Healthcare’s workforce crisis is no longer a temporary disruption. It is becoming a defining structural test for the industry’s next era.
Margins remain thin and technology is advancing faster than organizational readiness. Burnout persists even as hiring stabilizes in some markets. At the same time, demographic shifts, wage pressure, safety concerns and generational change are reshaping what clinicians and staff expect from their employers.
When Becker’s asked 103 healthcare leaders, “What do you anticipate being the most pressing workforce challenge in 2026, and how are you preparing to address it?” the responses revealed an industry preparing for permanent redesign.
Across all 103 responses, 10 themes stood out.
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1. The Human-AI integration challenge. Artificial intelligence is moving from pilot to enterprise deployment. Leaders expect 2026 to test whether organizations can align workforce capability with rapidly advancing automation. The challenge is not just technical deployment but cultural adoption and redesign of roles. Executives warn that poorly managed implementation could widen burnout rather than reduce it. Governance, training and workflow redesign are becoming central workforce strategies but systems need an extra push to take the next step in overall transformation.
“One of the most pressing workforce challenges is the anticipated ‘Human-AI Synergy Gap’ — the disconnect between the rapid deployment of agentic AI and the workforce’s ability to effectively integrate it,” said Stephen Motew, MD, president and CEO of UF Health in Gainesville, Fla. “The last two years were characterized by experimenting with AI, and now we will start to see wholesale job redesign. Because we already have a culture of adopting technology, UF Health’s philosophy is to explore practical applications of AI to improve the health of the communities we serve.”
UF Health’s clinicians and researchers have access to the university’s supercomputer and can use the technology to power digital twin programming that will simulate thousands of patient scenarios. The system is already using the technology to improve ICU operations and offers students more than 230 AI-related classes across campus.
2. Sustaining engagement in an era of constant change. Burnout has evolved from a pandemic aftershock into an enduring operational risk. Leaders said workforce fatigue is being driven by continuous transformation, regulatory shifts and new technology deployments. Engagement is now treated as a strategic lever tied directly to quality and margin. Many systems are embedding frontline collaboration into change management efforts.
“The most pressing workforce challenge in 2026 is sustained staff engagement,” said Theresa McDonnell, DNP, RN, senior vice president and chief nursing executive of Duke University Health System in Durham, N.C. “With the deployment of new technologies to drive efficiency, we risk disengagement if the workforce experiences change to them rather than designed with them. At Duke we are focused on working with our frontline clinicians, staff and technical experts to solve the problems together.”
3. Physician workforce shortages. Physician shortages remain a dominant concern across markets. Leaders expect shortages to intensify as care complexity increases and retirements accelerate. Recruitment strategies are expanding nationally, but executives emphasized that hiring alone will not solve access gaps. Multidisciplinary team models are becoming more prominent. Long-term workforce modeling is increasingly tied to service line expansion plans.
“Physician workforce shortages will continue to be one of the most pressing challenges in 2026,” Conor P. Delaney, MD, PhD, president of Cleveland Clinic Florida Market and executive vice president of Cleveland Clinic. “Like many healthcare systems, Cleveland Clinic has been addressing this proactively over the past several years, taking steps to strengthen our workforce and ensure patients can continue to access care close to home.”
Over the last six years, Cleveland Clinic Florida has grown the physician workforce 91%, including adding nearly 100 new physicians last year. The system is expanding primary care, emergency department capacity and specialty services to meet patient demand.
“These efforts are part of a longer-term approach to addressing workforce challenges rather than reacting to them as they arise,” said Dr. Delaney. “Our focus will continue to be supporting multidisciplinary teams so that patients receive timely, compassionate care throughout the communities we serve.”
4. There is no overnight talent pipeline solution. Workforce supply constraints cannot be solved quickly. Training physicians, nurses and allied professionals requires sustained investment over years. Leaders described tension between short-term margin pressures and long-term workforce development. Academic partnerships and residency expansion are central strategies. Workforce sustainability is increasingly framed as a strategic obligation rather than an HR initiative.
“The most pressing workforce challenge in 2026 is that there is no overnight solution to the supply problem — and the work required often runs counter to short-term economic signals that favor restraint,” said Rebecca Napier, vice president of finance and administration at The University of New Mexico Health Sciences Center in Albuquerque. “Building a sustainable workforce takes time, planning, and sustained investment, even when the operating environment encourages caution.”
The health system has strategically scaled capacity across the clinical delivery system to expand access and ensure high quality care and now is investing in the academic, research and instructional infrastructure to support growth.
“This approach requires intentional tradeoffs – prioritizing long-term workforce development even when it means pacing investments elsewhere,” Ms. Napier said. “We view workforce sustainability as a strategic obligation to our patients, our learners and the communities we serve, not a short-term operational fix.”
5. Labor cost pressures mount amid the quest for financial stability. Labor costs remain the largest expense line for most systems. Executives described balancing staffing levels with financial discipline as increasingly complex. Wage compression, mandated increases and reimbursement lag are compressing margins. Workforce management capabilities are being strengthened to align staffing with acuity and demand. Leaders see workforce agility as both a financial and operational necessity.
