The Right Health Workers in the Right Places

Health providers are not always located where patients need services. In general, rural and low-income areas have substantially fewer health care providers per capita, especially specialists, than urban, high-income areas. Additionally, people of color are substantially underrepresented in health professions compared to their presence in the general population, often making cultural competence more challenging. For more information on health equity in the workforce, click here.

Different programs and strategies are being developed to help with this maldistribution of health providers:

  • Incentive Programs: State and federal programs place service-obligated providers in shortage areas or facilities in exchange for scholarships or loan repayments. Additionally, foreign-trained physicians can waive their home residency requirements after training in exchange for practicing in an underserved areas. The length of the service obligation depends on program requirements, hours treating patients, and the amount of the scholarships or the loans being repaid. For more information on incentive programs available to New Yorkers, click here. 
  • Pipeline Programs: Pipeline programs are a critical component of introducing middle and high school students to careers in health care. Mentoring, job shadowing, MASH camps, and other related programs give students an inside look into health care occupations. These programs help improve recruitment from underserved communities. Ultimately, these programs encourage students to enter the health field and return to practice in their communities.
  • Career Ladders/Lattices: Career ladders and lattices assist the existing health workforce in obtaining more job opportunities within health care. Career paths such as nurse aide – to licensed practical nurse – to registered nurse not only addresses critical workforce shortages but provides more economical stability for health care workers. 
  • Role Substitution: Role substitution is important in both creating a team-based approach to care as well as in increasing access to care, especially for underserved populations. Role substitution better utilizes the existing health workforce, within their respective scopes of practice, which in turn allows higher-level staff to see and treat more complex patients. One example in behavioral health is substituting psychiatric nurse practitioners, clinical social workers, and/or peer counselors for psychiatrists. 

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