The healthcare workforce crisis has been called urgent for years. What leaders across the country now describe is a problem that has moved past urgency into a breakdown across the pipeline, the employment relationship and the financial equation that has long made healthcare staffing viable.
Leaders describing those pressures come from community hospitals, multispecialty clinics and regional health networks. Their market contexts differ, but their observations converge on a common conclusion: the workforce challenges now reshaping healthcare are permanent and the strategies that managed previous cycles may not be sufficient for this one.
Here are six observations based on expertise from top executives speaking at the Becker’s CEO + CFO Roundtable Nov. 2-5 in Chicago. Register here today!
1. The old playbook isn’t working.
The workforce shortage is real and with how quickly healthcare is transforming — being pushed by AI and technology solutions, patient demand and legislative changes, the playbook of the past may not hold up.
“The question is no longer whether we have a workforce shortage,” Ashwani Bhatia, MD, CEO of BayCare Clinic in Green Bay, Wis., said. “The real question is whether we have reached a point where traditional solutions are no longer enough.”
Dr. Bhatia called for sustained investment in the next generation of healthcare professionals, deliberate use of technology and AI to reduce administrative burden and support the workforce, and stronger regional partnerships designed to improve access and deliver value.
“If we continue to do what we’ve always done, we will fall further behind,” Dr. Bhatia said. “At BayCare Clinic, we see the need to invest in the next generation of healthcare professionals, embrace technology and AI to improve efficiency, reduce administrative costs and support our workforce, and build stronger regional partnerships to improve access while delivering value for patients and employers.”
2. The ‘tech desert’ is a reality in many states.
A nationwide shortage of 100,000 healthcare workers is projected by 2028, according to Mercer analysis. But hospital and clinic executives say those numbers understate what they are actually navigating.
The shortage has spread beyond registered nurses into the allied health roles that diagnostic care depends on — radiology technicians, respiratory therapists and cardiac rehabilitation specialists. The radiology technologist vacancy rate has reached 18.1%, according to data cited by the American Society of Radiologic Technologists, and projections for radiologist supply suggest the problem will intensify through the next decade.
“I call it the tech desert, especially in more rural hospitals,” Margaret Dimond, PhD, president of UM Health Regional Network in Ann Arbor, said. “From respiratory, radiology, cardiac rehab, etc., there are key shortages, despite offers with sign on bonuses. It is impacting timely testing for both in and outpatients. The causal factors include lack of ‘introduction’ of healthcare options that do not include college degrees, to lack of formalized partnerships between school systems and hospitals.”
Dr. Dimond also challenged the assumption that technology can absorb the gap these roles represent.
“[AI] or automation cannot fully replace the technicians needed to perform needed diagnostic testing for patients who are suffering, and physicians who need conclusive results before surgery, or a clinical treatment plan can be developed,” she said.
3. Hospitals still relying on locum tenens are feeling the pinch.
The workforce gap has persisted, in part, because of how healthcare has adapted to it. While some hospitals and systems gradually reduced travel staff, for others reliance on agency staff and locum tenens providers has grown into a structural dependency. In the view of Wyatt Brieser, CEO of Hammond-Henry Hospital in Geneseo, Ill., that dependency is corroding the foundation of hospital culture.
“Healthcare organizations are increasingly reliant on agency staff and locum tenens providers, creating a renter culture rather than an owner culture,” Mr. Brieser said. “When caregivers lack long-term connection to an organization, accountability, continuity, and ultimately quality can suffer. While these challenges existed before COVID-19, the pandemic accelerated them and exposed underlying fractures in the healthcare workforce. Many frontline caregivers have lost the joy, purpose, and fulfillment that once drew them to patient care, and are leaving for roles that offer better compensation, greater flexibility, or less direct exposure to the daily pressures of healthcare.”
Patients experience the consequences of that shift directly. Care teams become less familiar, continuity erodes and the trusted relationships foundational to healing become harder to build and maintain. For the permanent staff who absorb coverage gaps, the fatigue is compounding. And for health system CFOs, the contingent labor cost structure has become one of the clearest expressions of an underlying financial equation that no longer works.
