Data guideRead at source, 9 September 2026

The Healthcare Workforce Shortage, by Role: 1.3 Million Openings a Year, and 91% of Them Are Replacements

Almost everything written about the healthcare workforce shortage is about physicians and registered nurses. The federal projections say the pressure is somewhere else. Across the five largest non-physician healthcare occupations, the Bureau of Labor Statistics projects 1,306,100 job openings a year between 2025 and 2035 — and only 121,040 of them exist because the work is growing. The other 1,185,060, or 91 percent, are replacements for people leaving. The single largest line is not nursing: home health and personal care aides need 760,500 people a year, more than four times the 180,800 projected for registered nurses. If you run a home care agency, a skilled nursing facility or a senior living community, that ratio is your hiring problem in one number, and it is a churn problem rather than a pipeline problem.

The five occupations that carry the shortage

These five account for more than eleven million jobs between them, and they are the roles that frontline healthcare employers actually hire. Read the last two columns together: the replacement share is what tells you whether a bigger pipeline would fix anything.

Source: BLS Occupational Outlook Handbook, 2025–35 projections for each occupation, read 9 September 2026. Growth a year is the published decade employment change divided by ten. Replacement share is the published annual openings minus that figure, as a percentage of openings. Employment for all five is the sum of the individual figures.

Three things the table says that the policy literature does not

First, nursing assistants are the tightest occupation on the list and almost nobody says so. BLS projects the occupation to grow 3 percent over the decade — as fast as average, not faster — while still needing 203,300 people a year. Do the subtraction and 98 percent of those openings are replacements. There is no version of that problem that a larger training pipeline solves on its own, because the pipeline is not where the people are going. We take the occupation apart on the CNA shortage.

Second, the aide occupation is four times the size of the nursing one and pays a third as much. Home health and personal care aides are projected to need 760,500 people a year at a median of $35,800, against 180,800 registered nurses at $97,550. Both numbers matter, but they describe different businesses. If your organization is mostly aides, national coverage of “the nursing shortage” is describing someone else’s problem. Ours on that occupation is the caregiver shortage.

Third, growth and replacement need different money. Medical assistants are the one genuinely expanding role here, at 13 percent over the decade, and even there nine openings in ten are refills. When the openings are refills, a bigger pipeline fills a bucket with a hole in it, and what decides the return on the same budget is how long the people you hire stay. That is why we publish nurse turnover rates and caregiver turnover next to the recruiting pages rather than in a separate section.

The pharmacy technician shortage

Pharmacy technicians held about 471,200 jobs in 2025, and BLS projects the occupation to grow 6 percent, adding 30,100 posts by 2035. It also projects 44,700 openings a year. Growth accounts for about 3,010 of them, so roughly 93 percent are replacements. The median wage was $45,750 in May 2025.

The pay table shows where the replacements go. Pharmacies and drug retailers employ 51 percent of all technicians at a median of $39,240. Hospitals employ 18 percent and pay $50,760, which is $11,520 more for the same job title. Ambulatory care ($48,860) and general merchandise retailers ($48,150) also pay above the retail pharmacy rate. The largest employer of technicians is the lowest-paying setting on the list, so it trains people who then move to better-paid settings.

Pharmacy technician recruitment: the hiring move

For a hospital or clinic, the candidate pool is the retail technician already doing the work, and the ad should lead with the pay and the schedule, because that is the gap. For a retail pharmacy, the ad has to win on something other than rate, or accept that it is recruiting entry-level candidates and training them. BLS notes that most states regulate pharmacy technicians in some way, and that some states and employers require certification. State exactly what your state requires, and say whether you pay for certification. Our pharmacy technician job description has the posting.

The pharmacist shortage

Pharmacists held about 325,200 jobs in 2025, and BLS projects 5 percent growth, adding 17,100 posts by 2035, with about 12,500 openings a year. Growth accounts for about 1,710 of them, so roughly 86 percent are replacements — a lower share than the frontline roles above. The median wage was $140,910 in May 2025, or $67.75 an hour.

The shortage shows up most sharply inside hospitals and in specialist roles. In ASHP’s 2024 national survey of hospital pharmacy practice, reported in June 2025, over half of hospitals reported insufficient clinical pharmacy specialists, and nearly 88 percent reported shortages of experienced pharmacy technicians. Independent pharmacies report it too: in the National Community Pharmacists Association’s February 2024 survey, 67 percent of owners and managers said it was difficult to fill open positions, with technicians in highest demand (76 percent), followed by clerks and front-end staff (42 percent) and pharmacists (36 percent).

For employers the pharmacist and pharmacy technician shortages are linked: a pharmacist covering technician work is a pharmacist not doing clinical work. Filling the technician seats, where the pay gap between retail and hospital settings is large, is often the faster fix.

