The physician workforce is facing an array of challenges in the year ahead as the U.S. faces a projected shortage of 141,160 full-time equivalent physicians in 2038, according to a December report from the Health Resources and Services Administration.
From confusion and controversy surrounding new visa requirements for foreign-trained physicians to changes in funding for medical shcools, here are X trends shaping the physician workforce in 2026:
The status of H1-B visas
In September 2025, President Donald Trump signed an executive order requiring employers to pay a $100,000 fee for each new H-1B visa application — an increase from the roughly $3,500 employers previously paid. The fee took effect Sept. 21.
The policy received significant pushback from health system leaders whose organizations often rely on the H‑1B visa program to sponsor physicians and medical residents to fill critical staffing gaps.
More than 4,000 research centers and hospitals sponsored visas as of June 2025, federal data previously cited by Bloomberg shows. Research has shown disruptions to the program could worsen access to care, particularly in rural and medically underserved areas that disproportionately depend on international medical graduates.
The American Medical Association applauded legislation introduced March 17 to exempt physicians and other healthcare professionals from a $100,000 filing fee on new H-1B visa petitions. The legislation was introduced by Reps. Mike Lawler, R-N.Y., Sanford D. Bishop, Jr., D-Ga., Maria Elvira Salazar, R-Fla., and Yvette Clarke, D-N.Y. The AMA also said it previously joined 53 medical societies in urging the Department of Homeland Security to exempt physicians, residents and fellows from the $100,000 H-1B visa application fee.
Physicians are prioritizing autonomy
Physician turnover risk remains lower than other clinical roles, but retention hinges less on workload and more on control, according to a new report from SullivanCotter and Lotis Blue. In a survey of more than 1,000 clinicians, physicians ranked clinical discretion, the ability to exercise independent medical judgment, as the single most important factor influencing their decision to stay.
Among clinicians surveyed, 80% intend to stay, 11% are considering leaving, and 9% said they quit a healthcare job in the past year. That marks a steep decline from a 19% quit rate in the prior study. Nearly six in 10 departures were driven by job-related factors, a 10 percentage-point increase.
Physician stay-or-leave decisions concentrate heavily in the care environment (28%) and total rewards, including compensation and benefits (30%). Together, those two categories account for more than half of overall influence. Compared with other roles, physicians place markedly less weight on schedule and job demands, suggesting workload alone does not explain exit risk once baseline thresholds are met.
Older physicians opting out of cognitive testing
Some health systems are requiring physicians 70 and older to undergo comprehensive cognitive evaluations, but any physicians choose to retire instead.
The physician workforce has faced an aging problem for decades. In 2005, more than 11% of physicians were 65 or older. That number rose to 22.4% in 2025, according to the Association of American Medical Colleges. At older ages, reaction times slow, knowledge can become outdated and some can experience cognitive decline. However, systems do not want to push experienced physicians out of patient care.
To address cognitive concerns, some systems have created late-career practitioner programs that mandate physicians 70 and older to be screened for cognitive and physical defects. Screenings are required before their privileges and credentials are renewed on a yearly or two-year basis. Depending on the results, physicians may see a change in job responsibilities or how they practice.
It is estimated there are as many as 200 late-career practitioner programs across the country, including at large systems such as Charlottesville, Va.-based UVA Health, Stanford (Calif.) Health Care, Philadelphia-based Penn Medicine and Hartford (Conn.) HealthCare.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 18–20 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
