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Researchers Identify Strategies to Ensure, Sustain Health Workforce During Pandemic

Erin Fraher, PhD, MPP

Erin Fraher, PhD, MPP

CHAPEL HILL, N.C. – April 8, 2020 – Erin Fraher, PhD, Director of the Carolina Health Workforce Research Center at the University of North Carolina (UNC), joins six other directors of privately and publicly funded health workforce research centers to highlight state strategies to ensure and sustain the health workforce to meet patient needs during the COVID-19 pandemic. The article, “Ensuring and Sustaining a Pandemic Workforce,” was published today in the New England Journal of Medicine. Read here.

This article is the second one published in the journal that brings the collective experience of these directors on the health workforce. In the first article, published on February 13, 2020, Dr. Fraher and colleagues voiced their concern about how state regulations governing the practice of many health care professionals are resulting in unwanted and counterproductive outcomes for patients. The barriers identified in their first article are now more evident than ever as state and health system leaders seek to quickly ramp up their health workforce to meet the surge of patient demand from COVID-19.

State and health system leaders are learning from one another and working together to remove bureaucratic hurdles to mobilize and flex the health workforce. One common strategy being deployed across states is making requests under the Social Security Act Section 1135 for the authority to waive requirements during emergencies, which allows states greater flexibility in the deployment of health care workers.

Another strategy is working with licensing boards to reinstate recently expired licenses through temporary extensions to encourage retired health professionals to re-enter the workforce. Dr. Fraher and colleagues also recognized efforts by health professional societies, health care educators, and accreditors to find education and training solutions to bolster the health workforce. These include accelerating education programs for essential workers such as respiratory therapists, retraining health care workers such as physical therapists who have seen reduced clinical volume to provide needed care, redeploying health professional students to assist in medical tasks to free up other clinicians, and engaging social workers and community health workers to address social needs. As non-COVID-19 patients still require ongoing care, health care workers are increasingly turning to telehealth to deliver care, which has become easier with, for example, the removal of supervision of requirements by insurers.

The authors call on leaders to take swift action to expand and sustain the health workforce to help our country meet the needs of patients during this COVID-19 pandemic, and to evaluate these changes to inform any future response to pandemics.

This perspective piece complements additional efforts by Dr. Fraher and her team provide data and analysis on the availability of needed health professionals in North Carolina. Her team has put out blogs and data visualizations on respiratory therapists, critical care nurses, infectious disease physicians, and primary care access. Coming blogs will address acute care physicians and Certified Registered Nurse Anesthetists (CRNAs).

Dr. Fraher is Associate Professor in the UNC Department of Family Medicine in the School of Medicine.

The health workforce centers that came together for this article are:

  • The Carolina Health Workforce Research Center, the Cecil G. Sheps Center for Health Services Research, and the Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill (E.P.F.)
  • the Department of Health Policy and Management and the Fitzhugh Mullan Institute for Health Workforce Equity, Milken Institute School of Public Health, George Washington University, Washington, DC (P.P.)
  • the Department of Family Medicine and the Center for Health Workforce Studies, School of Medicine, University of Washington, Seattle (B.K.F.)
  • the Health Workforce Research Center on Long-Term Care, the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco (J.S.)
  • the New York Center for Health Workforce Studies (J.M.) and the Health Workforce Technical Assistance Center (D.A.), SUNY School of Public Health, Rensselaer
  • the Behavioral Health Workforce Research Center and the Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor (A.J.B.)
  • and the Center for Interdisciplinary Health Workforce Studies, College of Nursing, Montana State University, Bozeman (P.I.B.).


Media contact: Heather Wilson,, (603)-422-2458