Healthcare Needs People, Not Promises

Healthcare serves as the leading sector for job expansion in the United States employing 13% of the national workforce in 2025 compared to 9% in 2000. The healthcare sector generates more employment than all other industries in 38 states while hospitals and clinics maintain their position as economic pillars throughout rural areas. The industry expansion results from three main factors: population aging combined with increased insurance coverage and rising chronic disease prevalence. The healthcare industry experiences a paradoxical situation because it generates jobs at unprecedented rates yet faces an ongoing shortage of qualified medical providers.

The medical doctor retirement wave became more intense after the COVID-19 pandemic and burnout consequences which accelerated the process. The shortage of medical schools together with limited residency slots creates an additional barrier that reduces the number of new physicians entering practice. And the aging U.S. population creates rising demand for specialized medical services especially in geriatrics and oncology and chronic disease management. This expanding gap between healthcare access and availability causes hospitals and clinics to face strains while potentially affecting patients directly.

Currently there are 202 medical schools in the U.S., 60 are allopathic (MD) and 42 are osteopathic (DO). The AAMC has predicted a shortage of physicians from 37,800 rising to 124,00 by 2034. (AAMC) As the sector continues to face shortages, it is looking to the government and the private sector where Alice L. Walton recently opened a bespoke medical school in Arkansas. But donors with this level of resources are a limited pool. Unless the government aligns with public and private healthcare companies supporting increased investments in education, workforce support and provider retention programs we are likely to continue to see shortages. 

What do you think- should the US increase acceptance of foreign trained medical doctors from accredited institutions? Is the ascendency of front line service roles for nurse practitioners, and physicians assistants the answer for general practices? The somewhat glamorous, remunerative and selfless mission of healthcare careers has disappeared. Long hours, decreased pay, burnout and the burdens of the administrative overhead, have led many to avoid or leave the profession. (Ama-assn.org). 

Do you believe narrative practices may help aid retention and increase physcian wellbeing? Do you think reguiring yearly CME's in narrative medicine may benefit our providers?  What's your take- write a piece, comment or share your own journey. Reach out at info@narrativemindworks.org

-Lauren Manning

Heartbeat of health: Reimagining the healthcare workforce of the future

McKinsey Health Institute Report, second quarter 2025 

Closing the healthcare worker shortage gap could eliminate 7 percent of the global disease burden and add $1.1 trillion to the global economy.

Over the last century, people have lived longer, yet the portion of life spent in poor health remains unchanged, resulting in more years battling chronic and infectious diseases. 1  Individuals face a growing reality: Access to healthcare professionals when one is sick, elderly, or in pain can no longer be taken for granted.

That is because a global shortage of at least ten million healthcare workers is expected in 2030, according to the World Health Organization, with upper estimates over 78 million (see sidebar “Defin

ition of healthcare workers”).2  Without enough healthcare workers to deliver care, fewer people have access to services that save lives and improve quality of life.

Addressing the healthcare worker shortage is an opportunity to profoundly advance health worldwide, adding years to life and life to years. McKinsey Health Institute’s analysis finds that closing this shortage could avert 189 million years of life lost to early death and lived with disability, accounting for 7 percent of all disease burden (see appendix, “Disease burden and GDP impact sizing methodology”). To put this into context, closing the shortage would have as much positive benefit as eliminating the disease burden stemming from maternal and neonatal morbidity and mortality conditions.5

Closing the healthcare worker gap can also have an immense impact on the global economy to the tune of $1.1 trillion, roughly equal to the GDP of Switzerland.6  The McKinsey Health Institute (MHI) estimates that around $300 billion of that could be a direct result of the greater number of healthcare worker jobs (Exhibit 1). However, the much larger economic stimulus comes from the ripple effects healthcare workers have on making all workforces healthier and indirectly creating non-healthcare jobs (for details, see appendix, “Disease burden and GDP impact sizing methodology”).

The shortage of healthcare workers and the potential for improvement are not evenly distributed globally. Africa, with 17 percent of the world’s population, accounts for 52 percent of the shortage and over 70 percent of the opportunity to reduce disease burden (Exhibit 2). However, less than 20 percent of the GDP opportunity is concentrated in Africa, highlighting the variation in disease burden averted and GDP gained by closing the shortage. Further, while global life expectancy at birth could be extended a year and a half by eliminating the worker shortage, this improvement pales in comparison to the potential for Africa, where individuals could live seven years longer.7

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The healthcare workforce needs attention, investment, and innovation. In this report, MHI considers how to address the healthcare worker shortage by not only increasing the supply of healthcare workers but also fundamentally reimagining the “who,” “how,” and “where” of healthcare service delivery.

