Minnesota could face a dire health care worker shortage in the near future if the state does not do more to recruit and retain workers, according to a Health Department report released Tuesday.

The report based on surveys of state health care workers found burnout could lead to "alarming" workforce losses, particularly in rural Minnesota. About one in five rural health providers said they plan to leave their profession in the next five years, with the largest projected losses to be among physicians. One in three rural physicians said they planned to leave the profession.

"We are going to need several approaches and solutions aimed at both recruiting the future workforce and retaining the current one," state Health Commissioner Jan Malcolm said in a statement Tuesday. "We in government and health care must do more to prioritize retention, work with educational institutions to expand clinical training opportunities and focus more broadly on the care team, including nurses, physicians, physician assistants, respiratory therapists and others."

Job vacancies have increased in nearly all health care professions since the start of the COVID-19 pandemic, the report found. Vacancy rates were highest in 2021 among mental health and substance abuse counseling occupations, with one in four jobs open. Licensed practical nurses, or LPNs, had the second-highest job vacancy rate at 17%.

Respiratory therapists were most likely to want a career switch, with 27% saying they planned to leave the profession in the next five years. Twenty-two percent of LPNs, 20% of physicians and 19% of registered nurses surveyed said they also planned to leave their professions, the report said.

Among health care workers planning to switch professions, physician assistants and respiratory therapists were most likely to do so because of burnout or job dissatisfaction.

"The share citing burnout has increased across all licensed health professions," the report said. "While this finding may not be surprising, it is a clear example of the devastating effects of COVID on the workforce."

Sam Fettig, a spokesman for the Minnesota Nurses Association, said the Health Department report validated concerns being raised by nurses at hospitals across the state. More nurses are working longer hours and leaving for jobs outside the profession, he noted.

Registered nurses are Minnesota's most in-demand occupation, with 43,000 job openings expected over the next decade, according to the state Department of Employment and Economic Development.

Several measures must be taken to avoid critical workforce shortages, the report said.

To improve retention, health care systems should strive to make jobs safer, more flexible and more lucrative. They also should consider targeted efforts to retain physician assistants, respiratory therapists and other health care team members who are more likely to suffer from burnout, the report recommends.

Professional training programs should expand clinical opportunities, especially in rural areas. And the state should consider incentives ranging from loan forgiveness for health care providers to scholarships and stipends for those interested in these professions.

"Very likely there isn't a single fix," the report said. "This multifaceted issue needs a multisectoral solution that involves all aspects of workforce development, recruitment, and retention."