, Chair, Senate Committee on Health, California State Senate
Mitchell Katz, Director, Los Angeles County Department of Health Services
Rishi Manchanda, President, HealthBegins
Arnold Milstein, Medical Director, Pacific Business Group on Health
Eloy Ortiz Oakley, Chancellor, California Community Colleges
Nirav Shah, Senior Vice President and Chief Operating Officer, Clinical Operations, Kaiser Permanente, Southern California
Sheila Thornton, President and CEO, OneFuture Coachella Valley
Timothy White, Chancellor, California State University
Assemblymember Jim Wood, Chair, Health Committee, California State Assembly
Donna Wyatt, Director, Career and College Transitions Division, California Department of Education
Heather Young, Dean and Professor, Betty Irene Moore School of Nursing, UC Davis
Sandra R. Hernández, MD, is president and CEO of the California Health Care Foundation. Prior to joining CHCF, Sandra was CEO of The San Francisco Foundation, which she led for 16 years. She previously served as director of public health for the City and County of San Francisco. She also cochaired San Francisco’s Universal Healthcare Council, which designed Healthy San Francisco. It was the first time a local government in the US attempted to provide health care for all of its constituents.
In February 2018, Sandra was appointed by Governor Jerry Brown to the Covered California board of directors. She also serves on the Betty Irene Moore School of Nursing Advisory Council at UC Davis and on the UC Regents Health Services Committee. Sandra is an assistant clinical professor at the UCSF School of Medicine. She practiced at San Francisco General Hospital in the HIV/AIDS Clinic from 1984 to 2016.
Sandra is a graduate of Yale University, the Tufts School of Medicine, and the certificate program for senior executives in state and local government at Harvard University’s John F. Kennedy School of Government.