The respiratory therapist shortage

Respiratory therapy is small and growing fast. BLS counts about 142,000 respiratory therapists in 2025 and projects 9 percent growth, much faster than average, adding 12,100 posts by 2035, with 8,600 openings a year. About 1,210 of those a year come from growth, so roughly 86 percent are replacements. That is a lower replacement share than any of the nursing, aide, assistant or pharmacy technician roles above, and the median wage is higher than every one of those roles except registered nurses, at $82,280. The typical entry requirement is an associate degree, and therapists must be licensed in every state except Alaska.

Pay barely differs by setting. Hospitals employ 80 percent of therapists at a median of $82,730, nursing care facilities $79,270 and physician offices $77,890. There is little pay premium to offer, so the hiring move is the schedule, the unit and the shift pattern, stated plainly in the ad. The audience is also expensive to reach. Credentialed allied health roles sit at the top of our costs: in our 2026 Social Job Advertising Benchmark the allied health and imaging role family ran a $54.37 median cost per applicant at a 10 percent apply rate, one of the three most expensive of fifteen role families. A short form matters more here than almost anywhere. The posting is on our respiratory therapist job description.

The medical assistant shortage

Medical assistants are in the table above: 833,900 employed in 2025, 109,700 openings a year, and 13 percent projected growth, much faster than average. Even so, about 90 percent of openings are refills. The median wage was $45,690 in May 2025.

Offices of physicians employ 56 percent of medical assistants at a median of $45,520. Outpatient care centers pay $48,560 and hospitals $46,910, while offices of other health practitioners pay $38,400. The hiring move is mostly about requirements rather than pay. BLS states that most states do not require certification, though employers may prefer or require it, and some states set their own prerequisites. Making certification a hard requirement where your state does not demand it screens out recent graduates and experienced uncertified assistants, in an occupation that needs 109,700 people a year. Our medical assistant job description shows which requirement lines to keep.

Therapists, imaging and surgical techs

The physical therapist shortage, the occupational therapist shortage, and shortages of sonographers, radiology techs and surgical techs are smaller in absolute numbers than the aide and nursing roles, but a larger share of their openings comes from growth, and they cost far more to recruit. Same method as the table above:

Source: BLS Occupational Outlook Handbook and occupational projections table, 2025–35, read September 23, 2026. Radiologic technologists and surgical technologists are shown without the MRI technologists and surgical assistants the Handbook combines them with. Replacement share uses the same arithmetic as the table above.

The therapy roles are the one place on this page where growth is a large part of the problem: a quarter of physical and occupational therapist openings are new posts. They are also the most expensive audience we reach. In our 2026 Social Job Advertising Benchmark, therapy campaigns (PT, OT and SLP) ran a $74.62 median cost per applicant at a 5 percent apply rate, the highest of the fifteen role families, and allied health and imaging ran $54.37. For those roles the application has to be short, because the audience is small and every abandoned form is expensive. Role pages: therapy staffing, physical therapist assistant, radiology technologist and surgical technologist.

The behavioral health and mental health workforce shortage

The mental health shortage is the one HRSA measures most directly. In its designated HPSA quarterly summary as of 30 June 2026, there were 7,109 mental health professional shortage area designations covering 157,149,246 people, with 26.53 percent of need met, and 7,825 more practitioners needed to remove every designation. Read that last figure carefully: HRSA notes that most mental health designations are currently based on the ratio of population to psychiatrists only, so it is mostly a psychiatrist count and does not measure counselors, social workers or frontline staff.

The frontline behavioral health workforce is where most employers actually hire, and BLS projects it among the fastest-growing groups on this page. Same method as the tables above:

Source: BLS Occupational Outlook Handbook entries for counselors, psychiatric technicians and aides and clinical laboratory technologists and technicians, last modified 27 August 2026, read 24 September 2026. Replacement share: counselors add 98,000 posts over the decade (9,800 a year) against 50,500 openings; psychiatric technicians and aides add 36,700 (3,670 a year) against 21,900; lab staff add 9,400 (940 a year) against 20,800.

Behavioral health is also where advertising results vary most. In our 2026 Social Job Advertising Benchmark, the behavioral health and DSP role family ran a $55.55 median cost per applicant at a 9 percent apply rate, with the middle half of campaigns between $18.36 and $334.56, the widest band of any family. A band that wide says the employer’s own form, pay line and schedule decide the result more than the market does. Role pages: direct support professional, substance abuse counselor and psychiatric technician.

