The United States is entering a critical shortage of physicians. The Association of American Medical Colleges projects a deficit of up to 86,000 doctors by 2036, less severe than the earlier forecast of 124,000 by 2034. Demand is accelerating as Baby Boomers age and as more physicians themselves retire or cut back hours.
Meanwhile, graduate medical education slots remain capped, limiting the flow of new primary care physicians into frontline roles.
COVID-19 exposed and deepened these vulnerabilities. An AMA analysis found the pandemic intensified burnout and prompted early retirements, shrinking the workforce just as delayed care created surging backlogs.
Geographic maldistribution compounds the crisis: rural communities, already underserved, now face travel distances measured in hours for specialty visits, while even major cities report month-long waits for primary care appointments.
The ripple effects are stark. Patients wait longer, hospitals rely on costly locum tenens coverage, and remaining clinicians shoulder heavier panels that threaten quality and satisfaction.
Throughout this article, we dissect the forces behind the shortage, trace its impact on patient care, and spotlight the modern recruitment, staffing, and retention strategies that healthcare organizations are adopting to ensure a sustainable physician workforce.
Root Causes of the Physician Shortage
A widening gap between the nation’s care needs and its clinical capacity has become one of America’s most urgent public health challenges. Primary care physician shortages are accelerating even as an aging population drives higher demand for patient care.
Multiple forces, from training bottlenecks to surging burnout, now converge to limit the number of medical professionals available to communities, health systems, and healthcare organizations across the country.
Shrinking Pipeline of Medical Graduates
U.S. medical schools enrolled about 100,000 students in 2024-25, only a 1.8% increase year over year. That progress stalls at the residency level, where Medicare funding caps from the 1997 Balanced Budget Act restrict new positions and slow the recruitment process into residency programs. From 2006 to 2016, enrollment climbed 21% while residency slots rose just 13%, leaving qualified prospective physicians unmatched and delaying entry into medical specialties that are in high demand.
Congress approved the Resident Physician Shortage Reduction Act of 2023 to add 14,000 slots, but those positions will phase in gradually. Meanwhile, fewer graduates pursue primary care practices; only 9.5% of third-year internal medicine residents intend to enter general primary care.
High debt loads and lower reimbursement rates in rural settings further discourage service in these communities, often leaving them dependent on foreign-trained physicians and advanced practice provider teams.
Aging Physician Workforce and Retirement Trends
Experienced physicians form the backbone of many medical practices. Yet, more than two in five active doctors will be at traditional retirement age within the next decade, according to an AAMC analysis. As of 2021, approximately 46.7% of active physicians in the United States were aged 55 or older, indicating a significant portion of the workforce nearing retirement age.
As these clinicians exit, their vital role in mentoring younger colleagues disappears, weakening physician retention and raising the rate of physicians leaving full-time work earlier than planned.
COVID-19’s Long-Term Workforce Impact
The pandemic intensified shortages of physicians by driving unprecedented attrition. An estimated 117,000 physicians left the workforce in 2021 alone, and one AMA survey found one in four planning to leave their current post within two years.
Burnout, grief, and long hours amid crisis conditions strained mental health and accelerated exits, particularly in high-demand specialty areas such as emergency medicine. Health care recruitment teams must now manage backlogs of deferred procedures while caring for COVID “long-haulers,” stretching health systems already short on staff.
Rising Physician Burnout and Job Dissatisfaction
Burnout levels have reached historic highs. A 2021 study reported that 62.8% of doctors exhibited at least one burnout symptom, correlating with lower physician retention and increased turnover costs estimated at $4.6 billion annually.
One-third of medical groups lost a doctor to early retirement in 2021 because of burnout, according to an MGMA poll.
Contributing factors include excessive administrative tasks, electronic health record frustrations, and limited autonomy, all of which erode satisfaction and impede the quality of patient care. Addressing these systemic stressors is essential to keep health professionals engaged and stabilize the supply.
How Physician Shortages Are Impacting Healthcare Delivery
A shrinking physician workforce is already reshaping patient care across the United States. Primary care clinics, high-demand specialty services, and entire health systems confront widening access gaps, rising costs, and uneven patient outcomes.
The result is longer queues, heavier reliance on advanced practice provider teams, and growing public frustration, especially in rural communities and underserved city neighborhoods.
Strain on Primary Care Access
Primary care physician shortages limit the very front door of patient care. The federal government lists 7,749 primary care Health Professional Shortage Areas, affecting 77.3 million people. Eliminating those shortages would require another 13,300 practitioners.
