US: Healthcare Workers - World Health Systems Facts

Density of medical doctors (per 10,000 population), 2015-2023: 36.81
Density of nursing and midwifery personnel (per 10,000 population), 2016-2023: 133.76
Density of dentists (per 10,000 population), 2016-2023: 6
Density of pharmacists (per 10,000 population), 2015-2023: 11.13

Source: World health statistics 2025: monitoring health for the SDGs, Sustainable Development Goals. Tables of health statistics by country and area, WHO region and globally. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.

Hospital workforce per 1,000 population, 2021
– Physicians: 1.06
– Nurses and midwives: 8.38
– Healthcare assistants: NA
– Other health service providers: 2.11
– Other staff: 21.3
Practicing doctors per 1,000 population, 2021: 2.7
Share of different categories of doctors, 2021
– General practitioners: 11.5%
– Specialists: 88.5%
Share of foreign-trained doctors, 2021: 25.0%
Practicing nurses per 1,000 population, 2021: 12.0
Share of foreign-trained nurses, 2021: 6.1%
Ratio of nurses to doctors, 2021: 4.3
Practicing pharmacists per 100,000 population, 2021: 94
Community pharmacies per 100,000 population, 2021: 20
Long-term care workers per 100 people aged 65 and over, 2021: 4.5
Share of informal carers among the population aged 50 and over, 2021
– Total: 7%
Share of long-term care workers who work part time or on fixed contracts, 2020
– Part-time: 33.9%
– Fixed-term contract: NA
Average hourly wages of personal care workers, as a share of economy-wide average wage, 2018
– Residential (facility-based) care: 51%
– Home-based care: 51%

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.

Professionally Active Primary Care Physicians in the US by Field:
• Internal Medicine: 202,904
• Family Medicine/General Practice: 144,919
• Pediatrics: 91,258
• Obstetrics & Gynecology: 55,477
• Geriatrics: 1,507
• Total: 496,065

Source: Kaiser Family Foundation. Professionally Active Primary Care Physicians by Field. Timeframe: January 2022. Last accessed April 19, 2022.

Professionally Active Specialist Physicians In the US by Field:
• Psychiatry: 56,368
• Surgery: 54,419
• Anesthesiology: 51,282
• Emergency Medicine: 60,204
• Radiology: 48,823
• Cardiology: 33,341
• Oncology: 21,712
• Endocrinology, Diabetes, and Metabolism: 8,430
• All Other Specialties: 230,497
• Total: 565,076

Source: Kaiser Family Foundation. Professionally Active Specialist Physicians In the US By Field. Timeframe: January 2022. Last accessed April 19, 2022.

“Overall, respondents described that career ladders play a key role in retaining existing staff by providing a clear path for professional growth, at times leading employees to progress from entry-level positions to leadership roles. However, their impact on recruitment efforts and fostering diversity is less pronounced. Respondents noted that career ladders supported retention efforts more than recruitment efforts, and were generally thought to be unrelated to engaging diverse candidates to fill vacancies. While health departments can develop comprehensive career ladders and succession planning programs, federal and state policies related to career and conditional employment and funding limitations for salary adjustments can impact consistent implementation across job classifications and position levels.²⁷ The challenges of implementing comprehensive career ladder programs are compounded by civil service requirements, funding limitations, and complex recruitment processes that can inadvertently impact diverse candidates in attempts to mitigate bias.

“This study also underscores the interconnectedness of career ladders and succession planning as strategies to maintain a skilled and diverse public health workforce. By providing opportunities for staff to develop leadership skills and offering additional educational benefits, the career ladder movement not only promotes internal advancement but also supports the continuity of operations and the retention of institutional knowledge during leadership changes. Nevertheless, these strategies are often made difficult given the challenges presented by state-level human resource policies that can curtail the effective implementation of career ladder and succession planning initiatives.

“Despite the aging workforce, COVID-19 departures, and high turnover rates highlighting the immediate need for managing leadership transitions, few public health agencies engage in formal succession planning.^1-3,5,9 These findings support the lack of use of succession plans by the health departments that participated in this study due in part to barriers identified. Darnell and Campbell (2015) found that while over 60% of local health departments were very or extremely concerned about recruiting and retaining qualified staff, only 40% were actively engaged in formal or informal succession planning. Public health agencies may encounter barriers preventing the use of succession planning including low prioritization, not having qualified mentors, or state-level policies that limit local health department flexibility in workforce decisions, which our findings also support.^2,5,9,28

“For governmental public health agencies, succession planning may help alleviate growing leadership vacancies due to retirement and high turnover rates.^2,3 Similarly, succession planning may help improve workplace diversity by offering pathways to leadership for individuals who may have otherwise lacked the necessary education, training, and mentorship.^1,8,14 Furthermore, succession planning may help improve operational efficiency in light of growing budgetary restrictions.⁵ Without addressing the barriers to implementing formal succession planning, these benefits will not be realized for governmental public health.”

