Why relevance matters.

IN SOME EDUCATIONAL CIRCLES, relevance is an unacceptable word. It raises fears that the ancient and liberal arts will be sacrificed on the altar of expediency and that all higher education will be subsumed by vocational training. Relevance in the college and university business is frequently dismissed as a horrific quality that would lead to the creation of curricula that pandered to students' notions of what was and wasn't currently relevant in their lives. I don't believe that to be true, but I do believe that higher education has a profound obligation to be relevant for this simple fact: Educational policy profoundly influences future supply, not only in this country but around the world. Educational institutions are self-governing and largely free from outside influences in matters of degree programs and curricula. Yet they play the vital role--sometimes the only role--in creating relevant educational programs. If colleges and universities don't respond to educational shortages, who will? If colleges and universities don't create and implement degree programs that respond to societal challenges, who will? Relevance matters.

The 1993 National Academy of Science report "Allied Health Services: Avoiding Crises" included this prophetic observation: "If no steps are taken to bolster the future supply of personnel in several allied health fields, health care institutions will be hampered in meeting the public's demand for services." In 2003, the Department of Health and Human Services told Congress that "the aging 'baby boomer generation' will be the most significant factor in increasing the demand for lung-term care services over the next half century," with increases in the number of elderly expected to increase from about eight million in 2000 to around 19 million by 2050. Twenty-seven million Americans will be using nursing facilities, alternative residential care, or home care services by 2050. This past April, Medical News Today, covering the second annual FuturePoint Summit (a coalition of academic and business leaders in the health care field committed to finding solutions to the allied health workforce shortages) reported that "a shortage of at least 1.6 million to 2.5 million allied health workers is predicted by 2020." Compounding the problem is the aging of our current health care workforce. According to Dr. Jennifer Schindel of Health Workforce Solutions, the average age of long-term care workers is 48, the average age of health educators is 47, almost 50 percent of our clinical lab technicians will be eligible for retirement by 2010, and close to 50 percent of our certified counselors are over age 55, as are 30 percent of our social workers. Although the projections may vary from prognosticator to prognosticator, the consensus is the same: Our country is already facing shortages of educated and trained professionals in the allied health fields despite rapid growth in the number of frontline health care professionals. The Bureau of Labor Statistics projects that the "frontline workforce is growing faster (32.6 percent) than the growth rate of all health and health care occupations (23.3 percent), and significantly faster than the growth rate for all occupations (14.8 percent) in the United States workforce." Unfortunately, this projection reflects only the increase in jobs needed due to occupational growth and doesn't consider the need for occupational replacements--a number which is projected to require growth of more than 49 percent just to keep up with demand. This means that the number of positions created by the need to replace departing employees will exceed the growth rate in new positions by 17 percent.

In the case of many health care professions, colleges and universities are the sole preparer of new entrants. According to the Robert Wood Johnson Foundation, this crisis cannot be resolved without a commitment from higher education to create relevant degree programs. This approach will require insititutions to reshape their program curricula and position themselves as career partners.

We all know about the nursing shortage, but it is just the tip of the iceberg. There are over 100 professions under the umbrella of the frontline health care workforce, and the shortages in many of these fields are already upon us. Just ask any health care professional you know. The 2006 RWJF report describes these professions as "critical, highly visible components of the United States healthcare system; they provide vital contributions to the public, their patients, key constituents and the organizations they serve," and urges educational institutions to assess their programs in the context of emergent employer needs and changing student situations and demands, to create delivery mechanisms to employ new teaching and learning technologies that allow for more distance learning, assessment of competence, work-based learning and simulation, and to commit to students throughout a lifetime of practice and growth.

Over the next decade, more than half of the 30 fastest growing positions will fall within allied health disciplines. According to the Bureau of Labor Standards, the disciplines in this group are growing faster than average through 2010, and the increasing complexity of the health care environment has further fueled demand. As an example, HIPAA (the Health Insurance Portability and Accountability Act of 1996) compliance has increased the need for professionals in the areas of medical records, coding, and the preparation of medical transcripts. Respiratory therapists, physical therapists, occupational therapists, and speech and language therapists are in short supply, as is every variety of laboratory professional.

My institution, the National University System, includes the second-largest private nonprofit institution in California, National University, which has more than 110,000 alumni. Located in the nation's most populous state with the world's eighth largest economy, we tend to experience societal trends first. According to the Center for California Health Workforce Studies, the state is facing severe shortages of laboratory technicians and technologists, respiratory care practitioners, and diagnostic imaging professionals, among others, right now. These shortages are mirrored across the country and around the world and are particularly acute in rural areas. The critical issues of supply, demand, and utilization in the health professions are major problems currently impacting the quality of our lives and the lives of our friends, our neighbors, and our loved ones. Just a few more reasons why relevance matters.

By Jerry C. Lee, chancellor, National University System (Calif.)