Geography magnifies the problem. Only about 10% of physicians serve the one-fifth of Americans living in rural settings, leaving just 13 physicians per 10,000 residents compared with 33 in metropolitan areas.
More than 90% of rural counties meet shortage criteria, and over 7% of all U.S. counties have no primary care physician at all. In inner-city neighborhoods, Medicaid patients often face month-long waits; nationally, the average delay for a new family medicine visit is 20 days.
When preventive visits slip, hypertension, diabetes, and mental health conditions progress until emergency rooms become the default safety net, driving up the reimbursement rate burden for health care organizations already under strain.
Backlogs in Specialty Care
Shortages of physicians extend far beyond primary care. A 2022 survey of fifteen large metro areas found patients waited an average of 26 days for an initial specialty consult; obstetrics-gynecology averaged 31 days, while orthopedic surgery stretched to 34 days.
In smaller towns, a neurologist or endocrinologist may visit monthly, leaving six-month lags for crucial evaluations. Rural patients requiring mental health or pediatric subspecialists often travel hours, compounding public health challenges already linked to primary care physician shortages. Even in well-served cities, referral volumes rise as the population ages.
Yet, 20% of doctors intend to cut clinical hours, shrinking effective capacity in medical practices that already struggle with the recruitment process delays. Each postponed colonoscopy, joint replacement, or cardiac consult allows disease to progress, undermining patient care goals and inflating downstream costs.
Dependence on Locum Tenens and Temporary Coverage
To keep doors open, health systems increasingly substitute permanent staffing with temporary physicians. In 2022, 88% of hospitals and medical groups employed locum tenens doctors; nearly 90% cited shortages as the driver.
Recruitment can take four months for a primary care role and five to ten months for a high-demand specialty, leaving executives little choice but to pay premium rates, travel, and housing to temporary staff. Continuous turnover disrupts continuity of care, complicates quality initiatives, and inflates budgets.
This is money that might otherwise support residency programs or health care recruitment incentives aimed at physician retention.
Declining Patient Satisfaction and Continuity
Patients feel the pressure directly. Most adults say their doctors spend too little time with them, and 53% believe physicians are already at capacity. Only 11% feel their visit lasts long enough for high-quality care.
Continuity also erodes when rotating locum doctors or overbooked clinics prevent patients from seeing the same clinician twice; yet 90% of patients rank a stable physician relationship as crucial.
Disruptions lead to repeated tests, medication errors, and lower adherence, particularly for chronic diseases that rely on steady follow-up. A recent national poll showed more than 70% of adults doubt the system meets their needs, citing delayed access and hurried visits.
System-Wide Consequences
Overreliance on stopgap measures hampers long-term planning, and persistent shortages raise the rate of physicians leaving full-time practice by forcing remaining clinicians into unsustainable schedules. Without strategic investment in residency programs, targeted incentives for rural communities, and modernized reimbursement frameworks that reward patient care continuity, shortages of physicians will deepen.
Expanding telehealth can help, but virtual visits alone cannot replace the high-touch care many patients require. Solving the crisis will demand coordinated action across healthcare practices, public agencies, and academic medical schools to produce, place, and retain the next generation of primary care physicians and high-demand specialty experts.
Challenges in Physician Recruitment and Retention
Health care organizations are pressing to expand the physician workforce, yet the recruitment process is slow and costly, and physician retention remains fragile.
High turnover siphons revenue, geographic and specialty mismatches leave rural communities and high-demand specialty fields underserved, credentialing delays stall onboarding, and the incentives on offer rarely outweigh lifestyle or financial drawbacks.
High Turnover Rates and Recruitment Costs
Turnover surged during the pandemic and shows little sign of easing. U.S. hospitals lose about $4.6 billion each year to provider churn, alongside nearly $1 billion in excess patient care costs linked to disrupted continuity.
A single physician vacancy can result in an average annual loss of $2,378,727 in net revenue for hospitals, according to Merritt Hawkins' 2019 Physician Inpatient/Outpatient Revenue Survey.
To mitigate such losses, hospitals often offer substantial recruitment incentives. In fact, 89% of physician recruitment assignments included signing bonuses, with an average bonus amount of $31,473. Additionally, 17% of these assignments offered student loan repayment assistance, with an average repayment amount of $117,217.
