Viewpoint: Direct service workers are healthcare's unsung heroes 

While physicians and nurses got the most attention for dealing with the chronic stress and burnout exacerbated by the pandemic, direct service workers should also be appreciated, Jehan El-Bayoumi, MD, founder of the Rodham Institute at Washington, D.C.-based George Washington University, wrote in The Hill Dec. 6. 

Physicians and nurses only make up around 20 percent of the total U.S. medical workforce, Dr. El-Bayoumi wrote. On the other hand, direct service workers like nurse assistants, home health aides and personal care aides make up a large portion of the workforce, totaling over 4 million. 

They care for some of the most vulnerable people, yet are among the most undervalued and underpaid. They also represent an extremely diverse group of people, with 88 percent of the direct service workers in the Washington, D.C., area being women and people of color, and 32 percent being immigrants. In the same area, around 20 percent of these workers live in poverty, and at least 1 in 10 do not have health insurance despite being at higher risk of exposure to infectious diseases.

Dr. El-Bayoumi urged health leaders to act now to change the system for these vital, unprotected workers. Protecting them, she argued, will save the entire system from collapse. 

"We cannot heal a mortal wound with Band-Aids. We cannot continue to tolerate a system where direct service workers struggle to make ends meet," she wrote. 

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