Workforce shortages remain one of the most persistent operational challenges facing health systems competing for a shrinking pool of specialty-trained physicians, nurses and healthcare professionals.
Nearly half of executives say staff shortages have reduced their capacity to serve patients, and 103 health system leaders recently named physician workforce shortages among their top concerns heading into 2026.
The pressure is especially acute in oncology, where an aging population and rising cancer incidence are driving demand for cancer care even as the oncology workforce itself nears retirement age.
Becker’s asked six oncology leaders to name the oncology role that’s hardest to fill right now and describe one specific change they’ve made to close that gap.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Name the oncology role that’s hardest to fill right now. What’s one specific change you’ve made — to the job itself or to how you recruit for it — in the last year?
Don Dizon, MD. Service Line Chief of Hematology and Oncology at Tufts Medicine (Burlington, Mass.): In my opinion, it’s becoming increasingly harder to hire clinical and translational physicians into academic oncology. There has to be more to an academic position than seeing patients. I think in the era of evaluation by RVU, we are not able to recruit, let alone retain, talented academically inclined clinicians the way we did 10 or even five years ago. It is not an impossible task, but the onus really is on us as academic leaders and health systems to make the profession of academic oncology not only attractive but feasible. In an era where people have trained with a focus on work-life balance, gone are the days where the job came first. Not that that’s a bad thing.
Laura Goff, MD. Executive Medical Director of Cancer Patient Care Center at Vanderbilt-Ingram Cancer Center (Nashville, Tenn.): There is tremendous demand for many roles across oncology, but physicians in general are our most in-demand resource. Radiation oncologists, surgical oncologists and medical oncologists are frequently inundated with offers from health systems as well as locums companies. As health systems, including ours, have expanded to meet patients closer to home, it can be difficult to recruit physicians to service more rural areas for all specialties.
However, the hardest role to fill has been for dedicated breast radiologists. We refer to our breast cancer program as the “front door” of our cancer center as it is often the most common reason that a referring physician or a household decision-maker would first connect with us. Colleagues across the country share this same issue as supply has not kept pace with the volume of patients needing these services.
One specific change we have made to our recruiting for all our highly in-demand oncology physicians is to target signing them much farther in advance than we ever have before. In the past, we typically would sign about one year out at most, and often we were looking for positions that we needed to fill in three to six months.
Now we are working to project two and three years out, identifying top-tier physicians in training and working to have them join our team. We have expanded our recruitment team and provide white-glove experiences for physicians we are recruiting. Additionally, we present all opportunities across the health system to potential candidates so that we may truly find a fit for the kind of practice a promising physician may want for their career.
Marcia Gruber-Page, MSN, RN. System Vice President of Oncology at CommonSpirit Health (Chicago): As a nurse and administrative service line leader, I think registered nurses with oncology experience in outpatient settings are the most difficult role to fill. The vast majority of oncology care occurs in outpatient clinics and offices. Accurately assessing, educating a patient about their disease and preparing them for their treatment and its implications is crucial because these patients are only with us for the short time they are in the clinic.
Blake Herring, MSN, RN. Associate Director for Clinical Administration at UVA Comprehensive Cancer Center; Associate Chief Service Lines – Cancer Services for UVA Health (Charlottesville, Va.): The most challenging oncology role to fill currently is the radiation therapist position. Over the last year, we launched an “Earn While You Learn” program for current staff interested in becoming radiation therapists. This program allows employees to work part time while attending radiation therapy school, with financial support from us. This strategy enables us to invest in our current team and build an internal pipeline for a hard-to-recruit role. Our first participant is set to graduate in May 2027, and we see this as a key part of our long-term workforce planning.
Diane Reidy-Lagunes, MD. Chief, Division of Medical Oncology; Vice President for Oncology Services at Duke University Health System (Durham, N.C.): One of our most challenging oncology roles to fill right now is radiation oncology and radiology technologists. We’ve shifted from treating this primarily as a recruiting problem to looking at the role itself and the pipeline. One tangible change is that we’re developing clearer internal career pathways, with opportunities to build skills, take on greater responsibility and advance within the organization. We actively encourage employees interested in this career path to pursue associate-degree programs in nuclear medicine and radiology technology and are strengthening relationships with local training programs to create a more sustainable pipeline into these roles.
The goal is to make these positions more competitive, improve retention and development, and create a stronger long-term workforce pipeline rather than simply reposting the same opening.
This is also a role that illustrates how interdependent and integrated cancer care has become. An oncologist can’t take care of patients effectively if the patient can’t get the PET scan, MRI, biopsy, radiation treatment or other critical components of their care. These roles may not always be the most visible, but they are essential to delivering timely, high-quality cancer care.
Theodoros Teknos, MD, PhD. President and Scientific Director of the Seidman Cancer Center at University Hospitals; Deputy Director of the Case Comprehensive Cancer Center (Cleveland): One of our most difficult positions to recruit is the community oncologist, particularly at rural and geographically dispersed sites. The challenge is creating a role that combines the best of academic and community oncology. Physicians want the autonomy and relationships that come with building a community practice, but many also want to remain connected to fellows, teaching, clinical trials and subspecialty colleagues. And they want to do all of this while maintaining a reasonable quality of life. Our responsibility is to create that connection while providing the staffing, infrastructure and local team needed to build a strong and sustainable practice.
Clinical research nurses and coordinators are a persistent recruitment challenge. The work is complex, as they need to understand complex protocols, regulatory requirements, clinical operations and the patient experience, which makes experienced candidates particularly scarce. We also compete directly with industry for these roles. The longer-term solution is to build our own pathway with formal training, mentorship and progressive levels of responsibility so that clinical research becomes a visible career rather than a position people discover accidentally.
Cancer registry professionals are increasingly difficult to recruit and retain, even though their work is essential to accreditation, quality reporting and quantifying outcomes. Addressing that shortage requires us to reconsider geographic hiring restrictions, modernize compensation practices and use large language models and other technology to reduce manual abstraction and thus emphasize the mentally stimulating components of the work. The goal is to ensure the work is sustainable and registrars are not bogged down with the mundane components of the job.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
