Navigating the Physician Shortage: What Healthcare Leaders Need to Know

According to the most recent HRSA data, the U.S. is projected to face an overall shortage of 141,160 full-time equivalent physicians by 2038. At the current trajectory, the national physician supply is expected to meet only 88% of the projected demand.

The physician shortage is changing how healthcare leaders think about access, capacity, and workforce planning. As demand continues to outpace supply, organizations are navigating both immediate coverage gaps and longer-term sustainability challenges.

Understanding the factors behind the physician shortage and evaluating ways to respond is key to maintaining patient access and building a stable workforce. 

Of the 35 physician specialties analyzed by HRSA, 30 are projected to experience shortages by 2038. The specialties facing the greatest constraints include vascular surgery at just 66% supply adequacy, ophthalmology at 72%, and thoracic surgery at 73%. 

Primary care is where the gap is felt most directly by patients. The National Center for Health Workforce Analysis projects a shortage of 70,610 primary care physicians by 2038, including:

These are the providers patients rely on for preventive care, chronic disease management, and continuity of care. When these positions go unfilled, patients feel it in longer wait times, reduced access, and gaps in ongoing care.

Rural and non-metropolitan communities bear a disproportionate share of the burden. The physician shortage in rural areas is projected to reach 58% by 2038, compared to just 5% in metro areas. The rural primary care shortage alone is expected to reach 39%. These numbers are compounded by the closure of more than 100 rural hospitals over the last decade, which has already reduced the care infrastructure available to some of the most underserved populations in the country.

The current physician shortage is not the result of a single cause. Several factors have been building simultaneously, and together they are creating a physician supply and demand imbalance.

An aging patient population: By 2030, one in five Americans will be 65 or older. According to HRSA, 93% of older adults live with at least one chronic condition, which means the demand for physician services is not just growing; it is becoming more complex. An older population requires more care, more frequently, and across more specialties.

An aging workforce: According to the AAMC, approximately 42% of active physicians are expected to reach retirement age within the next decade, and more than 20% are already 65 or older. Retirement timing varies, but historically, around 30% of physicians retire between the ages of 60 and 65, with another 12% leaving practice before age 60. As these physicians exit, their patient panels do not go with them. That demand moves to a system that is already stretched.

A training pipeline that has not kept pace: Medical school enrollment has grown by more than 35% since 2002, but the number of available residency positions has not followed. The Balanced Budget Act of 1997 capped Medicare-funded residency slots, and while some have been added since, the growth has been limited. Graduate medical education is the bridge between medical school and independent practice, and when residency capacity is capped, the number of physicians who can complete that transition each year is capped with it.

Physician burnout is accelerating early exits: According to the AMA's 2025 national physician comparison report, 41.9% of physicians reported at least one symptom of burnout. The downstream effects are predictable: reduced hours, earlier retirements, and experienced providers leaving practice sooner than planned.

To mitigate these shortfalls, healthcare leaders and policymakers are pursuing several strategies to narrow the gap. None of them are immediate fixes, but together they represent a meaningful response to the shortage of physicians that has been building for years.

The Resident Physician Shortage Reduction Act proposes adding 14,000 Medicare-supported residency positions over seven years, at a rate of 2,000 slots per year from 2026 through 2032. At least 10% of those positions would be directed toward rural hospitals, medically underserved communities, and areas with newer medical schools. Without lifting the federal cap on Medicare-funded residency positions, the training pipeline will continue to fall short of what the country needs. 

Expanding the roles of Advanced Practice Providers (APPs), including Nurse Practitioners and Physician Assistants, is one of the most practical near-term strategies for extending physician capacity. APPs handle a significant share of everyday patient care: conducting visits, managing chronic conditions, and prescribing medications. Today, roughly a quarter of all U.S. health visits are delivered by NPs and PAs, freeing physicians to focus on more complex cases. Nurse practitioner jobs are projected to grow 45% by 2032, making them one of the fastest-growing professions in the country, while physician assistant jobs are projected to grow at 27%. HRSA projections indicate that high APP utilization could significantly reduce the projected physician gap by 2038, though scope-of-practice laws continue to limit how far this strategy can go in some states. Healthcare facilities that build collaborative care models now will be better positioned to serve their communities regardless of what the physician pipeline delivers.

Telemedicine has expanded access in communities where physician supply is thinnest, particularly in rural and underserved areas. Removing geography as a barrier to care allows specialists to serve patients who might otherwise go without access, and as reimbursement policies continue to evolve, its role in bridging the gap is expected to grow.

Retaining experienced physicians in active practice is one of the most cost-effective responses to the shortage. Reducing administrative burden and building supportive practice environments keeps providers in the field longer, buying time while pipeline solutions like GME expansion work their way through the system.

The U.S. physician shortage is the result of compounding pressures that have built over decades, and there is no single policy or strategy that resolves it on its own. Progress is happening, but closing a gap of this size will take sustained effort from policymakers, healthcare organizations, and the broader medical community over the long term.

For healthcare facilities navigating these pressures today, CI Health Group partners with organizations nationwide to help them find and place the physicians and Advanced Practice Providers their communities need.