In the last four years, Beth Israel Lahey Health has expanded its primary care physician workforce by 30%, but its specialty workforce has remained relatively stagnant, according to its chief clinical officer, Rob Fields, MD.
There are a few factors for this recruitment issue, he said.
For one, some medical students tend to avoid specialties known for lower pay, which translates into certain specialties failing to keep pace with patient demand. Private equity and venture capital are investing in the more lucrative specialties, Dr. Fields said, further exacerbating the gap.
The 14-hospital system struggles to recruit endocrinologists, neurologists, gastroenterologists, anesthesiologists and, to some degree, radiologists. With an average $526,000 salary, as of 2025, radiology is the third highest-paid specialty. Gastroenterology and anesthesiology average more than $500,000 per year.
Neurologists earn on average $332,000, a 3% decrease in the last year, according to Medscape. Although diabetes and endocrinology physicians saw the largest pay increase among specialties, at 7%, they are among the least lucrative, at $274,000 per year.
A significant share of the U.S. population is entering retirement age, too.
“You have a shrinking workforce, higher demand,” said Dr. Fields, who also serves as executive vice president of the Cambridge, Mass.-based system. “It’s like, whoa, a significant mismatch of supply, demand.”
“The other sort of phenomenon of an aging population is that they utilize so much more healthcare than a commercially insured patient,” he told Becker’s. “So in the hospital services, it can be three to four times the amount of a working age adult. That’s a huge amount of demand that’s being created every day as more people age into Medicare.”
To buck this trend, Dr. Fields said Beth Israel needs to compete harder to recruit the small pool of physicians in these specialties. It might not be able to create more gastroenterologists, he said, but the system can tweak the delivery model to cut inefficiencies and create a culture that attracts specialists.
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