Why financial incentives aren't enough to deal with health-care staffing shortages

As many provinces and territories deal with health-care worker shortages and overcrowded emergency departments, politicians are turning to financial incentives to keep or recruit staff. 

In the last seven months, at least five provinces have announced retention bonuses of tens of thousands or other recruitment perks to keep or attract doctors and nurses.

But is financial compensation the right recruitment tool?

Some researchers and recruiters say based on studies and their own experience, one-time financial incentives aren't effective enough at keeping health-care workers in their jobs. 

"Financial incentives have always been, and will continue to be, Band-Aid solutions," said Maria Mathews, a professor in the family medicine department at Western University in London, Ont.

Nurses' unions and national health leaders have said that financial incentives are just one piece of the puzzle needed to fix the ongoing strain on health care.

Working conditions, wages and the long hours are all things that need to be addressed, they've said. 

"What's important for these physicians and nurses? In 2022, it's quality of life," said David Este, professor emeritus of social work at University of Calgary, who has studied the issue.

"If they are working in hospitals that are chronically understaffed … and those working conditions are sustained over a long period, I don't think that financial incentives have the ability to deal with the nature of a work environment."

Provincial and territorial governments have relied on financial incentives for decades, according to a 2015 study which Mathews co-authored. These incentives vary from province to province, and they also vary based on the specific role and the need in the area. 

Ontario, Alberta, Newfoundland, Nova Scotia and P.E.I. are the most recent provinces to announce some type of financial compensation for new or existing family doctors or nurses.

It's a move Mathews has seen many times before, adding that politicians turn to financial incentives because it can be given relatively quickly.

"The problem isn't going to be solved just by giving people financial incentives. Because if that was the case, we wouldn't be losing nurses," added Este. 

And there are marked differences across the compensation initiatives recently announced by provincial governments and funded by taxpayers.