To meaningfully address the growing physician shortfall, the nation’s healthcare system must confront long-standing structural barriers that limit individuals’ capacity to enter, remain in and thrive in the field, health system leaders say.
These include the high cost of medical education, excessive administrative and documentation burdens and the need for broader adoption of team-based care models that allow physicians to focus on complex patient care.
Becker’s recently asked five physician executives what they believe is missing from conversations about combating the physician shortage, and what it will take to build a more sustainable workforce.
Note: Responses are listed in alphabetical order and have been lightly edited for length and clarity.
Anthony Aquilina, DO. Executive Vice President and Chief Physician Executive at WellSpan Health (York, Pa.): Healthcare leaders have an obligation to our communities to provide timely access to needed services. Our first tactical approach is to make sure our providers can limit the amount of time they spend doing nonproductive tasks. Forcing doctors to spend time on insurance company demands for prior authorization and peer-to-peer review are a disservice to not only our team members but to our patients. We at WellSpan are addressing the time demands put on providers by documentation needs by using AI-assisted documentation tools that produce notes from ambient conversation.
As a country, we also need to look at artificial limits put on the number of post-graduate training spots for shortage specialties. Lastly, we must solve the primary-care interest deficit that exists in medical school training. We need to elevate the primary care specialties both in prestige in medical school faculty and also in reimbursement for the critically important role they play in keeping Americans healthy.
Marjorie Bessel, MD. Chief Clinical Officer at Banner Health (Phoenix): At Banner Health we are tackling this on two fronts: keeping those already in the workforce from burning out and building the pipeline of new physicians. Retention can include solutions like adjusting compensation incentives to closely align achievable physician efforts for results aligned with system strategy, and leveraging technology like ambient scribing that reduces the daily administrative burden placed on physicians. We are also using more team-based models to reduce the cognitive load on individual physicians and freeing them up for more collaborative, impactful work. We’re seeing results with our comprehensive strategy, in which burnout rates continue to trend downward. We are also training 1,300 residents and fellows in 91 different programs each year.
David Christensen, MD. Senior Vice President, Chief Physician Executive and President at Valley Children’s Medical Group (Madera, Calif.): I think the issue is not only a shortage, but also where the new physicians are focusing their attention as they head through the medical system. There’s the four years in medical school, and then at least three to five years of further training in residency. During that time period, they are developing major debt because medical schools on average are about $70,000 per year in tuition plus living expenses. So when these doctors are looking to their future, they’re going to come out of medical school with $300,000 to $400,000 in debt, all the while earning interest, which they have to pay back. So a lot of their decision-making on what specialty they want to go into is based on, “How do I pay these loans back in a quick manner?” because a lot of their lives are on hold because they’re training so long.
A lot of what we see on the pediatric side is a lot of people don’t want to go into pediatrics because it’s one of the lower-paying specialties. And if they are going into a pediatric specialty, they are thinking about whether they can pay loans back in a timely manner. Look at pediatric anesthesiology. To become an anesthesiologist, you have to do four years of residency, and then you can go out and practice to be an adult anesthesiologist. If you want to do pediatric anesthesiologist, you have to add in a whole additional year to your training, in which case your loans are continuing to accrue. The decision-making thought process is, “Do I want to add a year on or do I just want to get out into the workforce and start paying those loans back?” Ultimately, it really comes down to, how do we impact that debt load on these people coming out of medical school and training so that going into a primary care specialty isn’t seen as a negative financially. Some of that has to do with the market and how they compensate physicians, but I really believe that part of the solution has to be loan repayment.
I’m an example of that. Thirty years ago, my first practice was in a rural setting in the mountains here in Northern California. For two years, not only did I learn a lot in this community, but I also had part of my loans paid back, which was really huge for me, but it also helped that community have a pediatrician. Perhaps an option would be to say, OK, and I know they’re doing some of this here, but it probably needs to be much wider that if you provide two years or four years in this setting, we will waive your loans. Maybe that needs to be a requirement if people graduate from the residency — that they have to put in a few years in a high needs area in order to get their loans paid back.
Juan Sanchez, MD. Chief Academic Officer at HCA Healthcare (Nashville, Tenn.): What is often overlooked is the growing shortage in specialty care. There is some recent evidence suggesting that the gap in primary care might be closed by medical school expansions and advanced practice clinicians. However, with the rapid pace of medical innovation and the emergence of new diagnostic and therapeutic advances, the demand for specialty care is expected to rise significantly.
Health system leaders must adopt a strategic and proactive approach to physician recruitment and retention. This includes:
- Expanding specialty pipelines by developing and supporting programs to attract medical students and residents to high-need specialties, particularly in underserved areas.
- Investing in workforce innovation by implementing team-based care models and leveraging technology-driven efficiencies to extend the reach of specialists and mitigate physician burnout.
- Enhancing retention strategies through prioritizing work-life balance, reducing administrative burdens, and fostering a supportive workplace culture that promotes physician well-being and professional growth.
Baligh Yehia, MD. President and Chief Transformation officer at Jefferson Health (Philadelphia): In 2022, the American Medical Association found that 40% of physicians had moderate interest in leaving their current organization within two years. While not all have acted on this intent, many clinicians and leaders have sought alternative paths. At Jefferson Health, we recognize that addressing the physician shortage requires more than just recruitment — it demands a reimagining of career development, workload distribution and the day-to-day realities of medical practice.
As a leading academic health system, we are committed to strengthening the bridge between medical education and clinical practice. Each year, we train approximately 1,000 medical students at the Sidney Kimmel Medical College at Thomas Jefferson University, and 30% of our graduates choose to continue their residency training at Jefferson Health. Beyond expanding our workforce, we have streamlined staffing models to reduce bureaucratic barriers and enhance efficiency.
However, the conversation must go deeper. What makes a career in medicine truly fulfilling? Physicians dedicate their lives to patient care — not late-night note-taking and administrative burdens. That’s why we are actively testing ambient scribes, optimizing the electronic health record and implementing other solutions with our health plan, such as reducing prior authorization requirements. We’re also thinking differently about the entire care team so members can collaborate more efficiently, share data and resources and leverage technology in strategic ways. These efforts can restore balance, ensuring our physicians can practice at the top of their license and focus on what matters most: their patients and their families.