The average time to fill a family medicine or internal medicine physician vacancy is approximately 180 days, while specialties such as neurology can take up to 211 days, and some surgical specialties may require over 230 days to fill. Each unfilled slot stretches remaining staff, feeds burnout, and jeopardizes physician retention across the organization.
Geographic and Specialty Mismatch
Maldistribution continues despite expanded residency programs. Only 10% of physicians serve the 20% of Americans in rural settings, and forecasts indicate 34 states will face severe physician deficits by 2030.
Primary care remains the pressure point. Just 24.4% of the workforce practices family medicine, general internal medicine, or pediatrics, and fewer than 1 in 10 internal medicine residents plan a generalist career.
Meanwhile, subspecialists cluster in metropolitan hubs, leaving rural clinics and safety-net hospitals without cardiologists, psychiatrists, or geriatricians. These gaps compound public health challenges and increase the rate of physicians forced to cover broader patient panels.
Credentialing Delays and Licensure Bottlenecks
Even after a successful hire, paperwork can sideline physicians for months. State licensure and hospital credentialing often add 90-150 days before a new doctor can bill for patient care.
Although more than 30 states now use the Interstate Medical Licensure Compact to shorten wait times, many boards still rely on manual processes, and payer enrollment can tack on additional weeks. For rural communities, these delays prolong reliance on locum tenens staff and worsen primary care physician shortages during peak demand seasons.
Limited Incentives for Underserved Practice
Loan-repayment and bonus programs help, but seldom offset income gaps in underserved areas. The National Health Service Corps placed 20,000 clinicians in shortage zones in 2022, and the Conrad 30 program has directed 18,500 international graduates to rural or inner-city sites since 2000.
Yet many physicians depart when their commitments end. Even generous offers, such as the 41% of employers that include large loan-repayment packages, cannot always match the earning power, flexible schedules, and professional networks available in urban systems.
Improving reimbursement rate structures, expanding telehealth support, and strengthening community resources are therefore essential to make underserved placements viable long-term.
Modern Physician Recruitment Strategies That Work
Healthcare organizations tackling primary care physician shortages have shifted their recruitment process from print ads to integrated, data-driven tactics. The most successful efforts combine a strong physician-centric brand, digital networking, a seamless candidate experience, and purposeful use of foreign-trained physicians.
Together, these approaches help rural communities and urban safety-net clinics secure medical professionals in high-demand specialty and primary care practices, protecting patient care despite tight labor markets.
Build a Physician-Focused Employer Brand
Culture now outweighs cash. A 2021 survey of final-year residents ranked adequate personal time, flexible schedules, and supportive culture ahead of compensation when choosing jobs. To appeal to prospective physicians, health systems highlight mentoring programs, physician leadership roles, and transparent reimbursement rate structures.
More than 70 hospitals have earned AMA' Joy in Medicine' recognition for combating burnout, and each features the award prominently in their recruitment materials. Experienced physicians who feel valued become brand ambassadors, reinforcing physician retention while attracting new talent.
“The goal of the Joy in Medicine Health System Recognition Program is to unite the health care community in building a nationwide culture committed to the well-being of clinical care teams by helping health organizations invest in action plans promoting professional fulfillment and meaning that clinicians find in caring for their patients.” - Christine Sinsky, M.D., AMA vice president of professional satisfaction.
Leverage Digital Platforms and Social Media
Recruiters now meet medical professionals online. Doximity reports that 80% of U.S. doctors use its network, allowing targeted outreach by specialty or geographic preference.
LinkedIn and specialty society boards extend reach to primary care physicians and high-demand specialty candidates alike, while Instagram reels showcasing rural settings or advanced practice provider teams humanize the employer brand. Artificial-intelligence tools parse thousands of profiles, rapidly matching candidates to roles and cutting search times, according to Medical Economics.
Deliver a Seamless Candidate Experience
Speed wins offers. AMN Healthcare’s 2024 incentive review shows the average signing bonus for physicians is $31,473, and relocation assistance averages $11,284, yet those perks matter only if the hiring timeline is swift. Leading health systems answer inquiries within 24 hours, schedule virtual interviews within days, and begin state licensure paperwork immediately after contract signature.
Personalizing site visits, like introducing spouses to local employers or schools, helps rural candidates overcome lifestyle hesitations. Early credentialing shortens onboarding, letting new hires start patient care sooner and easing strain on existing medical practices.
