Seeking cures for health care employment.

• Author: Richardson, Jeffrey
• Position: Shortage of personnel in Alaska's healthcare industry

Alaska's health care industry battles to retain workers in face of national shortages and unique Alaskan challenges.

Occupational therapist Linda Glick opened Alaska Hand Rehabilitation in Anchorage six and a half years ago. With the swelling number of work-related repetitive-motion injuries, the clinic has experienced double-digit growth in clients and revenues every year. She decided she needed extra hands to help meet the demand.

Glick began advertising in professional journals, networking through personal contacts across the country and posting notices at professional conferences. Then she waited. And waited.

"I started looking for two additional occupational and hand therapists in December of 1990," she recalls. "By March of '91, I had found only one."

Glick rewrote her ad copy, and waited some more. "It wasn't until June of this year, 15 months later, that I finally found the second person to round out my team," Glick reports. "It was a long haul, but the number of occupational therapists out there is just really limited, which means the supply of qualified people I want working with my clients is even more limited. Plus, when you get somebody good on the line, then you have to start talking them through all of their stereotyped impressions of life in Alaska. It's a big deal for them."

Stories like Glick's are common in Alaska's health care industry. Not only does the state suffer from the same staffing shortages that plague the rest of the country, but medical facilities here, both large and small, face special challenges in recruiting and retaining adequate staff to meet needs. In rural Alaska, medical staffing is an acute problem.

"We've got a hiring advantage in Alaska," says Richard Mandsager, a physician and director of the Alaska Native Medical Center in Anchorage, referring to the attraction of many to Alaska's unique lifestyles. "But on the other side, especially for families, are concerns about winter and a host of unfamiliar factors such as schools, job opportunities for spouses and the cost of traveling Outside to see family members."

On a national level, shortages of medical personnel are resulting from rapidly expanding medical specialization and technology. Driven by increased demand and an expanding base of medical knowledge, new therapies and machines are being developed faster than people are being trained to apply them.

While the vacancy rate for nursing positions averages 10 percent nationwide -- and appears to be moderating thanks to higher school enrollments and innovative retention strategies -- vacancy rates for other key positions are even higher and still are increasing, according to the American Hospital Association. Among such key positions: physical therapist, 16.6 percent vacancy in 1991; occupational therapist, 14.2 percent; radiation-therapy technologist, 12.9 percent; cytotechnologist, 12.8 percent; and physician's assistant, 12.8 percent.

The hospital association predicts the skill-shortage trend will continue, in part due to insufficient openings in underfunded public schools that train for these positions.

The Alaska Department of Labor reported in 1991 that shortages of dental assistants, medical assistants, medical technologists, licensed practical nurses, registered nurses, physical therapists, occupational therapists and respiratory therapists are the most serious in the Alaska health care industry. But medical experts note current or projected problems in retention for a host of other positions, including physicians, pharmacists and administrators.

Although nursing vacancy rates are as low as 1 percent for some urban Alaska facilities, the statewide picture is more bleak. A 1991 report by the Alaska Native Health Board states: "Simply put, Alaska is not producing enough nurses to fill current need, not enough qualified nurses from Outside are willing to...