“We continue to struggle with recruitment in many clinical areas due to a shrinking workforce,” said Rob Chestnut, senior vice president and CFO of LMH Health in Lawrence, Kan. “This is happening at a time when reimbursement is not keeping pace with increasing wages. These competing factors are leading to margin compression that is not sustainable over the long-term horizon.”
4. The increased demand for healthcare is exacerbating workforce shortages.
On the demand side, the pressure has intensified. Patients are arriving sicker and older, requiring more complex care. Greg Rosencrance, MD, president and CEO of WVU Medicine Thomas Hospitals in Morgantown, W.Va., describes the resulting gap between community need and organizational capacity as the defining challenge in his market. But it’s not insurmountable.
“Rather than allowing those challenges to define us, we have chosen to invest in our caregivers, expand access to advanced services and strengthen the clinical capabilities our communities deserve,” said Dr. Rosencrance. “Every strategic decision we make is guided by a simple principle: quality and safety come first, because access to exceptional care close to home matters.”
That mismatch lands most visibly on frontline workers, and the human toll is rising. Zachary Yoder, RN, president of three OSF HealthCare hospitals in the Peoria, Ill., market — St. Mary Medical Center, Holy Family Medical Center and St. Luke Medical Center — warns that technology, widely anticipated as a partial solution to staffing strain, carries its own risk if deployed without sufficient attention to caregiver experience.
“As clinicians care for sicker patients with fewer resources and greater administrative responsibilities, the risk of burnout, compassion fatigue, and workforce attrition continues to rise,” Mr. Yoder said. “Rapid technological advancements, while offering tremendous opportunities, can unintentionally create additional burdens if they are not thoughtfully implemented and integrated into clinical practice.”
5. Paying top talent more isn’t solving all the problems.
Workforce shortages are not only about compensation. Swannie Jett, CEO of Park DuValle Community Health Center in Louisville, Ky., said the expectations of workers, particularly those entering healthcare now, have shifted in ways that traditional benefits and salary structures have been slow to reflect.
“As competition for talent continues to increase, salaries have escalated beyond what many organizations originally budgeted for or anticipated,” she said. “Many employers are finding it difficult to balance rising labor costs with the need to maintain quality services, invest in infrastructure, and meet other operational demands.”
Compensation isn’t the only lever hospitals need to pull to secure the top talent. Many industries and organizations offer more flexible schedules and employee-friendly perks that embrace a lifestyle hard to replicate in healthcare.
“Employees are increasingly seeking workplace flexibility, professional development opportunities, and a healthy work-life balance,” she said. “Organizations that fail to address these expectations may continue to experience staffing shortages and high turnover rates. If these workforce challenges continue unchecked, they have the potential to significantly impact productivity, organizational performance, and the ability to effectively serve communities and stakeholders.”
6. Rural healthcare shortages have a ripple effect.
Nowhere is the cumulative weight of these pressures more acute than in rural healthcare, where workforce instability has accelerated into service collapse across entire communities. Tom Vasko, CEO of Newman Memorial Hospital in Shattuck, Okla., challenges the framing that treats rural and urban healthcare as separate problems competing for the same limited resources.
“America does not have an urban healthcare system and a rural healthcare system. It has one healthcare system,” Mr. Vasko said. “Rural hospitals provide care for nearly 60 million Americans, serve as the first point of access for millions more, stabilize critically ill and injured patients, and function as the connective tissue between local communities and tertiary medical centers. When rural healthcare weakens, the consequences inevitably reverberate throughout the entire healthcare continuum.”
Workforce stability is foundational infrastructure, and the current trajectory is not sustainable for the communities and care continuum that rural and community hospitals were built to serve.
“A healthcare system focused on survival cannot simultaneously lead the world in advancing medicine,” Mr. Vasko said.
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.
