The workforce: Burnout, retention and where AI fits

Hospitals and health systems across the country are seeing staff shortages, and that’s one of the key topics addressed during the Chief Healthcare Executive Roundtable.

Our panel of top healthcare leaders talked about the persistent problem of burnout in the industry, and it’s making it harder to keep top talent. The panel sees great potential with AI to reduce the workload on doctors and nurses, but the leaders also recognize there are concerns about AI.

Our panel includes:

• Robert Garrett, FACHE — CEO, Hackensack Meridian Health
• Benjamin P. Levy, M.D. — clinical director of medical oncology, Johns Hopkins Sidney Kimmel Cancer Center
• Deepak L. Bhatt, M.D., M.P.H., M.B.A. — director, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine
• Kevin Beiner — COO, Northwell Health
• Stephanie Wierwille — moderator; EVP, strategy and innovation, BPD

Transcript

Stephanie Wierwille

There's been a lot of discussion about the workforce already, and Dr. Bhatt, you brought this up very early. The workforce challenges continue, and staffing shortages keep growing, especially around physicians and nurses. As we think about those financial discussions, labor expenses are a large portion of total expenses, but we also need a larger workforce to deliver great care. Dr. Bhatt, as you think about where we are now, three-plus years past the height of COVID, how does the workforce environment compare, and where are you seeing challenges?

Deepak Bhatt, M.D.

Healthcare professionals in general really stepped up during the pandemic. It was incredible to see and to be part of. I was never part of wartime medicine, but it felt like what wartime medicine is like: lots of sick patients, triaging people, life-and-death decisions, but everybody working together to do what's best with whatever resources they had in front of them. In many respects it showed the best the health care system can do, but as I alluded to earlier, it also exposed the cracks. It was a stress test that the health care system failed in aggregate, showing there's a lot that needs to be improved.

During the pandemic people stepped up and went beyond the call of duty, but that's not sustainable over years. It forced us to address the fact that nurses are often getting burned out because we're asking them to do more and more, often not appropriately increasing their pay, and that's something they shouldn't have to tolerate. Likewise, physicians: you tell them to do more, and in general they'll say, "Yes, thank you, may I have another," but at a certain point that isn't sustainable either. It's not merely a financial issue, though compensation is part of it and we shouldn't gloss over that. It's also what people sometimes call moral burnout. The prior authorization issue we mentioned is a killer. Beyond impeding and slowing down patient care, it's a lot of work for physicians, nurses, administrators, the whole apparatus. It's one thing to do work you think is helping a patient; nobody complains about that. But it's busy work, paperwork that, as many prior authorizations are, is designed to impede care, and that adds to the whole environment of burnout. We need to address these issues holistically and make it a better environment for everyone working in health care, whether inpatient or outpatient. If you have nurses and physicians who are happy and feel their efforts are justly rewarded and directly benefiting their patients, that's a win for everybody.

Stephanie Wierwille

“To your point about the additional administrative work constantly on physicians, you mentioned prior authorizations, and I'm sure we all have a hundred stories about where that fell on a physician or care team. Dr. Levy, you mentioned earlier that you see AI and technology as one possible solution. There's been wide success in things like ambient listening and imaging. Are there other areas where you think technology can support this workforce challenge, and if not, tell us more about the challenges you're seeing.

Benjamin Levy, M.D.

“Dr. Bhatt said it well. COVID was the zenith of this, everyone stepping up and working hard, and since then there's been a physiologic and moral breakdown and burnout. That's leading to shortages. We're having real challenges with physician and nurse retention, and this is across the country. Some of it is related to burnout, and some to these additional tasks that aren't leading to the improvement of a patient.

On how AI comes in here: one thing that's percolated throughout this conversation is that patients have a lot more knowledge at their fingertips. When patients' lives are in the crosshairs with oncology, they really go at it to assess the information out there. At our own institution we've seen a 30 to 40% spike in MyChart messages in Epic since the advent of AI, so there are a lot of questions coming in. I've talked to others across the country in oncology, and one thing being looked at is how AI can answer some patient questions. It seemed like science fiction five or ten years ago, but if it can be done accurately and carefully, it could help. I'd say 20% of my administrative duties outside of clinic are answering these patient messages; some are good questions, some are not, and that's okay, but how do we get some help in shouldering all of them? They're detail-oriented and sophisticated. That's another potential avenue where AI could assist. We want to answer patients' questions, we want them to feel tucked in and listened to, but some of it has become a little untenable. This is not the patient's fault; it's the fault of where we are in a system of very complex care, coupled with access to answers that may be true or false. There are a lot of ways this can be used carefully.

Stephanie Wierwille

Yes, and I love that you landed on "carefully." I'm chuckling a little because the overarching AI story is that it's going to save us all time, and what we're seeing is that it's true, and also there are all these unintended things happening, like messages coming in, patients having five-hour conversations with their chatbot in the middle of the night. They'd rather talk to their doctor in a lot of cases, but that's not possible. Does this spark any light bulbs, or is anyone else putting things in place to solve these workforce burnout, morale or trust challenges?

Robert Garrett

If I could jump in, let me cite a couple of statistics, because my colleagues talked about COVID, and our health care teams across the country stepped up in an unprecedented way. COVID taught us a lot, too. On the burnout question, I've seen statistics that since COVID, between one in four and one in five nurses across the country have left the profession, and that the burnout rate among physicians in 2026 is close to 60%. So the answer really is flexibility. We've tried to learn from COVID. Many people had to work remotely; some couldn't. So we put in more hybrid working models at Hackensack Meridian, which has helped stabilize some of the workforce issues. We've heightened the focus on employee well-being, which will be necessary to decrease burnout. As an example, we've enhanced our behavioral health benefits for team members, created quiet and restorative rooms at our hospitals, and created a 24/7 employee mental health emergency hotline.

