Physician shortages continue to challenge access, operational stability, and care team performance, pushing healthcare leaders to rethink how they build and sustain their clinical workforce. What was once a focus on coverage alone has evolved into a broader strategy centered on retention, well-being, staffing models, and long-term resilience.
To gain a clearer view of how health systems are adapting, Medicus partnered with the American Hospital Association (AHA) to bring together executives from three leading organizations to share how they are strengthening their clinical workforce and supporting resilience across their teams.
Panelists Included:
Six themes emerged from this discussion, offering insight into how each of these leaders has adapted workforce strategies to maintain stability across their organizations.
Workforce Models Are Shifting Toward More Dynamic, Multi-Layered Coverage
Persistent physician shortages and shifting patient demand are exposing the limits of traditional staffing models. Across the panel, leaders emphasized that stability no longer comes from a single approach to coverage. It comes from building more dynamic, multi-layered workforce models that can flex with volume, protect access, and reduce sustained pressure on core teams.
This shift is taking shape through several targeted changes in how coverage is structured and delivered:
- Hybrid coverage models are becoming more common. Graves described a more strategic approach to workforce planning, identifying where hybrid teams can be most effective, how flexibility can be built into coverage, and how these models can help differentiate in a competitive physician market.
- Advanced Practice Providers are being integrated more intentionally across care settings. APPs are playing a more central role across care settings, with expanded responsibilities in clinic coverage, hospital rounding, and procedures within scope, positioning them as a core component of long-term staffing strategy.
- System-level flexibility can strengthen coverage. Leslie described using broader system resources to stabilize local scheduling gaps. In radiology, this includes pulling from employed models in other parts of the system to reinforce coverage where it is most needed.
- Coverage models are being built around actual demand. Dr. Cook described staffing to case-volume analytics, using interventional radiologists, PAs, NPs, flexible shifts, and remote reading capacity to better match supply with workload.
Together, these shifts point to a broader change in how workforce models are being designed.
“What we used to call nontraditional staffing plans are becoming more and more traditional.” — Deborah Graves, President of BJC Health System, Memorial Hospital Belleville | Shiloh
Proactive Workforce Management Is Becoming a Core Operating Discipline
Workforce strategy is increasingly being shaped by how early leaders can identify and respond to strain. Waiting for burnout to surface is no longer viable. Across the panel, leaders emphasized the importance of recognizing early signals of disengagement and making adjustments before those pressures lead to turnover or performance breakdowns.
Leaders are taking a more proactive workforce approach in several key ways:
- Workforce and operational metrics are being monitored together. Graves pointed to turnover, retention, patient-to-provider ratios, and time to fill, while Leslie added first-year turnover and regular engagement surveys as indicators that can signal deeper issues.
- Leaders are watching for behavioral signs of disengagement. Dr. Cook described monitoring meeting attendance, punctuality, responsiveness, and whether people seem present and candid in one-on-one conversations.
- Early staffing adjustments can reduce downstream strain. When volume at UMC unexpectedly grew by 25,000 exams, Dr. Cook said his team reengaged locums, used teleradiology on the same platform, and added shifts before radiologists became overwhelmed.
Even in environments that appear stable on the surface, underlying strain can persist. As Leslie noted, this disconnect reinforces the need to act earlier, with burnout and distress continuing to represent “a material operating risk” even when traditional metrics suggest stability.
Retention Is Won in the Day-to-Day Work Environment
One of the clearest themes from the discussion was that retention challenges are emerging long before a physician decides to leave. Across organizations, the pressure points are embedded in the day-to-day realities of practice: administrative demands that pull physicians away from patient care, schedules that are difficult to sustain, and a growing need for stronger, more consistent support. In this environment, clinician experience is no longer a secondary focus. It is directly tied to workforce stability.
Health systems are responding by reworking the day-to-day experience of practice in more intentional ways:
- Reducing administrative burden is becoming a clearer retention lever. At Corewell Health, Leslie pointed to efforts to help physicians work at the top of their license, give them time back in the day, and improve efficiency through documentation support and other workflow changes.
- Well-being is moving closer to core operations. Rather than treating well-being as a side initiative, Leslie described the importance of embedding it into the organization’s operating infrastructure, highlighting structured well-being support, coaching, and measurable program outcomes.
- Flexibility is becoming part of the practice model itself. In radiology, Dr. Cook described building flexibility into scheduling through home reading, adjustable shift start times, and greater physician input into how coverage is structured.
- Supportive environments are increasingly part of the value proposition. Graves pointed to flexibility, visibility, and recognition as essential to keeping physicians engaged, particularly as expectations around the work environment continue to shift.
