The shifting landscape in medical practice staffing

Christopher Mazzolini

Medical practices have always had to balance patient care needs with the realities of business operations. Yet since the start of the COVID-19 pandemic, that balance has grown more precarious. Today, staffing is one of the most pressing challenges faced by practice administrators and physicians. At Physicians Practice, we recently surveyed our audience of medical professionals to gauge the state of staffing, pay, and benefits in 2025. The findings in our 2025 Physicians Practice Staffing & Salary Survey provide a window into where practices are succeeding — and where they continue to struggle — in building and retaining high-functioning teams.

Understaffing persists, even as some practices grow

The most glaring statistic from our survey is that 41% of respondents consider themselves understaffed today—up significantly from 27% who reported understaffing five years ago. Paradoxically, 44% of respondents say they have hired more staff in the past five years, indicating that even a hiring push can fail to keep pace with patient demand and administrative complexity. Meanwhile, 53% feel they are adequately staffed, and only 6% say they are overstaffed.

In looking ahead, the majority (60%) expect their staffing levels to remain the same in 2025, while a third (34%) anticipate bringing on additional employees. This suggests a steady, cautious approach: Practices want to ensure they can handle patient volumes without overstretching budgets or risking layoffs down the line.

Finding qualified people: The single biggest hurdle

When asked about the biggest staffing challenges, an overwhelming 76% of respondents cited finding qualified staff. Although the labor market’s tightness is less acute than in previous years, a significant shortage of skilled professionals continues—particularly in positions requiring specialized clinical or administrative knowledge. Other top concerns include:

• Increased workload/dual roles(37%),
• High staff turnover(20%), and
• Lack of professionalism(22%).

These issues echo many of the soft-skill concerns we hear anecdotally from practice managers: how to balance the need for reliable, congenial team players with the reality that some roles (like billers/coders or medical assistants) are in especially high demand.

Despite widely voiced concerns over reimbursement shortfalls, 69% of practices gave staff raises in 2024. Among the 31% that did not, the most frequently cited reason was decreasing reimbursements by payers and patients, highlighting just how central revenue pressures are in dictating compensation decisions. Check out the full report for more detail on what our survey respondents pay specific positions.

Benefits: Stability and modest improvements

Our survey reveals a generally stable benefit structure:

• Paid time off (sick days, vacation, personal days) is nearly universal at 92%.
• Health insurance is offered by 78% of respondents, followed by retirement plans at 70%, dental at 62%, and vision at 57%.
• Only 10% have added benefits in the past year, while 75% report no changes.

Practices clearly recognize that competitive benefits can be a differentiator in recruitment and retention. Offering robust PTO, some level of health coverage, and retirement options can help stabilize staffing, even if salaries are not at the very top of the local market range.

Words of wisdom from the field

One unique facet of this year’s survey was the open-ended advice administrators and physicians shared. Their suggestions revolve around several common themes. Here's what they had to say, in their own words:

• Invest in people: “Train, train, train new employees,” and “Treat your staff well (financially) and they will be loyal.”
• Act quickly on poor fits: “Don’t delay in getting rid of poor performers,” and “If someone is not a good fit or brings negativity, don’t wait to remove them.”
• Foster a team culture: “Lead by example, not intimidation,” and “Build that team and continue perfecting it every day.”
• Stay flexible: “Give more flexibility, especially to mothers,” and “Be sure the staff is satisfied.”
• Plan for the future: “Start getting ready for AI,” “Control overhead by limiting staffing to adequate numbers,” and “We can’t cover our costs by just seeing patients.”

Looking ahead: Balancing costs and care

As we head deeper into 2025, the tension between adequate staffing, compensation, and practice profitability remains at the forefront. With a majority of practices still relying on traditional fee-for-service reimbursement (and only 21% blending it with value-based care), controlling overhead is challenging. Some practitioners see concierge or direct pay models as key to solving the financial puzzle, but these are far from universal solutions.

In the face of these complexities, the survey data affirms a few universal truths:

• Practices that offer competitive pay and meaningful benefits see stronger retention.
• A positive workplace culture—where team members are trained, respected, and recognized—remains the single most powerful antidote to staffing shortages.
• Leaders must be agile, ready to adjust staff levels, explore new reimbursement models, and embrace emerging technologies (like AI and digital health solutions).

The feedback from our survey participants is clear: Finding and keeping the right people is critical, yet there is no one-size-fits-all recipe for success. As you look to refine your own practice’s staffing approach, consider investing in quality talent, staying open to new operational models, and fostering an environment that genuinely values employees. By doing so, you can position your practice not just to survive, but to thrive in a rapidly changing medical practice landscape.

Chris Mazzolini is a content vice president at MJH Life Sciences, overseeing a roster of brands including Physicians Practice, Medical Economics and Pharmaceutical Executive.

Be sure to check out The Mazz Report on LinkedIn for more insight into the business of medicine.