Fifty-nine percent of healthcare executives said in a recent survey that physician specialists are the most difficult clinical job to fill, but the specialty that is most difficult for systems varies by state.
Hospitals and health systems are grappling with a national physician shortage. Across all physician specialties in the U.S., there is a projected shortage of 141,160 full-time equivalent physicians in 2038, according to a December report from the Health Resources and Services Administration. Pay and financial incentives used to have the greatest impact on physician recruitment, but in recent years, physicians are making their decisions based on other factors, such as culture and work-life balance.
In the next ten years, physician specialties are expected to grow an average of 3%, with dermatologists and psychiatrists being the fastest-growing specialties at 6%, according to Bureau of Labor Statistics data. In contrast, OBGYNs and general pediatricians are the slowest growing specialties at 1%.
In 2026, Match Day recorded a 93.5% match rate for all positions and a 93.3% rate for PGY-1 positions — both 0.8% lower than 2025 match rates, according to the National Resident Matching Program. Four specialties saw a decline by 1.4%: internal medicine, internal medicine-pediatrics, pediatrics and family medicine. Emergency medicine and psychiatry also had lower match rates in 2026 with 95.6% and 97.4%, respectively.
Becker’s reached out to three systems to see which specialties are the most difficult to recruit, and how they are confronting this challenge.
Adena Medical Group
Leaders at the Chillicothe, Ohio-based system are most concerned about any specialty with a lot of subspecialized fellowships.
“Take urology — we certainly have the volume for general urologic services, but a lot of urologists coming out of training are not general urologists willing to take hospital call,” Brooke Burns, president of Adena Medical Group, told Becker’s. “They’re subspecialized, and that makes recruitment really challenging.”
The system is having similar difficulties with recruiting noninvasive cardiology clinicians, especially electrophysiology, and psychiatrists.
As a medium-size health system, Adena finds it difficult to compete with larger systems that can offer a reduced call burden and greater work-life balance. This makes it difficult for the system to maintain inpatient coverage and call.
To solve this, the system is using advanced practice providers when appropriate and bringing in locum physicians from other health systems to fill call gaps. It also established residency programs in family medicine, internal medicine and psychiatry, along with a sports medicine fellowship to improve its pipeline.
Henry Ford Medical Group
Leaders at the Detroit-based system are most concerned about radiologists and anesthesiologists.
“It’s not that it’s particularly difficult to recruit someone into those roles,” John Deledda, MD, chief medical officer of Henry Ford Medical Group and chairperson for the department of emergency medicine, told Becker’s. “The challenge is that the economics around those specialties are starting to negatively impact our ability to recruit. It’s at what cost we can find them, and how we prevent that cost from ultimately landing on the patient.”
In radiology, for example, AI disruptions, geographic considerations and payer mix have compounded to make compensation escalate.
“What ends up happening is organizations in the same geography start competing against each other, offering higher and higher rates, and physicians jump from system to system chasing compensation,” Dr. Deledda said. “Competing organizations are not sitting down locally and saying, ‘The cost of healthcare in our geography is getting out of hand — we need to do something about this together.’ Instead, we’re all sitting in rooms strategizing about how to pay someone else’s radiologist more to bring them into our workforce. That’s an unfortunate and unsustainable trend.”
A similar trend is playing out among anesthesiologists, with the added layer of complexity since there are multiple certified positions that can provide anesthesiology services, such as board-certified anesthesiologists, certified registered nurse anesthetists, and in some states, certified anesthesia associates. This has led to compensation compression.
Henry Ford Health System is tackling this by building clinically integrated networks, value-based contracts, shared savings plans and downside risk arrangements that benefit patients by controlling cost and elevating quality, Dr. Deledda said. About 60% of the system’s revenue comes from value-based contracts, a number well above average.
MaineHealth
The Portland-based system has found primary care specialties such as family medicine and internal medicine the most difficult to recruit across the system. In hospitals specifically, anesthesiologists, particularly pediatric anesthesiologists, and radiologists are the most difficult to recruit, followed by oncologists and nephrology. As with other systems, the difficulty stems from physicians subspecializing and tough competition in pay.
System leaders are expanding residency programs, building relationships with external agencies and building pipelines to bring in new physicians. They are also reconsidering which services are needed at which hospitals.
“The days of having someone on site five days a week are largely gone,” Adrian Moran, MD, chief medical and transformation officer at MaineHealth, told Becker’s. “We try to tailor clinical needs realistically — not compromising patient care or quality, but being honest about workforce shortages and how people want to practice medicine. Meeting everyone somewhere in the middle requires constant conversation, and it’s fragile.”
These conversations include asking if an on-site radiologist is needed or if the same quality of service can be provided remotely. In anesthesiology, leaders are pushing physicians to be more flexible about supervision models, and challenging critical care and emergency medicine physicians to consider if they can take on services traditionally performed by anesthesia.
“We have to think broadly and innovatively about who delivers care, because if we don’t, we’ll start closing hospitals,” Dr. Moran said. “And when smaller hospitals close, those patients flow to larger systems, which then face the same pressures at greater volume.”
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