As expectations shift, leaders are recognizing that the work environment itself plays a defining role in whether physicians stay or leave.
"If we’re not creating workable environments, we’re going to continue to see burnout and lack of retention." — Deborah Graves, President of BJC Health System, Memorial Hospital Belleville | Shiloh
Provider Engagement Strengthens Culture & Retention
Improving the work environment is only part of the equation. Workforce strategies are proving more effective when physicians also have a direct role in shaping them. Engagement increases when clinicians are not just supported, but actively involved in how care is delivered.
Across the panel, leaders emphasized shared ownership as a way to strengthen alignment and build more sustainable models. This is taking shape through several focused approaches:
- Department-level autonomy can improve engagement. At Corewell, Leslie described a cascading goal process that allows physician and APP teams to define what matters most in their own groups, then escalate barriers up through the organization so those issues can be addressed.
- Regular dialogue helps leaders hear what is really happening. Dr. Cook described monthly one-on-one meetings, open-ended questions, and follow-up emails to confirm what he heard and what may still need attention.
- Schedule design is stronger when physicians help build it. At UMC, subspecialty radiology groups help determine where coverage is most needed and how schedules should reflect actual demand, which Dr. Cook said has contributed to faster turnaround times and stronger engagement.
- Physician governance strengthens participation. Graves emphasized involving providers at the start of problem-solving conversations so they can help build the solutions, not just react to them later.
At its core, engagement is built on ownership. As Dr. Cook emphasized, creating an environment where physicians feel heard and have a meaningful role in shaping the practice is critical.
“This is your practice, you own this, you’re a member of this team. And what you say counts.” — Dr.Cook, Medical Director and Chief of Radiology, University Medical Center of Southern Nevada
Interim Support Can Stabilize Teams While Supporting Future Growth
The panelists challenged the idea that locum tenens is only a short-term fix. Instead, it is increasingly being used as a strategic lever to stabilize workloads, protect care delivery, and create the capacity needed to improve recruitment, culture, and performance over time.
Leaders are using interim staffing support in more intentional ways:
- Short-term coverage can reduce pressure on permanent teams. Graves described a hospitalist team that had too few full-time providers, high patient-to-provider ratios, and difficulty keeping new hires. Increasing locums support helped stabilize workloads while the organization reset the model.
- Temporary support can help long-term recruitment. In that same turnaround, Graves said the organization hired 13 providers in one year after stabilizing ratios and holding the team accountable to a new culture.
- Continuity matters in interim coverage. Graves also described the value of using the same locums providers repeatedly so teams and patients can build familiarity, and those clinicians can contribute to internal improvement efforts.
- Early relief can produce measurable operational gains. Leslie said that when Corewell pulled the trigger earlier in radiology and added locum tenens support, turnaround times improved relatively quickly as backlog came back under control.
Graves connected this to a broader operational strategy, noting that investing in locum tenens helped stabilize a hospitalist program, improve performance, and support long-term hiring. In her words, it often requires “short-term expense for long-term gain.”
Long-Term Stability Requires Earlier, More Deliberate Workforce Planning
Beyond immediate staffing gaps, the discussion made clear that long-term workforce stability depends on planning earlier and more deliberately. The pressures the panelists described were not temporary: an aging clinician workforce, rising patient complexity, specialty shortages, rural fragility, and the need to build a stronger recruiting infrastructure before turnover hits.
Leaders are responding by shifting from reactive hiring to more forward-looking workforce strategies:
- Succession planning is starting earlier. Graves said organizations are having those conversations sooner, especially as more tenured physicians near retirement and replacement becomes harder.
- Some service lines remain especially fragile. Leslie pointed to radiology and anesthesia as persistent pressure points, particularly in rural settings where recruiting can be more difficult.
- Coverage has to be matched more tightly to demand. Leslie identified matching coverage with demand as a crucial risk area leaders should be preparing for now.
- Recruitment needs to function as an engine, not a reaction. Dr. Cook described the radiology labor market as a game of musical chairs, with far fewer new radiologists entering the field than the number leaving it, which raises the stakes for sustained recruiting.
As these pressures continue to build, the importance of early planning becomes more apparent.
“Without the recruitment engine, you’re just playing catch-up every single time.” — Dr.Cook, Medical Director and Chief of Radiology, University Medical Center of Southern Nevada
Reinforcing Workforce Strategy as a Core Operating Priority
The discussion made clear that strengthening the clinical workforce requires more than filling gaps as they emerge. Across the panel, leaders emphasized the importance of reducing strain on clinicians, building more flexible staffing models, and planning earlier for long-term stability. While each organization is approaching the challenge differently, the shared priority is creating workforce strategies that better support retention, resilience, and continuity of care.
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