This working paper synthesizes critical problems identified by interviews with more than 40 leaders in the Boston
area health care industry and places them in the context of work and family issues. At present, the defining
circumstance for the health care industry nationally as well as regionally is an extraordinary reorganization, not yet
fully negotiated, in the provision and financing of health care. Hoped-for controls on increased costs of medical care
have fallen far short of their promise. Pressures to limit expenditures have produced dispiriting conditions for the
entire healthcare workforce. Under such strains, relations between managers and workers providing care are
uneasy.
Five key issues affect a broad cross-section of occupational groups, albeit in different ways: staffing shortages; long
work hours and inflexible schedules; degraded and unsupportive working conditions; lack of opportunities for
training and advancement; professional and employee voices are insufficiently heard. The paper concludes with
possible ways to address such issues
