US Pediatricians’ Experiences with Staff Shortages in 2024

Marsicek SM, Gottschlich EA, Starmer AJ, Kist TW, Frintner MP

Presented at the 2025 Pediatric Academic Societies Annual Meeting

Background: Concerns about healthcare staff shortages in the US have been growing. There is a paucity of data on staff shortages from the pediatrician perspective.

Objective: Describe pediatrician-reported staff shortages and examine practice characteristics associated with reported shortages.

Methods: National weighted survey data collected in March-June 2024 from the AAP Pediatrician Life and Career Experience Study (PLACES), a longitudinal cohort study (2016-18, 2009-11, and 2002-04 residency graduates). Respondents were asked if they had any a) non-physician and b) physician staff shortages at their work setting in the past 12 months (yes, no for each) and about current non-physician staff shortages: advanced practice providers, nurses, clinical support staff, and administrative staff (no shortage, minimal shortage, moderate shortage, significant shortage for each). Chi-square tests examined variation in reporting any non-physician and physician shortages by practice characteristics: clinical focus (primary care, outpatient subspecialty care, inpatient subspecialty care, emergency care); patients with public insurance (<75% patients, >75% patients); practice area (urban, suburban, rural); and US Census region (NE, MW, S, W). Multivariable logistic regression further examined bivariate associations.

Results: Survey participation was 66% (analytic n=1710). Nine in 10 (88.9%) pediatricians reported any non-physician staff shortages in the past 12 months; more than half (55.6%) reported any physician shortages. Clinical focus was the only practice characteristic associated with reported non-physician staff shortages (Table); those in emergency care (98.1%) were most likely to report this, and the relationship held in multivariable analysis. All practice characteristics were associated with physician shortages in bivariate associations (Table), and all but practice area remained significant in multivariable analysis. Reported physician shortages were most common for those providing emergency care (aOR=2.10, 95% CI=1.34-3.31) compared to primary care providers.

Among pediatricians reporting any non-physician shortages, 2 in 3 reported current moderate (40.6%) or significant (26.8%) shortages of nurses and moderate (38.8%) or significant (26.9%) shortages of clinical support staff (Figure).

Conclusion: Nearly all PLACES pediatricians reported non-physician shortages, and more than half reported physician shortages in 2024. Providing emergency care was most strongly associated with both non-physician and physician shortages. Nurses and clinical support staff were the most common non-physician staff shortages.

Table 1. Practice Characteristics Associated with Reported Non-Physician and Physician Staff Shortages, 2024

Figure 1. Among PLACES Pediatricians Reporting Any Non-Physician Staff Shortages: Current Non-Physician Shortages