Source: Kate Beatty, Laura Hunt Trull, Christen Minnick, Kawther Al Ksir, Kristen Surles, Michael Meit, Expanding options to recruit, grow, and retain the public health workforce, Health Affairs Scholar, Volume 2, Issue 12, December 2024, qxae115, doi.org/10.1093/haschl/qxae115

“The United States has had a disproportionate number of specialist physicians compared to primary care physicians (PCPs) for many years. Between 1965 and 1992 the 65% increase in physicians was almost entirely in specialist areas (Bodenheimer & Pham (2010). The growth in specialists has since slowed, but that of general primary care physicians has not increased significantly.

“Between 2005 and 2015 the physician to population ratio of general primary care (family medicine, internal medicine, obstetrics, gynaecology and pediatrics) remained relatively stable, that of primary care subspecialties (of general primary care specialties listed above) increased 33%, and that of non-primary care specialties increased 52% (CDC, 2017a). In 2015 general primary care physicians were 37% of the physician workforce, primary care subspecialists were 11%, and non-primary care specialists comprised the remaining 52%. Compare those proportions of physicians to the percentage of office visits to these providers: in 2015, 47 % of office visits were to PCPs while 40% were to specialists (Frost & Hargraves, 2018). Community health centres in particular have severe shortages of PCPs, reporting vacancy rates of 25% for family physicians (NACHC, 2016). A 2018 report estimated that in 2016 a shortage of 13 800 PCPs existed, with the shortfall expected to increase to 14 ,800 (25th percentile) to 49 300 (75th percentile) by 2030 (AAMC, 2018). In contrast there were no to small shortfalls of various types of specialist in 2016. The shortfall of specialists is expected to grow, but to still be less than that of PCPs in 2030.”

Source: Rice T, Rosenau P, Unruh LY, Barnes AJ, van Ginneken E. United States of America: Health system review. Health Systems in Transition, 2020; 22(4): pp. i–441.

“Between 2021 and 2036, the U.S. population is projected to grow 8.4%, from about 331.9 million to 359.7 million people. The population under age 18 is projected to grow by 0.5%; the population age 65 and older by 34.1% — primarily due to the 54.7% growth in size of the population age 75 and older (Exhibit 20). As a result, the national prevalence and incidence of diseases that disproportionately affect older Americans is projected to grow rapidly. Demand for physicians who treat patients with these diseases is expected to grow as well. For example, the microsimulation demand model finds that between 2021 and 2036, the prevalence of diagnosed diabetes is projected to increase 22% (from 29.4 million to 35.8 million people), and the population with heart disease is projected to increase 23% (from 15.9 million to 19.6 million). High rates of growth are projected for the size of the population with a history of stroke (23% growth), heart attack (23%), and cancer (20%) associated with an aging population and improved survival rates.^75–77 This increase in disease prevalence will increase demand for most physicians’ specialties, especially primary care, endocrinology, cardiology, pulmonology, and oncology.”

Source: GlobalData Plc. The Complexities of Physician Supply and Demand: Projections From 2021 to 2036. Washington, DC: AAMC; 2024.

“• We continue to project that physician demand will grow faster than supply, leading to a projected total physician shortfall of between 46,900 and 121,900 physicians by 2032 (Exhibit ES-1). This projected shortfall range reflects updates to model inputs including updated population projections, revised starting demand and supply projections, updated estimates of physician specialty choice, larger starting-year shortfall estimates based on recently revised federal health professional shortage area (HPSA) designations for primary care and mental health, and lower projections of future insurance coverage expansion. The projected range is similar to the previous (2018) study’s projected shortfall range for 2030 of between 42,600 and 121,300 physicians.

” o A primary care physician shortage of 21,100 to 55,200 physicians is projected by 2032. The shortfall range reflects the projected rapid growth in the supply of APRNs and PAs and their role in care delivery, trends that might strengthen the nation’s primary care foundation and improve access to preventive care, and an estimate by the Health Resources and Services Administration that nearly 14,472 primary care physicians are needed to remove the primary care shortage designation from all currently designated shortage areas.

” o Projected shortfalls in non-primary care specialty categories of 24,800 to 65,800 physicians, including a 14,300 to 23,400 shortfall in 2032 for surgical specialties. The range reflects different assumptions about shifting workforce patterns for physicians and other professionals. In the surgical specialties, a largely stagnant projected supply also contributes to projected shortages.”

