Rural physician burnout and staffing shortage impact in 2025

Physician shortages related to burnout and other factors are critically undermining health care access in rural America, many areas of which are now commonly referred to as “medical deserts.” According to a recent study, physicians were 82.3 percent¹ more likely to experience burnout than workers in other occupations.

This disparity is exacerbated by an aging rural physician workforce. With more than half of rural doctors aged 50 or older, there will be a projected 23 percent decline in rural physicians by 2030 due to retirements.⁴ The Association of American Medical Colleges estimates the United States could face a shortage of up to 86,000 physicians by 2036.²

Additionally, rural areas have approximately 30 physicians or specialists per 100,000 people, compared to 263 in urban areas.⁵  This scarcity leads to delayed care, increased travel distances for patients, and higher rates of chronic diseases and mortality. 

Spotlight on surgical services: A vital area at risk

Surgeon burnout presents a profound and escalating challenge for rural hospitals. “Surgeon burnout is real — and it’s creating critical workforce gaps as seasoned surgeons retire early or scale back,” says Richard L. Makowiec, Synergy Health Partners chief medical officer.

Unlike urban hospitals that often have backup providers or specialized support, rural facilities operate with limited staff, meaning even a single surgeon’s reduced performance or departure can jeopardize surgical services for an entire region.⁶

In rural areas these effects are magnified, as patients with conditions requiring urgent intervention such as appendicitis, trauma, or cancer may experience worse outcomes or forego care altogether.⁷

Furthermore, the loss of surgical capabilities may lead to the financial decline of rural hospitals, many of which rely on surgical procedures to maintain revenue streams. This can trigger a cascading effect that threatens the viability of other departments, ultimately placing additional strain on the remaining health care workforce and creating a vicious cycle of overwork, dissatisfaction, and attrition that can lead to a heightened risk of hospital closures. 

Community-level effects

The consequences for rural communities are profound. Surgeons in rural areas often fill multiple roles, making them integral not only to health infrastructure but also to community trust and resilience. 

Burnout can erode these relationships, leading to increased turnover and a sense of instability in local health care. This can dissuade other health care professionals from relocating to or remaining in rural areas, further exacerbating workforce shortages. 

Maintaining adequate surgical services in rural America requires addressing these critical challenges in a collaborative fashion that involves input from medical professionals, policymakers, and community stakeholders. Specific action items can include strengthening rural surgical training programs and implementing financial and logistical support for rural hospitals and surgeons. 

How hospitals can combat burnout in rural communities

Many rural health care systems have relied on traditional, short-term staffing models such as locum tenens to fill in vacancies caused by not only physician burnout but also during vacations, leaves of absence, or times of high or seasonal demand.

While the use of temporary solutions is often necessary, they can be costly and do not provide a long-term solution. To create an overall plan for success that covers budgetary constraints and the well-being of physicians, rural hospitals need innovative, outside-the-box solutions to ensure alignment with hospital and community goals.

Creating forward-thinking strategies is essential for hospitals aiming to combat physician burnout and safeguard the future of patient care. By embracing innovation such as digital health tools and mental wellness programs, rural hospitals can proactively support their physician staff before burnout takes root.

“Rural health care leaders must act now: adopt flexible staffing, invest in surgeon well-being, and protect access for the communities they serve,” Makowiec says. 

Key components for success

• Implement flexible scheduling: Allow for part-time, job-sharing, or rotating shifts to help physicians maintain work-life balance.
• Limit on-call responsibility: Limit on-call hours and bring in inpatient support if needed.
• Offer mental health support services: Provide confidential access to counseling, peer support groups, and wellness programs.
• Streamline administrative tasks: Reduce EHR burdens and clerical workload by hiring scribes or utilizing AI-assisted documentation tools.
• Provide competitive compensation and incentives: Include rural retention bonuses, loan repayment programs, and performance-based incentives.
• Foster a supportive leadership culture: Train managers to recognize the signs of burnout and create an environment where staff feel heard and valued.
• Encourage peer recognition programs: Boost morale by highlighting accomplishments and dedication through regular praise or awards.
• Invest in onsite Amenities: Provide access to fitness equipment, healthy meals, and quiet spaces to decompress during long shifts.
• Enhance team-based care models: Distribute workload among nurses, advanced practice providers, and ancillary staff to reduce physician overload.

The cumulative impact of surgeon burnout in rural communities is not just a workforce issue — it is a threat to the long-term health, stability, and sustainability of rural America. By prioritizing physician well-being and implementing supportive structures, rural hospitals can enhance provider satisfaction and improve patient care outcomes.

NRHA adapted the above piece from Synergy Health Partners, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.

About the author: Daniel Siegel, MBA, CEO at Synergy Health Partners, has dedicated more than 15 years to scaling innovative physician staffing and management programs that align incentives to support clinicians and hospitals while expanding patient access to quality surgical care.