Incorporate International Medical Graduates
Foreign-trained physicians already make up 25% of the U.S. physician workforce and often choose to work in underserved areas.
The Conrad 30 J-1 waiver places hundreds of IMGs each year in rural communities, while H-1B sponsorship helps health systems fill mental health and primary care physician shortages that domestic residency programs cannot. Structured mentorship, EHR orientation, and community integration support these doctors, improving physician retention and strengthening local health systems.
Align Incentives With Lifestyle
Financial packages remain critical, but today’s health professionals also expect flexible schedules, manageable patient loads, and opportunities to address public health challenges, such as mental health initiatives.
The same AMN review notes that relocation and loan-repayment incentives appear in 18% of offers, yet candidates still prioritize culture and work-life balance. By bundling competitive pay with autonomy, telehealth options, and advanced practice provider support, healthcare practices make rural settings and high-demand specialty roles more attractive to prospective physicians.
Measure Success Through Retention
High turnover undercuts even the best recruitment process, inflating the rate for physicians leaving and forcing renewed health care recruitment cycles.
Organizations that couple modern hiring tactics with continuous mentorship, clear career paths, and wellness resources sustain stable medical schools’ graduates and seasoned clinicians alike. This integrated strategy ensures that patient care, especially in primary care physician shortages and high-need rural communities, remains resilient.
Adapting Staffing Models to a Changing Workforce
Physician shortages have pushed healthcare organizations and health systems to rethink how they deploy talent so that patient care remains reliable in rural communities and busy urban centers alike.
By introducing flexible schedules, expanding telemedicine, refining compensation, and formalizing team-based care, leaders can improve physician retention, stretch each primary care physician’s reach, and keep high-demand specialty services open despite tight labor markets.
Flexible Schedules Keep Physicians Practicing
Work-life balance is now a prime driver of career decisions. About 10–15% of physicians already work fewer than 30 hours a week, and surveys show lifestyle factors outrank income when residents choose their first jobs.
Hospitals, therefore, advertise four-day clinics, job-sharing contracts, and sabbaticals to attract experienced physicians who might otherwise leave. Advanced practice provider pools cover clinics when part-timers are off, ensuring patient care is continuous even as doctors enjoy truly flexible schedules. The approach keeps valuable expertise in the workforce and lowers burnout risk, expanding effective capacity at a time of primary care physician shortages.
Telemedicine Expands Reach and Flexibility
Virtual care turns geographic barriers into scheduling puzzles that physicians can solve from home. An AMA study found 74% of doctors now work in practices that offer telehealth, a leap from pre-pandemic days.
Cardiologists can follow heart-failure patients in distant counties by video, and psychiatrists can deliver mental health therapy across multiple primary care practices without relocating. Hybrid schedules reduce commute strain, broaden clinic hours, and appeal to prospective physicians who demand flexibility.
Telemedicine also supports team models in which an onsite nurse practitioner presents complex cases to a supervising physician via video, raising the reimbursement rate potential while filling care gaps in underserved settings.
Compensation Packages Align With Modern Expectations
Money still matters, but physicians want compensation that recognizes quality, loan burdens, and family needs. The latest AMN review pegged the average signing bonus at over $37,000, and 41% of employers now include sizable loan-repayment aid.
Many contracts split pay between productivity metrics and value incentives so clinicians are rewarded for preventive care, team leadership, and patient-satisfaction scores rather than sheer visit counts. Rural hospitals sometimes layer retention bonuses on top of market-leading base salaries to offset lower commercial-payer mixes.
Transparent, regularly reviewed packages reassure medical professionals that their earnings and benefits track local market changes, which is key for long-term physician retention.
Team-Based Care Multiplies Limited Physician Time
Letting every clinician practice at the top of their license is essential when specialists are scarce. Nurse practitioner employment is projected to climb 45% this decade. In patient-centered medical homes, these advanced practice providers handle routine diabetes checks, hypertension titrations, and patient education while physicians focus on diagnostics and complex cases.
Hospitalist programs pair one doctor with one PA to round on an entire unit, increasing throughput without eroding quality. Clear protocols, shared electronic records, and regular huddles keep communication smooth and help the full team deliver coordinated, high-quality patient care.
International Medical Graduates Bridge Persistent Gaps
Foreign-trained physicians remain a vital resource when domestic recruitment stalls. Through the Conrad 30 waiver, more than 18,500 IMGs have accepted three-year posts in shortage areas since 2000, often in primary care or mental health roles that sustain community clinics. Hospitals that streamline visa sponsorship, provide cultural-competency training, and pair IMGs with local mentors gain dedicated doctors who frequently stay after their commitment ends.
