Most rural healthcare organizations are not simply short on doctors — many are one physician departure away from creating a serious gap. A new report from Jackson Physician Search, LocumTenens.com and Medical Group Management Association (MGMA), titled Rural Healthcare Specialty Priorities: Rural Physician Workforce Survey, reveals that in the specialties rural communities depend on most, local physician capacity is stretched too thin. More than two in three respondents (68%) described family medicine capacity as insufficient or fragile, and majorities said the same for internal medicine (76%), general surgery (61%) and OB/GYN (61%).

These findings come from an August 2026 survey that gathered responses from 227 administrators and clinicians on which specialties matter most, how secure current coverage really is, and which coverage models hold up over the short and long term.

“The research recognizes an insightful truth: A rural shortage is not always an empty position. Often, the service is still operating but with little room to absorb a departure or another disruption,” said Akash Madiah, acting chief executive officer of MGMA. “This report gives leaders a strategic framework to help identify that risk earlier and decide whether a specialty needs to be protected, grown or covered differently.”

Rural organizations often recruit for one opening while a second departure is already forming — but they’re seeing it too late.

The survey found that rural organizations are rarely ahead of their physician vacancies. Just 12% of administrators’ most consequential vacancies were anticipated more than a year in advance, and 57% were anticipated less than six months before they occurred or not anticipated at all. That’s true even though the next departure is often already visible. Sixty-four percent of administrators expect at least one physician to retire or reduce hours within five years, yet only 41% of those have a formal succession plan for any of those departures.

Among administrators running an active physician search, 81% have at least one other high-impact specialty with no permanent search underway.

“Nearly two-thirds of rural administrators already expect a physician to retire or cut back within five years, but our survey found that fewer than half of them have a formal plan for it,” said Helen Falkner, president of Jackson Physician Search. “That’s where a lot of rural vacancies start. If succession planning waits for the resignation letter, you’re already behind. It has to start when a retirement first comes into view, with a timeline and a recruiting plan attached to every specialty the community can’t afford to lose.”

Open positions strain the clinicians left behind.

Two-thirds of the most consequential physician vacancies from the past three years are still open searches today. Administrators tie these vacancies to longer patient wait times, heavier workloads for remaining staff and lost patient volume — and 23% said an existing vacancy made it harder to recruit for other open positions. However, few organizations have quantified that cost. Only 25% of administrators formally estimated the financial effect of their most consequential vacancy, leaving most without a clear way to weigh the cost of recruiting earlier or arranging interim coverage against the cost of leaving a position open.

Not every rural specialty needs the same fix.

The report’s centerpiece, the Rural Specialty Priority Map, holds that no single coverage strategy fits every specialty. While permanent recruitment remains the long-term goal in nearly every case, the survey found the right bridge coverage varies widely. Respondents rated locum tenens the strongest short-term option for OB/GYN and general surgery. At the same time, telehealth was rated a viable long-term option for behavioral health by 70% of respondents, even as most respondents rejected it for OB/GYN, emergency medicine and general surgery.

“Everyone focuses on the permanent hire, but few of these positions get filled instantly as someone has to hold the practice together while the search plays out,” said Dr. Pamela Ograbisz, vice president of clinical operations at LocumTenens.com and LT Telehealth. “The data demonstrates that the bridge cannot be one-size-fits-all. For OB/GYN and general surgery, a 1099 contractor can buy the system time, but for behavioral health and many other subspecialties, telehealth should not be viewed as a temporary fix. It is a sustainable solution for most organizations. Every specialty deserves an answer: what model actually solves this, not just what’s convenient.”

In practice, organizations don’t always use the bridge they rate highest. Locum tenens was rated as the strongest short-term option of any coverage model (47%), yet it was used in only 12% of cases where an opening occurred. Organizations more often leaned on physician and APP models (21%) or internal physician cross-coverage (18%) — capacity already inside the building — and only 19% of those vacancies had a contingency plan in place before the gap opened.

Clinicians without backup are more likely to consider leaving.

Additionally, the survey points to retention risk among clinicians already in place. Sixty-five percent of current rural clinicians said they lack adequate specialist and colleague backup. Among them, 67% said they are at least somewhat likely to leave their current position within two years, compared with 44% of clinicians who have adequate backup. The survey also shows a path back: Nearly half (45%) of clinicians who have left rural practice said they would consider returning. Their top conditions — competitive compensation (47%) and better specialty coverage and colleague backup (45%) — are the same improvements current clinicians say they want most.

The full report, Rural Healthcare Specialty Priorities: Rural Physician Workforce Survey, is available now.

About Jackson Physician Search

Jackson Physician Search is an established industry leader in physician recruitment and pioneered the recruitment methodologies standard in the industry today. The firm specializes in the permanent recruitment of physicians, physician executives, and advanced practice providers for hospitals, health systems, academic medical centers, and medical groups across the United States. Headquartered in Alpharetta, GA, the company is recognized for its track record of results built on client trust and transparent processes and fees. Jackson Physician Search is part of the Jackson Healthcare® family of companies. For more information, visit www.jacksonphysiciansearch.com.

About LocumTenens.com

LocumTenens.com specializes in optimizing healthcare staffing operations with flexible, hybrid, and temporary placement of physicians, advanced practitioners, social workers, and psychologists. With a presence in more than 90% of the nation’s top healthcare facilities and supporting 150 medical specialties, LocumTenens.com is dedicated to improving healthcare through innovative staffing solutions, connecting clients and clinicians to deliver exceptional and uninterrupted patient care. Founded in 1995, LocumTenens.com is the largest provider of locum tenens services in the U.S. and a leader in the healthcare staffing industry, placing more than 7,000 clinicians annually who deliver care to more than 10 million patients. Headquartered in Alpharetta, Georgia, LocumTenens.com is part of the Jackson Healthcare® family of companies. Learn more at www.LocumTenens.com.

About MGMA

Founded in 1926, the Medical Group Management Association (MGMA) is the nation’s largest association focused on the business of medical practice management. MGMA consists of 15,000 group medical practices ranging from small private medical practices to large national health systems representing more than 350,000 physicians. MGMA helps nearly 60,000 medical practice leaders and the healthcare community solve the business challenges of running practices so that they can focus on providing outstanding patient care. Specifically, MGMA helps its members innovate and improve profitability and financial sustainability, and it provides the gold standard on industry benchmarks such as physician compensation. The association also advocates extensively on its members’ behalf on national regulatory and policy issues. To learn more, go to www.mgma.com or follow us on LinkedIn, X, and Facebook.

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