As the CBOH examines the healthcare workforce in 2025, a broad understanding of various healthcare occupations is essential. This report is the first in a series of brief overviews highlighting key workforce sectors that collectively shape the U.S. healthcare system.

Introduction

The U.S. healthcare system is built on the foundation of a highly skilled, adequately supplied, and equitably distributed workforce that ensures the delivery of quality care across diverse settings. From hospitals and clinics to long-term care facilities and home health services, healthcare professionals play a necessary role in maintaining the well-being of millions of Americans. As of 2023, the healthcare sector employed over 17 million professionals, making it the largest employment sector in the country.

However, persistent workforce challenges threaten the long-term sustainability of the system. A combination of factors, including aging demographics, workforce shortages, burnout, and training bottlenecks, has placed significant strain on both frontline providers and healthcare institutions. These pressures are particularly acute in medicine and nursing, two of the most essential professions that drive patient care.

This brief overview report highlights workforce trends and projected shortages in medicine and nursing.

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Summary of the Physician Workforce (2024)

Current Workforce and Distribution

• Total 933,788 professionally active physicians, with 800,355 providing direct patient care.
• Internists and family medicine physicians account for nearly 25% of all patient care doctors.
• 38.9% of practicing physicians are female, with medical school enrollments now majority female (55%).
• The average age of physicians is 51.2 years, with 20% over the age of 65, raising concerns about future retirements.
• Physician distribution is uneven: rural areas face significantly larger shortages than metro areas.

Projected Shortages

• The U.S. is expected to face a shortfall of 187,130 full-time equivalent (FTE) physicians by 2037.
• Shortages will be more pronounced in primary care, geriatrics, psychiatry, and rural medicine.
• Growth in medical school enrollment has increased 6% over the last five years, but still falls short of demand.

Workforce Challenges

• Burnout rates remain high: 49% of physicians report burnout, down from 53% in 2023.
• Mental health concerns: 20% of physicians report symptoms of depression.
• Retention issues: Many doctors are reducing work hours or leaving practice due to stress and administrative burdens.
• Financial pressures: Increased corporate involvement (e.g., private equity in staffing) raises concerns about care quality and job satisfaction.

Anticipated Changes

• Expansion of Graduate Medical Education (GME) funding, with 1,000 new Medicare-funded residency slots phased in over 2023-2027.
• Efforts to increase the number of primary care and rural physicians, including state-funded residency programs.
• Scope-of-practice expansions allow nurse practitioners (NPs) and physician assistants (PAs) to take on more roles, alleviating shortages.
• Telemedicine growth is helping mitigate physician access issues, especially in underserved areas.
• Advances in AI and automation may help reduce administrative burdens and improve efficiency.

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Summary of the Nursing Workforce (2024)

Current Workforce and Distribution

• Over 4 million nurses in the workforce, including registered nurses (RNs), licensed practical nurses (LPNs), and advanced practice registered nurses (APRNs).
• The number of RNs grew by 5.3% from 2019 to 2023.
• Nurse practitioners (NPs) grew by 35.5%, while LPNs declined by 8.4%.
• The majority of the nursing workforce (87.7%) is female, and the average age of an RN is 43.4 years.

Projected Shortages

• A nationwide shortage of 63,720 RNs by 2030.
• Rural areas will experience a 13% shortage of RNs by 2037, compared to 6% in urban areas.
• LPN shortages are particularly severe, with a 36% shortage (302,440 LPNs) projected by 2037.
• Declining enrollments in Bachelor of Science in Nursing (BSN) programs (down 9.9% from 2022-2023) signal potential long-term shortages.

Workforce Challenges

• Burnout rates are high, with 45% of RNs and LPNs reporting burnout.
• Retention issues: 41% of nurses indicate plans to leave their jobs within two years.
• Workplace violence and unsafe conditions contribute to high turnover, particularly in emergency departments and psychiatric units.
• Wages increased during the pandemic, but hospitals remain dependent on high-cost travel nurses.

Anticipated Changes

• Hospitals increasing sign-on bonuses, tuition assistance, and loan forgiveness to attract and retain nurses.
• International recruitment efforts (e.g., hiring foreign-trained nurses) to supplement the workforce.
• Telehealth and virtual nursing are expanding, allowing experienced nurses to handle tasks remotely.
• Legislation supporting workplace protections (e.g., nurse staffing laws, workplace violence prevention).
• Innovative training models, including hospital-run nursing schools and apprenticeship programs, aim to bolster the pipeline of new nurses.

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Workforce Challenges Across Medicine and Nursing

1. Burnout & Mental Health

Burnout is a growing concern, exacerbated by COVID-19:

• 49% of physicians reported burnout in 2024, an improvement from 63% in 2021, but still higher than pre-pandemic levels.
• 45% of RNs and LPNs experience burnout multiple times a week.

2. Job Satisfaction & Retention Issues

• 28.7% of healthcare workers and 41% of nurses plan to leave their jobs within two years.
• Physician satisfaction dropped sharply, with only 57.1% saying they would choose medicine again as a career in 2021, down from 72.2% in 2020.
• A U.S. Census Bureau study found higher post-pandemic exit rates in healthcare compared to pre-pandemic levels.

3. Aging Population & Workforce

• The U.S. population over 65 is projected to grow from 17% in 2022 (58 million people) to 23% by 2050 (82 million people).
• Older patients will require geriatric-trained providers, but geriatrics remains an undersupplied specialty.

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Future Outlook & Considerations

Despite workforce challenges, some positive trends exist:

• Medical school enrollment increased 6%, with more female students.
• New RN licensing numbers are growing, helping offset anticipated shortages.
• The NP workforce is expanding rapidly, helping fill primary care gaps.

Conclusion

The U.S. healthcare workforce is facing severe shortages, high burnout, and demographic shifts. The demand for care is increasing, particularly due to an aging population and growing chronic disease burdens. While medical and nursing school enrollments show promise, systemic workforce challenges require urgent intervention. Future workforce investments should focus on mental health support, retention strategies, and equitable workforce distribution to ensure high-quality, accessible healthcare.

For a more in-depth analysis of the physician and nursing workforces, as well as insights into other healthcare professions such as dentists and allied health workers, refer to the HRSA State of the Health Workforce Report.