Understanding Helathcare Worker Dynamics

Four country archetypes represent how challenges and priorities differ based on healthcare workforce dynamics.

Each country faces unique supply and demand dynamics in the healthcare labor market,8  so customizing solutions is essential for addressing the global shortage. Solutions cannot be limited to recruiting more healthcare workers based on population needs; countries also must ensure there are enough available healthcare jobs in a region or country.

Countries can be categorized based on whether they have enough healthcare workers relative to population needs and enough employment opportunities for new and existing healthcare professionals. Either of these may reflect deeper challenges such as economic, educational, or policy constraints. To help stakeholders frame potential opportunities for improvement, MHI’s analysis categorized countries by these two dimensions to define four archetypes (Exhibit 3):

The solution to the workforce shortage is not only “add more workers.” The four country archetypes illustrate different healthcare workforce dynamics, showing how shortages vary relative to population needs and whether there are enough employment opportunities for new and existing healthcare professionals. W orker-scarce countries. A worker-scarce country has too few healthcare workers to serve its population, and many of its healthcare jobs are unfilled. Examples include Brazil and Peru. Worker- and job-scarce countries. In a worker- and job-scarce country, there are too few healthcare workers to serve its population, as well as too few available healthcare jobs. Examples include Malawi and Nigeria.  Worker-advantaged countries. A worker-advantaged country has a high number of healthcare workers to serve its population, compared with other countries, but still has unfilled healthcare jobs. Examples include the United States an We strive to provide individuals with disabilities equal access to our website. If you would like information about this content we will be happy to work with you. Please email us at:  McKinsey_Website_Accessibility@mckinsey.com

Examination of these archetypes shows that each comes with its own challenges. More than half of all countries, representing 71 percent of the global population, are worker-scarce countries, with a low number of healthcare workers relative to the population but many open healthcare jobs. These countries have a median of 98 healthcare workers per 10,000 population. These are mostly middle-income countries across Latin America, Asia, and the Middle East. For example, Peru has fewer than 400,000 healthcare workers supporting a population of about 30 million,9  and there are 1.3 jobs for every healthcare worker.10  Because worker-scarce countries have capacity to absorb new healthcare workers, investments in training capacity are especially critical.

Worker- and job-scarce countries—those with the dual challenge of not enough healthcare workers and not enough available healthcare jobs to meet population health needs—include 42 countries, mostly low- and middle-income countries on the African continent. They have a median of 32 healthcare workers per 10,000 population, less than one-third the global median. These countries experience poorer health outcomes than the rest of the world: an individual’s median health-adjusted life expectancy is 55 years, compared with a global median health-adjusted life expectancy of 63 years,11  and their disease burden is nearly a third higher than the global median. These countries’ primary challenge is economic conditions that limit the ability to finance health systems, build critical infrastructure, train staff, and provide living wages for healthcare workers.12

Worker-advantaged countries, where relatively more healthcare workers serve their populations than the global median but some healthcare jobs are unfilled, include 47 countries, primarily in North America and Europe. These countries have more than three times the global median of healthcare workers per capita and more than ten times the median of worker- and job-scarce countries. They typically have better health outcomes, with an average health-adjusted life expectancy at birth of 70 years, compared with the global median of 63 years, with a roughly 8 percent lower disease burden. The largest opportunity in these countries is to support healthcare worker effectiveness, which can lead to increased healthcare worker capacity. But even in these countries, substantial disparities in the distribution of healthcare workers may persist.1

Worker-surplus countries. A worker surplus country is defined as one with a high number of healthcare workers to serve its population, compared with other countries, and too many qualified workers for the available jobs. No such countries exist.

A country cannot change from a scarcity archetype solely by adding more healthcare workers. Rather, countries need a broader lens that accounts for investment, regional and national priorities, and infrastructure.

*This is a partially excerpted from McKinsey Global Reports designed for a top line overview of challenges that continue to impact world global health.

Authors: Pooja Kumar  is a senior partner in McKinsey’s Philadelphia office and global leader of the McKinsey Health Institute (MHI), Tania Holt  is a senior partner in the London office, Yenli Wong  is a partner in the Southern California office and director of health worker capacity at MHI, and Marilyn Kimeu is an associate partner in the Nairobi office and co-director of health worker capacity at MHI.