Will Pandemic Politics Lead to Recruitment Challenges in Rural Communities?

It seems healthcare organizations in rural communities just can’t catch a break. Even before the pandemic, rural hospitals were struggling, and the arrival of COVID-19 has exacerbated the situation in more ways than one. Lost revenue from the cancellation of many nonemergency surgeries notwithstanding, the pandemic is pitting communities against the very healthcare workers who are there to care for them. The culprit? Divisive pandemic politics and “toxic individualism,” explains this recent NPR article.

According to NPR, more than a quarter of all the public health administrators in Kansas quit, retired or were fired in 2020, in a state where more than a quarter of the population live in rural settings. Some of these leaders received death threats or hired armed guards, the article stated.

But it doesn’t even take extreme intimidation or actual violence to have an impact. Nearly a year into a pandemic that is showing no signs of letting up, healthcare workers at all levels are feeling betrayed by their communities over a simple gesture—wearing (or not wearing) a mask.

Of course, patients not heeding medical advice is nothing new. Many chronic diseases could be prevented with the commonsense lifestyle changes healthcare providers have been prescribing for years. Medication adherence could keep many patients healthy and out of hospitals. But wearing a mask or not isn’t just about a single patient’s health. It’s about community, taking care of each other and caring about the greater good. It’s about all of the things rural communities have used in their recruitment pitch to healthcare workers for years.

Mike Lieb, vice president, interim services for HealthTechS3, had previously predicted a rise in executive departures as a result of the pandemic.

In a July post for this blog, he said the threat of a second wave of the virus may encourage some permanent leaders to retire. “People who are likely to consider retirement now will probably pack up themselves quickly and get out of the way,” he said at the time. In November, he said the prediction rang true, as he was seeing an uptick in demand for interim placement services.

Now, Lieb says he’s not surprised to hear that divisive pandemic politics is one of the driving forces behind some executives exits. “All executives are interims, whether their title includes the word or not,” he says. “Of all the healthcare professionals, they’re the most mobile.”

But he’s not ready to predict the same for rural healthcare providers, especially physicians. “Picking up and moving just isn’t as easy for them,” he says. “They could be attracted away for a different offer, but that’s not a quick and easy thing to do. More than leaving these communities, I think we’ll see an increase in frustration that leads to a decrease in quality of life, not just for them, but for their family and friends they’re carrying their frustrations home to.”

Lieb also sees possible ramifications for new recruitment efforts. “The pandemic has wiped some of the luster off the small-town environment and magnified unpleasant behaviors we knew people had all along,” he says. Nurses, who are more mobile, could be especially harder to attract. And positions that formerly were staffed by members of the community also could be challenging to fill.

“It’s easy to forget that behind every frontline nurse or doctor is a housekeeper, facilities manager, and food service staff,” he says. “And typically, these folks aren’t paid all that well but they’re taking many of the same risks and growing increasingly frustrated, as well.”

Despite the gloomy outlook, Lieb says there’s at least one silver lining of the pandemic—it appears to have brought many healthcare teams closer together. “I tend to be an optimist and I think during the worst of times you get the best of people,” he says. “I’m seeing hospital staff at all levels pull together now in ways I hadn’t always seen before.”