Source: Dall TM, Jones K, Chakrabarti R, Reynolds R, Iacobucci W. 2019 Update, The Complexities of Physician Supply and Demand: Projections from 2017 to 2032. Washington, DC: Association of American Medical Colleges; 2019.

“Some workforce analysts question whether there is an overall shortage of physicians, or whether instead, the shortages are mostly in underserved areas (Salsberg, 2015). According to these analyses, assessments of shortages should take maldistributions into consideration, as well as additions to the primary care workforce supply (greater utilization of NPs and PAs), and lowering of demand through improvements in care coordination, technologies and other efficiencies in the delivery system.

“Although nurse practitioners (NPs) and PAs have been filling in some of the gaps in primary care (in 2012 NPs comprised 20% of primary care providers in the United States (Poghosyan et al., 2013)), there is evidence that the primary–specialty physician imbalance is affecting access to primary care, especially in light of the increase in demand due to the ACA. In two simulations (2013 and 2016), median wait times for new patients in primary care were over a week in most states, and some wait times were over 30 days (Rhodes et al., 2014; Polsky et al., 2017). Wait times increased slightly between 2013 and 2016. In 2015, 48% of people in the United States who were sick could not obtain a same-day or a next-day appointment (Mossialos et al., 2015). Studies have also reported low-income patients having increased difficulty in obtaining primary care visits in Medicaid expansion states (Miller & Wherry, 2017).”

Source: Rice T, Rosenau P, Unruh LY, Barnes AJ, van Ginneken E. United States of America: Health system review. Health Systems in Transition, 2020; 22(4): pp. i–441.

“Within the health care workforce, gender wage gaps in the physician workforce are well established. Male physicians earn higher wages than women physicians across all medical specialties, and medical specialties that are dominated by men pay significantly more as compared with specialties where women are concentrated.^10-12 A recent estimate is that female physicians earn approximately 25% less than male physicians (>$2 million over their career),³ and the gap has persisted over decades.¹² Among a relatively homogenous group of physician researchers, male gender was associated with higher salary, even after adjustment for specialty, academic rank, leadership positions, publications, and research time.¹³

“The gender wage gap persists among other health care workers with high levels of training and education, including nurse practitioners.^14,15 A study that looked comprehensively across health care professionals found a gender earnings gap for pharmacists, dentists, physician assistants, and health care executives, and the wage gap fell consistently only for health care executives and pharmacists over time.¹⁶ Among nurses, male RNs out-earn female RNs across settings, specialties, and positions, with no narrowing of the pay gap over time.^17,18 Finally, few studies have examined the gender wage gap among health care workers with an associate’s degree or less, which represent a large share of health care occupations and are dominated by women. Past research has shown that, among among direct care workers, there is a persistent gender wage gap,^19-21 even though very few men hold direct care jobs.”

Source: Janette S Dill, Bianca K Frogner, The gender wage gap among health care workers across educational and occupational groups, Health Affairs Scholar, Volume 2, Issue 1, January 2024, qxad090, doi.org/10.1093/haschl/qxad090

“We found that, over the last decade, women’s representation dramatically increased over the last 2 decades in health care occupations that require high levels of education, including physicians, advanced practitioners, and therapists. For example, the percentage of women among physicians increased from 30% in 2003 to over 40% in 2021 in our sample (41% change), and the percentage of women among advanced practitioners increased from below 60% to over 70% over the last 2 decades (36% change). On the other hand, women’s representation dropped slightly—and men’s representation increased—in some health care occupations over time, including RNs, LPNs/LVNs, and aides/assistants. For example, in 2003, approximately 93% of RNs were nurses, but this dropped to approximately 88% in 2021. In general, occupations where women had lower representation 2 decades ago, like physicians, had strong growth in women’s representation over this time period, while occupations that were heavily women-dominated, like nursing, saw men’s representation increase during the same time period. This tradeoff in men’s vs women’s representation by occupation and education may be otherwise masked and appear to be stagnant in aggregate analyses of the health care industry.

“The gender wage gap decreased over the last 2 decades in many health care occupations—a trend that occurred across the United States⁴⁰—and notably among those where women’s representation increased substantially. For example, among advanced practitioners, the gender wage gap decreased from women’s earnings being approximately 50% of men’s earnings to approximately 65% of men’s earnings. We found a similar pattern among women and men physicians over the last 2 decades, although the gender wage gap among physicians remains much higher than the general population.⁴⁰ In general, women with higher levels of education (professional degrees, master’s degrees, or bachelor’s degrees) made substantial gains in terms of wage equity relative to men in the health care sector.

