Younger Generations of Hospice Workers Value Career Paths, Work-Life Balance

Hospices that are shaping their recruitment and retention strategies around work-life balance and career development have a fighting chance against competitors for sparse clinical staffing resources.

As workforce shortages mount throughout the health care system, competition in the labor market has intensified. Hospices are increasingly competing with other health care providers for clinical staff as more reach retirement age without enough younger workers stepping in to fill the gap. Some also leave the field due to burnout, or because they found higher compensation or a better career path elsewhere.

Career development and strong clinical leadership are key considerations to attracting workers who could stay with a company for the long haul, according to The Pennant Group’s (NYSE: PNTG) COO John Gochnour.


“We’ve put a lot of effort into educating and providing director of clinical service onboarding and training and leadership development. Ultimately, the experiences of our clinical staff emanates from the experience that those clinical leaders are having,” Gochnour said during a recent Hospice News webinar. “We’ve invested in different forms of training and development tools to continue to expand clinical knowledge and understanding.”

Demographic trends paint a broader picture of the clinical workforce’s capacity.

For example, the average age of licensed physicians in the United States is 51.7-years-old, according to a 2020 physician census report from the Federation of State Medical Boards (FSMB). Roughly a third (31.2% ) are 60 or older, compared to less than a quarter (23.9%) are younger than 40, reported FSMB.


FSMB researchers indicated that older physicians frequently work fewer hours and retire at higher rates. Simultaneously younger physicians are “placing more emphasis on work-life balance,” meaning they often value job opportunities that offer more reasonable or flexible hours.

These trends are a particular pain point for hospice and palliative care providers, according to Nick Seabrook, managing principal and senior vice president at SimiTree Healthcare Consulting.

Organizational culture will be a crucial factor in the recruitment and retention of younger health care workers, he said.

“The reality of the situation is right now there are just not enough fish in the pond,” Seabrook said during the webinar. “And unfortunately, it’s not only the home health and hospice boats that are out there doing the fishing. We’re competing with an entire health care continuum. The culture piece is really having purpose and having that culture of developing staff. That’s what folks are looking for. They’re looking for purpose — not just to serve the patients, but also how can they have a purpose within the organization.”

Hospices are often rowing upstream when it comes to hiring new clinicians.

As of 2019, more hospice and palliative care fellows were planning to work in hospitals rather than the home setting, according to research from the American Academy of Hospice and Palliative Medicine and the Health Workforce Institute at The George Washington University.

Less than 10% of new hospice and palliative physicians surveyed by those researchers indicated that they were headed to a hospice for employment post-graduation.

Additionally, roughly 29% of the surveyed physicians indicated that they had a difficult time finding a satisfactory position in the field. Though respondents indicated that job opportunities abound in clinical adult and pediatric hospice, compensation and geographic location were cited as the most frequent barriers.

Hospices will need to understand and adapt to the evolving needs and preferences of a younger clinical workforce as time goes on, according to Trisha Crissman, vice president and COO of home care and hospice at CommonSpirit Health.

Looking ahead, retention may hinge not only on taking a different viewpoint on scheduling strategies, but also a deeper integration of staff feedback, Crissman said.

CommonSpirit uses employee experience surveys and listening sessions to gauge staff satisfaction. The data they gathered are factored into retention and recruitment policies, she added.

“Last year our lowest scoring results from the survey were tied to the item, ‘my work leaves me emotionally drained,’” Crissman said. “During listening sessions, our employees stated that after-hours calls for nursing staff was a huge dissatisfier. Listening sessions are now hardwired to be part of our culture. It gives us a really valuable opportunity to continually understand the needs, wants and concerns of people.”

With this feedback from clinical staff, CommonSpirit began working with IntellaTriage, an after-hours nurse triage service provider. This allowed the home health and hospice provider to improve clinical satisfaction by reducing the burden on their schedules, Crissman stated. 

The organization has received positive staff feedback since implementing the change, along with a decrease in clinician turnover, she added.

In addition to work-life balance, professional development and guidance are also important to younger clinicians, according to Gochnour.

Today’s clinical leaders need to ensure that future generations are ready and able to take on the challenges and nuances of providing end-of-life care, especially as demand rises, he indicated. This means mentorship will be an important part of retention and sustainability.

“[It’s] just making sure that our local leaders recognize that our number one job, or one of our key priorities, is to be available to clinical teams so that we can answer difficult questions and help make sure that help make sure that we keep the patients out of the hospital, but also that our clinicians can confidently execute on care delivery,” he said.

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