Staffing of physician practices and medical groups continues to stagnate or worsen by some measures with doctors busier than ever amid a surge of patient visits, a new AMGA analysis shows.
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Staffing of physician practices and medical groups continues to stagnate or worsen by some measures with doctors busier than ever amid a surge of patient visits, a new analysis shows.
Total clinic staff per provider, which includes both physicians and advanced practice clinicians, is now at a median of 2.19 total clinic full-time equivalent employees, which is essentially the same as the 2.15 FTEs as last year, according to the American Medical Group Association’s 2025 Medical Clinic Staffing Survey.
The AMGA study is a snapshot into the labor problems in healthcare, which was hit hard by an economic trend of workers quitting their jobs in the wake of the Covid-19 pandemic and rising provider burnout. The survey by the group’s AMGA Consulting unit includes data from “medical groups around the country, representing almost 7,000 clinics and 29,000 providers across primary care, medical, surgical, and other
specialty-based areas,” AMGA said.
The survey found that staffing ratios per 10,000 work relative value units, which is a standardized way to measure the value of provider services saw “a 4.8% decrease within primary care specialties, while medical and surgical specialties saw a 2.4% and 1.1% increase, respectively, from the prior survey year,” AMGA Consulting’s analysis shows. “Meanwhile, over the past three years, primary care and medical specialties have seen a 5% to 7% decrease in total clinic staffing.”
Though staffing has improved in some areas, it’s not enough to meet increasing demand for healthcare services, which is threatening patient access to care. Many patients, particularly older Americans, put off getting routine healthcare, outpatient services and surgeries during the Covid-19 pandemic but are now suddenly seeking treatment.
Health insurance companies have already reflected this surge in patients with most of the nation’s biggest health plans, including UnitedHealth Group’s UnitedHealthcare, CVS Health’s Aetna, Humana and others battling historically high costs, particularly in the Medicare Advantage plans they sell to older Americans. The AMGA analysis is the latest to recognize this influx of patients.
“With medical groups seeing a decline in clinic staffing per 10k wRVUs, this continued surge in provider productivity creates an undeniable squeeze,” said Matthew Wells, senior director with AMGA Consulting.
“Every member of the clinic team is being asked to handle a greater burden,” Wells added. “In the face of intense industry pressures, from reimbursement shifts to labor shortages, these staffing trends demonstrate that medical groups are operating with fewer and fewer resources, which will inevitably lead to operational and access challenges.”
Already, AMGA data shows the clinic turnover rate rising from increasing workloads and that can add to burnout among medical care providers and their staff. The median turnover rate for “critical back-office support staff (registered nurses and medical assistants)” fell between 17% and 18%, AMGA said.
“Across the clinic, the overall turnover rates for support staff can range anywhere from 12% to 26%,” AMGA said in a statement accompanying its report.
To deal with worker shortages and higher turnover, more medical groups are turning to use of advanced practice clinicians, or APCs, that include nurse practitioners, physician assistants, certified nurse midwives and certified nurse anesthetists.
In states that allow such APCs to practice independently without physician supervision, APCs are in even greater uses. Over the past three survey years, APCs as a percent of providers increased “upwards of 7%, meaning that 7% more of the provider workforce is comprised of APCs,” AMGA’s report said.
But even the rise of advanced practice clinicians hasn’t been enough.
“Even with the increased recruitment of APCs coupled with additional visits overall, medical groups continue to grapple with staffing challenges to support the delivery of care,” said AMGA Consulting Chief Operating Officer Mike Coppola. “This trend is expected to continue for the foreseeable future.”