“However, for women with lower levels of education, the gender wage gap story is more complicated. The gender wage gap for RNs, technicians, LPNs/LVNs, and aides/assistants is, in general, smaller as compared with occupations that require higher levels of education. For example, women RNs made approximately 82% of men RNs, as compared with women physicians, who made approximately 70% of men physicians. However, in many lower-education, heavily women-dominated health care occupations, the gender wage gap widened over the last 20 years. For example, among aides/assistants, women earned approximately 85% of men in 2003, but this dropped to below 80% in 2021. Similarly, the gender wage gap for LPNs/LVNs and RNs remained basically stagnant or widened slightly over the last 2 decades. In these lower-wage jobs with high women representation, the gender wage gap is similar to what is seen nationally,⁴⁰ but unlike national trends towards closing of the pay gap, it is widening or stagnant in these occupations over time.”

“Because healthcare is a complex set of services provided in a variety of settings, it is not surprising that the human resources needed to provide these services are also varied and complex. The US Bureau of Labor Statistics (BLS) categorizes healthcare personnel into two main categories: ‘healthcare practitioners and technical occupations’ and ‘healthcare support occupations’ (BLS, 2018a, 2018b). The first category is further divided into practitioners with diagnostic and treatment capabilities, and healthcare technologists and technicians. The practitioners with diagnostic and treatment capabilities include chiropractors, dentists, optometrists, pharmacists, physicians, physician assistants, podiatrists and registered nurses (RNs), as well as a large grouping of therapists such as occupational, physical, respiratory, speech, language and others. In providing their specialized care these therapists consult and practise with other health professionals. The subcategory of technologists and technicians includes clinical laboratory technologists and technicians, dental hygienists, licensed practical (vocational) nurses (LPNs) and medical record technicians. The distinction between technologist and technician involves the level of education, which is longer for technologists, and work roles, which are more complex and analytical for technologists. In addition, technologists may supervise the work of technicians. The category of healthcare support occupations includes several types of aides (nursing, psychiatric and home health) and dental assistants.”

Source: Rice T, Rosenau P, Unruh LY, Barnes AJ, van Ginneken E. United States of America: Health system review. Health Systems in Transition, 2020; 22(4): pp. i–441.

“Physician assistants and nurse practitioners are more prevalent in rural and underserved areas, which have fewer primary care physicians (2,3,10). The findings—that the supply of primary care physicians increased as office locations became more urban, whereas the inclusion of physician assistants or nurse practitioners in primary care physician practices increased as office locations became less urban—are consistent with previous studies (2–4,10,11). State variation in the availability of physician assistants or nurse practitioners in primary care physician practices may also depend on the presence of integrated health care delivery systems, such as group health maintenance organizations, which include physician assistants and nurse practitioners more often than other physician practices (11). Our study found that physicians in multispecialty group practices had physician assistants or nurse practitioners in their practices more often than did single-specialty group practices or small (solo or partner) practices. Other factors, such as state variation in scope-of-practice laws for physician assistants and nurse practitioners and insurance payment policies, also affect the availability of physician assistants and nurse practitioners in physician practices (2–4,10,11).”

Source: Hing E, Hsiao CJ. State variability in supply of office-based primary care providers: United States, 2012. NCHS data brief, no 151. Hyattsville, MD: National Center for Health Statistics. 2014.

” • Demographics — specifically, population growth and aging — continue to be the primary driver of increasing demand from 2017 to 2032. During this period, the U.S. population is projected to grow by 10.3%, from about 326 million to 359 million. The population under age 18 is projected to grow by only 3.5%, while the population aged 65 and over is projected to grow by 48.0%. Because seniors have much higher per capita consumption of health care than younger populations, the percentage growth in demand for services used by seniors is projected to be much higher than the percentage growth in demand for pediatric services.

” • Achieving population health goals will raise demand for physicians in the long term. This scenario models the implications for physician demand associated with achieving select population health goals like reducing excess body weight; improving control of blood pressure, cholesterol, and blood glucose levels; and reducing smoking prevalence. Under this scenario, the longevity associated with improved population health would result in greater demand for services by 2032. The demand for physicians would thus be 33,900 FTEs higher in 2032 relative to demand levels in the absence of achieving these goals. Although prevention efforts likely will reduce demand for some specialties, like endocrinology, demand for other specialties, like geriatric medicine, will increase.”

US: Healthcare Workers - National Policies - World Health Systems Facts

World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

Page last updated June 12, 2025 by Doug McVay, Editor.