The physician shortage isn’t new, but the pressure is reaching a point where old strategies simply can’t keep up. Volumes are rising, expectations are shifting, and the imbalance between demand and workforce capacity is accelerating faster than leaders can adjust. At this year’s Becker’s CEO + CFO Roundtable, two healthcare executives shared what it actually takes to stay ahead of a physician shortage that’s gaining speed.
The panel featured:
Dr. Matthew Broom
Vice President and Chief Medical Officer, BJC Medical Group
Dr. Michael Loftus
Senior Vice President, Chief Medical and Quality Officer, RWJBarnabas Health
Together, they discussed how to build more agile staffing models, strengthen clinician engagement, and prepare for a new generation of physicians with evolving expectations.
Five Key Takeaways From the Discussion:
1. Old staffing playbooks no longer fit a new generation of physicians.
When it comes to leading through the physician shortage, both leaders agreed that traditional staffing playbooks no longer align with today's pace of change or clinicians' expectations around balance, flexibility, and autonomy.
"It's moving fast. Things are changing quickly and often," shared Dr. Broom. "What we used to do doesn't work anymore."
For example, at BJC HealthCare, Dr. Broom has seen this most clearly when examining the replacement ratio for physicians retiring. "For any cardiologists or gastroenterologists retiring, probably two of our new graduates are needed to replace them," Dr. Broom explained. The need for multiple new graduates reflects the changing expectations regarding call shifts, schedules, and what work-life balance entails for each physician. These shifts in expectations prompted Dr. Broom and his team to broaden their staffing strategies and incorporate new operational approaches, rather than relying on traditional models that no longer align with workforce needs.
Dr. Loftus echoed this perspective, sharing, "There is always going to be a shortage. I think we can anticipate that's the new normal." However, scale and integration matter, and that planning is increasingly done on a multi-year horizon. Instead of reacting to vacancies as they occur, he and his team are looking further upstream to understand where physician shortages are likely to emerge and how to align training, recruitment, and retention in advance to ensure stability.
For both executives, leading through the shortage requires moving from quick fixes to multi-year workforce planning supported by system-level structures built for long-term stability.
2. The service line model drives both resilience and flexibility.
Aligning leadership, staffing, and metrics across hospitals allows systems to coordinate coverage, eliminate silos, and deliver consistent care. At RWJBarnabas Health, Dr. Loftus shared that integration has enabled the redeployment of talent, standardization of processes, and more efficient responses to changing demand.
"The service line model saved us," Dr. Loftus said. "The ability for our health system to say, okay, these doctors are going to cover your hospital today, and we're going to pick up the slack elsewhere, that was enormous."
He added that external partnerships have also supported that flexibility. RWJBarnabas Health collaborated with the Medicus Transition Program for interim healthcare staffing, which provided short-term coverage and helped maintain continuity during transitions. "That support was essential," Dr. Loftus noted. "It allowed us to sustain access and move forward without disruption."
At BJC HealthCare, Dr. Broom described how integration has unified the health system under a common structure. Historically, the medical group had grown one practice at a time, resulting in wide variations from market to market. "We had clinics that were only 20% alike," he said. "Moving into a service line model allowed us to bring structure, transparency, and accountability across markets."
For both health systems, integration has become a platform for consistency and collaboration, supported by partnerships like Medicus that help extend coverage and preserve patient access when staffing needs shift.
3. Retention is emerging as the strongest lever for workforce stability.
While recruitment remains critical, both leaders emphasized that retention is now the most powerful way to sustain a strong workforce.
"It's really expensive to recruit and hire," said Dr. Broom. "It's even more so when there's turnover. It's worth the investment to build out a team that isn't just about bringing people in the door but holding on to them in a retention mechanism."
He described how BJC increasingly thinks about its workforce as a portfolio. "We really view our clinicians as investments for our company," he said. "Much like our financial investments, we need to have a diversified portfolio; we have to understand the ages, the training, the capabilities. Are we overextended or underextended in one area or another?" That perspective informs how Dr. Broom and his team monitor risk, plan for succession, and evaluate staffing across markets and specialties.
At RWJBarnabas Health, retention efforts focus heavily on visibility and responsiveness. Dr. Loftus highlighted senior leader rounding and a program called "You Said We Did," where feedback is aggregated and acted upon visibly. The aim is to show that input from frontline clinicians leads to tangible changes. He noted that turnover rates for physicians and nurses are significantly lower than industry averages, which supports both financial performance and patient experience.
Both leaders underscored that when a clinician leaves, the impact extends beyond that individual position. Referrals, patient relationships, and service line performance are all affected. Retention, in their view, is both a cultural priority and a strategic lever.
4. Academic partnerships are becoming a core strategy for long-term workforce planning.
Looking ahead, both executives see the clinical pipeline as a central focus for long-term workforce planning. The challenge is not only filling roles today but also ensuring a sustainable talent pool for tomorrow.
"You have more and more people competing for fewer and fewer graduates," said Dr. Loftus. "There just aren't enough graduating physicians to meet the needs." To address that reality, RWJBarnabas Health is deepening its partnership with academic programs, engaging trainees earlier, and providing a clearer view of real-world practice.
He noted that the health system is "more and more integrating with that pipeline earlier on," helping trainees understand what the workforce actually looks like and how the health system operates. The goal is to align training capacity with projected system needs, while positioning the health system as a place where new graduates want to build their careers.
BJC is taking a similar approach in its markets. Dr. Broom described how the health system has launched community residency programs in primary care and hospital medicine, in addition to its larger academic programs. These efforts are designed to supply clinicians for both urban and rural communities and to create tighter alignment between training and long-term workforce demand.
5. Flexible staffing and interim healthcare partnerships help protect patient access.
Despite the best plans, unexpected events remain inevitable: retirements, personal circumstances, sudden demand spikes, or challenges in a single practice that ripple across a service line.
"Life happens," said Dr. Broom. "We can't predict when something's going to happen, but we know something will throw off our plan." To stay agile, his team incorporates redundancy into staffing models and utilizes data dashboards to monitor age distribution, identify single points of failure, and ensure workload balance.
At RWJBarnabas Health, flexibility was critical during its radiology transition. "We worked with Medicus to provide some bridge locums coverage, which was essential in the short run and really helped provide that safety valve to help the existing radiologists work through a substantial clinical backlog," said Dr. Loftus.
Both leaders view interim healthcare staffing as more than a stopgap. It is a stabilizing tool that protects patient access and buys time for strategic change.
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