“This year, one of the most pressing workforce challenges we face is sustaining workforce agility amid continued labor shortages and rising labor costs,” said Robin Damschroder, executive vice president, CFO and president of value-based enterprise at Detroit-based Henry Ford Health. “The total cost of labor represents roughly half of our expenses, making even small inefficiencies financially significant.”
Henry Ford Health is strengthening enterprise workforce management and planning to align with real-time demand and patient acuity. They are also adding automation and AI tools to reduce administrative burden and improve productivity, with the goal of creating more engaged teams.
6. All eyes are on retention. Trust emerged as a recurring theme across responses. Leaders emphasized that workforce challenges often stem from breakdowns in transparency, communication and belonging. Engagement strategies are increasingly centered on reinforcing mission and shared purpose. Cultural transformation is being tracked alongside operational metrics. Retention is viewed as inseparable from leadership behavior.
The U.S. could lose 96,000 full time physicians in 2026 and 55% of the healthcare workforce reports that they are considering leaving their job within the next year. Nicole Fox, MD, associate chief medical officer and medical director of pediatric trauma at Camden, N.J.-based Cooper University Health Care, called these trends “unsustainable” and said health systems must be laser-focused on retention and clinician satisfaction. Technology and AI will play a role in increasing productivity and decreasing administrative burden, but that’s not all.
“Health systems must invest in programs like strategic onboarding as well as interventions such as peer support and coaching to promote career longevity,” said Dr. Fox. “This could include opportunities to further their education, acquire a new skill or become more involved at the system level through a committee, task force or leadership role.”
7. Workplace violence as a workforce threat. Aggression toward healthcare workers is influencing recruitment and retention decisions. Leaders said safety must be treated as a workforce imperative, not a compliance issue. Zero-tolerance policies, partnerships with law enforcement and post-incident support programs are expanding. Several executives tied workplace safety directly to long-term talent sustainability. Safety investments are becoming foundational to workforce strategy.
“Nearly every day, staff experience verbal, physical, and/or sexual threats or abuse. Safety at work should be a given,” said Emily Moorhead, president of Macomb Market at Henry Ford Health. “If this is not addressed proactively, healthcare will continue to lose dedicated professionals and fewer people will choose to enter the field at all, which will only worsen an already critical workforce shortage.”
Henry Ford Macomb enforces zero-tolerance policies and uses administrative discharge when appropriate. The hospital also works with local law enforcement to ensure staff has legal and mental health support after incidents.
8. Generational workforce shifts. Healthcare now operates with four generations working side by side. Leaders said differences in expectations around autonomy, communication and work-life balance are reshaping management approaches. Organizations that fail to adapt risk disengagement and turnover. Leadership development programs are increasingly tailored to generational dynamics. Workforce strategy now includes cultural flexibility.
“I don’t think we’re paying enough attention to the generational shift happening in the workforce,” Richard P. Lofgren, MD, president and CEO of OU Health in Oklahoma City. “Generations are approaching work in distinctly different ways.”
Leaders that approach their workforce as a monolith won’t optimize performance; understanding the generational preferences is essential for successful organizations. OU Health is shifting culture through the OU Health Ways values, intentionally aligning expectations across generational attitudes.
“We’re investing in understanding how different generations work, what motivates them and what they need to thrive,” said Dr. Lofgren. “That includes leadership development, mentorship and creating an environment where those differences become strengths rather than friction points.”
9. Burnout persists as health systems rush to automate. Administrative burden continues to drive dissatisfaction. Leaders are deploying automation, ambient documentation and predictive tools to reduce cognitive load. However, executives cautioned against simply automating flawed processes. Successful redesign requires deliberate governance and clinician involvement. Returning time to patient care has become a measurable goal.
Philadelphia-based Jefferson Health is focused on building a future-ready workforce with talent upskilling and reskilling for both clinical and nonclinical roles while leveraging AI to reduce administrative work.
“We launched a unique initiative to return 10 million clinician hours back to patient care over the next few years,” said Mark Whalen, executive vice president and enterprise chief strategy and transformation officer of Jefferson Health. “This not only improves efficiency but also supports retention and wellbeing.”
10. Lack of middle management leads to high turnover. Across systems, leaders pointed to management capability as central to workforce stability. Poor leadership accelerates turnover regardless of compensation levels. Health systems are expanding coaching, mentoring and structured leadership programs. Retention strategies now focus heavily on frontline manager development. Engagement is increasingly tied to leadership accountability.
“Gallup’s State of the American Manager report tells us that one in two employees have left a job to get away from a manager,” said Peter D. Banko, president and CEO of Baystate Health in Springfield, Mass. “Their research also demonstrates that leaders account for 70% of the variance in team member, physician and provider engagement. People leave their boss and their team, not their organization.”
Mr. Banko sees the best opportunity is supporting, coaching and developing leaders who can uplift their teams, and holding them accountable for reaching their goals.
“We know that when we do that effectively that work environment, engagement, retention and overall performance improvement quickly follow,” he said.