I agree with my colleagues that technology is a good answer to help reduce burnout and stabilize the workforce. One technology we rolled out since COVID is a virtual nursing program across our care sites. Those virtual nurses help nurses at the bedside, freeing them from some administrative tasks so they can spend more time on direct patient care. That has helped on burnout and stabilized our retention rates among frontline nurses. On the physician side, we've put in place some AI algorithms, as others have alluded to, to reduce burnout and give time back to physicians, by summarizing charting and those kinds of tasks. Since COVID, the proliferation of telehealth has also helped in behavioral health, because there's a significant shortage of psychiatrists and behavioral health team members, and we've been able to connect more patients with providers through telehealth. It's made a big difference in access to behavioral health services. Those are a few examples of the learnings from COVID we've put in place to help reduce turnover and stabilize retention.

Stephanie Wierwille

I love those examples. I'm curious to hear from any of the four of you: shortages are not a new topic, and in many cases the industry is a little exhausted by it, but sitting where you sit, how much of an issue are shortages right now, on things like wait times and access? It's not a coming issue, it's a present issue. Any quick quantification or qualitative thoughts on how much of a challenge the shortage is in June 2026?

Kevin Beiner

Speaking for the Northwell example, around the time of the pandemic we started to experience shortages in radiation tech, pharmacy tech, a lot of the mid-level tech positions, and obviously on the nursing side. So we took it inside; we created training programs within our own corporate university, but we also partnered with the City of New York to develop a high school with four tracks for high school kids: physical therapy, nursing, rad tech and pharmacy. At the end of it they go into college-level programs and become a talent pipeline for us.

I want to pause and reflect on something: only in health care would we be sprinting to innovate while we're still recovering. For us, it took five years to recover from COVID with respect to turnover and vacancy rates. Five years is a very long time. It's all the modalities described here, but it's also culture, and culture is not a passive thing; it requires a lot of investment. On the other side of that, coupled with the downward pressure on the top line, labor is a lot more expensive now. You see unions negotiating pay increases of between 5 and 7%, sometimes more, and that hides the fact that benefit costs are skyrocketing. So while we're simply trying to keep the lights on with our workforce, investing in training programs and dealing with premium pay for areas of shortage, the amount we get reimbursed for the care we deliver goes down. Again, I don't want to apologize for what we do as an industry; we should be explicit and transparent about the challenges we have.

Stephanie Wierwille

For sure. Anyone else want to add to that? I love the point about culture, Kevin, because it's such an important topic. This overarching topic has so many factors: what physicians, nurses and care teams are being asked to do, the consequences of AI, and the ongoing trust, or lack thereof, in the country, both from a patient standpoint and a workforce standpoint. One last question here: Bob and Kevin, you've both given examples of how you're leaning into workforce culture and well-being. Dr. Levy, Dr. Bhatt, anything you want to add on how to keep trust high among employees before we move on?

Benjamin Levy, M.D.

I'll give a small example that we're doing now, and I'm sure a lot of you are too. Starting six months ago, we arranged in-house massages for all of our nurses, neck and head massages. A professional company comes in and sets up in our big conference room. I've learned that it's the small things. The nurses love it, the fact that twice a month they can come in and do that. These are small things, but I think it's the small things that matter a lot of the time.

I agree with everyone that retention is a challenge right now, not only for physicians and nurses, but, something we probably haven't talked about, for research staff too. Finding coordinators, people who can do the budgets, and research nurses is incredibly challenging right now, and they're the engine for our research. Doing these small things is really important. I also think increasing face-to-face opportunities matters. I used to run a meeting that was virtual, and I got a lot of pressure over the past year to convert it to an in-person meeting. I said no one would come if it were in person, and I was wrong. The ability to share something in the physical space and just chat, even if it's the same content, matters, so we've begun to do that more and more. Again, small things that tell a story and create a theme for all the staff in our health system.

Deepak Bhatt, M.D.

Those are all great thoughts. Hearing all of this is making me a little anxious, and I could use a neck massage, as a matter of fact. But I agree with everyone. It's a matter of conveying team spirit, creating a culture that makes it feel like everyone is working toward patient care in unison. I'll mention a couple of things that haven't come up explicitly. We've been talking about AI, and it's very exciting; everyone has mentioned it. But it's also important to acknowledge that there's some angst out there about AI and its potential to displace people's jobs. As we innovate in AI, we need to recognize that fear and address it head-on, and say we're not trying to bring in AI to replace anybody, but to augment what people are doing, to make their work lives more fulfilling, not less, and to get rid of the mundane tasks that people don't get excited about. Otherwise there's a risk of a counter-clash, where people are more resistant to AI. It's been a little surprising to see how many college campuses are protesting AI; I wouldn't have predicted that would be a topic of controversy at a college graduation, but it's come up. We should realize there are sometimes stated or unstated fears about AI, in particular about displacing people's jobs.

One other point: there are many professions in the health care system where we're having shortages. Trying to get a CT tech or an echo tech can be very challenging. So we need, as health care centers, to perhaps get more into the business of training health care professionals, allied health professionals, the full spectrum, so that whatever stressor comes up, whether it's another pandemic, which statistically will probably happen eventually, we're really ready for it. A lot of that planning for the future takes resources.