Nurse practitioners and physician assistants are core to how many health systems keep clinics staffed and patients seen, especially as the U.S. manages an ongoing shortage of physicians — and the shift is beginning to show real costs for the workforce absorbing it.
The pressure driving that shift is well documented. The Association of American Medical Colleges projects the U.S. will be short by as many as 86,000 physicians by 2036, a gap driven largely by demographics. The U.S. population is expected to grow 8.4% over that period, but the population age 65 and older is projected to grow 34.1%, and the population 75 and older 54.7%. Meanwhile, 20% of the current physician workforce is already 65 or older, and another 22% is between ages 55 and 64 — a substantial share nearing retirement just as demand for care accelerates, according to the AAMC.
The shortage is not felt evenly. The AAMC’s analysis found that if underserved communities had the same access to physicians as better-served ones, the country would have needed roughly 202,800 more physicians as of 2021.
Health systems have found their most immediate answer in advanced practice providers, a category that includes nurse practitioners, physician assistants and certified registered nurse anesthetists. In CHG Healthcare’s 2026 Advanced Practice Provider Workforce Trends Report, a survey of 327 healthcare facility leaders, 92% said APPs are “very” or “extremely” important to their workforce strategy, up from 89% a year earlier. Ninety-seven percent said they plan to maintain or increase APP staffing in 2026, and 80% said deploying APPs has had a positive effect specifically on physician burnout.
Chris Purkey is president of CompHealth’s advanced practice provider division at CHG Healthcare.
“Advanced practice providers are closing critical gaps and driving better patient outcomes across health systems,” Mr. Purkey said.
The economics reinforce the trend. Kaufman Hall’s second-quarter 2026 “Physician Flash Report,” based on data from more than 200,000 employed physicians and APPs, found the median subsidy per physician full-time equivalent was $314,231, compared with $235,908 per provider FTE across the broader employed group that includes APPs. Provider labor’s share of total group expense rose from 70.5% to 71.3% year over year, even as spending on support staff and other nonlabor resources declined. Put simply, medical groups are asking a leaner support structure, weighted more toward direct patient-care staff, to produce more.
That heavier reliance arrives at a difficult moment for the nurse practitioner workforce. More than 30% of NPs say they are currently burned out, and nearly half have felt that way for more than two years, according to Medscape’s “Nurse Practitioner Burnout & Depression Report 2026,” a survey of 770 U.S. nurse practitioners published in August. Seven percent of respondents reported depression, and 16% said they were experiencing both conditions at once.
More than half of NPs attribute their burnout or depression primarily to job stress, and the top drivers they cite mirror what has pushed physicians toward burnout for years: excessive administrative tasks, insufficient compensation and long work hours. Sixty-four percent said the strain has affected their personal relationships, and only 16% believe their employers recognize the toll it’s taking, down from roughly 20% two years earlier. Asked what would help most, NPs pointed to higher pay, more manageable schedules and lighter patient loads.
Physician assistants are seeing similar demand, along with rising pay. Median PA compensation reached $140,000 in 2026, up from $134,000 in 2024, as the profession grew to more than 201,000 practitioners nationally, a 5.9% increase in a single year, Forbes reported in May, citing data from the National Commission on Certification of Physician Assistants. States have continued to expand PA authority to prescribe medications, diagnose independently and practice with less physician oversight, changes aimed largely at closing the same access gaps the AAMC has flagged.
NCCPA President and CEO Dawn Morton-Rias, EdD, has described the trend as a natural evolution of the role.
“PAs are a growing, adaptable workforce meeting the evolving needs of patients and health systems,” Ms. Morton-Rias said.
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