Retention-Focused Workforce Strategies
Recruiting physicians is costly, so keeping the doctors you have delivers the highest return for healthcare organizations.
Cultivating a Supportive, Collaborative Culture
Doctors stay where they feel heard, respected, and able to practice medicine instead of wading through bureaucracy. In a recent national survey, only 14% of physicians said visits allowed all the time needed for high-quality care, while 90% of patients deemed a strong physician relationship essential, as we explained above.
Forward-thinking systems respond by giving physicians seats on strategic committees, holding open forums with executives, and publicly celebrating clinical achievements. Predictable call schedules, equitable holiday rotations, and transparent vacation policies demonstrate that leadership values clinicians’ off-duty lives, an essential signal for long-term loyalty.
Offering Clear Leadership and Growth Paths
Many doctors want influence beyond RVU tallies. About 10-15% of the workforce already limits clinical hours, freeing time for teaching, research, or administration. Hospitals now sponsor mini-MBA programs, fund master classes in quality improvement, and reserve protected hours for physicians to lead informatics, telehealth, or population-health projects.
When clinicians see a credible pathway from frontline practice to service-line director or chief medical officer, they can envision an entire career within one organization instead of seeking growth elsewhere.
Formalizing Mentorship and Peer Support
Isolation fuels burnout, particularly for early-career hires in underserved areas. Structured mentorship pairs new doctors with seasoned colleagues for monthly meetings that cover workflow advice, clinical tips, and career planning.
Peer-support circles create a confidential space to debrief difficult cases, mitigating emotional strain that, unaddressed, can push physicians to resign. Specialty-specific or demographic-focused groups build community and provide tailored guidance. These low-cost programs weave physicians into the social fabric of the organization, significantly lowering voluntary departures.
Aligning Compensation With Modern Expectations
Although culture and growth matter most, competitive pay anchors loyalty. We remind you that the 2024 AMN incentive review set the average physician signing bonus at $31,473, while relocation stipends averaged roughly $11,000.
Many contracts now peg 10–20% of income to quality metrics or patient-experience scores, rewarding collaboration rather than sheer volume. Rural hospitals add multi-year loan-repayment grants or retention bonuses to close pay gaps caused by lower commercial-payer mixes. Transparent annual reviews assure clinicians that compensation keeps pace with regional benchmarks, removing another trigger for exits.
Stay Ahead of the Physician Shortage
Physician shortages and recruiting challenges in 2025 are redefining how healthcare organizations plan, hire, and retain critical talent.
In the face of mounting demand and dwindling supply, organizations that act with speed, creativity, and data-driven strategies will outperform those that hesitate.
Recognizing regional disparities, evolving candidate expectations, and rising competition is now essential, not optional.
The organizations that prioritize smarter recruitment efforts today will secure the top medical leaders of tomorrow.
If you’re looking to hire physicians for your organization, please contact us to see how we can help.
Frequently Asked Questions
What is one of the biggest challenges facing physicians today?
One of the biggest challenges facing physicians today is physician burnout, fueled by heavy patient loads, administrative demands, and healthcare staffing shortages. Doctors also face increasing pressure to adapt to evolving healthcare technology and regulatory changes while maintaining high standards of patient care.
What specialty has the biggest physician shortage?
Primary care specialties, such ophthalmology, and thoracic surgery are experiencing the most severe physician shortages. Rural areas and underserved communities are particularly affected, creating critical gaps in basic healthcare services.
Which doctor specialty is in the highest demand?
Primary care physicians remain the specialty in highest demand, but there is also a growing need for specialists in psychiatry, emergency medicine, and orthopedic surgery. The aging U.S. population and rising rates of chronic illness are driving increased demand across multiple medical fields.
What field of medicine has the least shortage?
Fields like pulmonology, emergency medicine, and neonatology tend to have the least physician shortages. These specialties typically offer favorable work-life balance and are more concentrated in urban and suburban regions where physician supply is higher.
What is the demand for doctors in the next 10 years?
The future demand for doctors is expected to grow substantially, with projections showing a shortage of up to 86,000 physicians by 2036 according to the Association of American Medical Colleges (AAMC). Factors such as an aging population, expanded access to healthcare, and increasing retirement rates among current doctors are key drivers behind the growing physician shortage.