The lab tech shortage

Clinical laboratory staff are the reverse of behavioral health: BLS projects 3 percent growth over the decade, about as fast as average, so roughly 95 percent of the 20,800 openings a year are replacements. The shortage a hospital lab feels is a refill problem. BLS says technologists typically need a bachelor’s degree and technicians typically complete an associate degree program, and that some states require laboratory personnel to be licensed or registered. State your own state’s requirement in the ad rather than a generic credential list, and name the shift, because lab work runs around the clock.

The medical laboratory scientist shortage

The medical laboratory scientist shortage is real, but no federal count isolates it. A medical laboratory scientist (MLS), also called a medical technologist, is the bachelor's-level role that runs high-complexity testing, and BLS reports it together with technicians in one occupation: 343,000 jobs in 2025 and about 20,800 openings a year. The closest direct evidence comes from the profession itself. The American Society for Clinical Pathology 2024 Vacancy Survey, published in the American Journal of Clinical Pathology, found that vacancy rates have declined compared with 2022 but "remain elevated relative to those observed before the COVID-19 pandemic," and that retirement rates are still rising, with 10 of the 17 laboratory departments surveyed reporting increases.

Two facts shape how an employer should hire into it.

• Pay depends on setting. BLS puts the May 2025 median at $62,930 for the combined occupation, with private general medical and surgical hospitals at $69,190, medical and diagnostic laboratories at $58,320 and physician offices at $56,850. Private general medical and surgical hospitals employ 36 percent of lab staff and medical and diagnostic laboratories 19 percent, so a standalone lab is competing for the same people at a lower median.
• The federal floor is lower than most postings. Under CLIA, 42 CFR 493.1489, high-complexity testing personnel may qualify with a bachelor's degree in a chemical, biological, clinical or medical laboratory science or medical technology, and also with an associate degree in a laboratory science or medical laboratory technology, among other routes, plus a state license where the state requires one. A posting that demands a bachelor's degree and MLS certification for every bench role is an employer choice, not a federal rule. Check your state's licensure law and your accreditor, then write the ad to the real minimum.

For advertising, no Boostpoint role family covers laboratory staff exactly. The closest is allied health and imaging, which ran a $54.37 median cost per applicant at a 10 percent apply rate in our 2026 Social Job Advertising Benchmark. Treat it as a reference point rather than a quote, keep the form short, and name the shift, since BLS notes that lab staff in facilities that are always open may work nights, weekends or holidays. The posting is on our medical technologist job description, and the entry-level role beneath it is on the lab assistant job description.

Sources read September 24, 2026: BLS Occupational Outlook Handbook, clinical laboratory technologists and technicians; ASCP 2024 Vacancy Survey abstract, American Journal of Clinical Pathology, volume 164, issue 5; 42 CFR 493.1489 in the eCFR.

Where each role page is

This page is the arithmetic. The role-level pages are where the hiring detail lives, and they are the ones to read if you are actually filling one of these seats.

What the mix costs to keep full

The reason to look at these roles together rather than one at a time is that they cost wildly different amounts to advertise, and most healthcare employers hire several of them at once. Across the 891 campaigns in our 2026 Social Job Advertising Benchmark, caregiver and home care roles produced applicants at a $3.76 median at a 31 percent apply rate — the highest apply rate of the fifteen role families, and the second-lowest median cost after customer service ($2.71) — while registered nurse campaigns ran $19.08 at 11 percent. That is a five-fold difference in the cost of the same outcome, and it means a single blended advertising budget will always be quietly subsidizing the clinical roles out of the aide ones.

“Healthcare worker shortage” and “healthcare workforce shortage” describe the same problem

The two phrases are used interchangeably, and both point at the same arithmetic on this page: about 1,306,100 openings a year across the five largest non-physician healthcare occupations, roughly 91% of them replacements rather than new positions. The distinction people sometimes draw — that a worker shortage is about individual roles and a workforce shortage is about the system — does not survive contact with the numbers, because the system-level figure is simply the sum of the role-level ones.

What the phrasing does change is where employers look for a cause. A healthcare worker shortage sounds like a supply problem, which points at training pipelines and immigration. A healthcare workforce shortage sounds structural, which points at policy. The data points somewhere less satisfying than either: nine in ten openings exist because somebody left a job that already existed. That is a retention and refill problem sitting inside individual employers, not a shortage of people in the country.

Related: Psychiatric Technician Job Description, Dialysis Technician Job Description, Patient Transporter Job Description, Home Care Aide Job Description.

The hospital staffing shortage, including rural hospitals

A hospital staffing shortage is mostly a registered nurse and LPN shortage seen from inside one building, and the federal projections say where it bites hardest. In HRSA's nurse workforce projections (National Center for Health Workforce Analysis, December 2025, base year 2023), the country is short 108,960 full-time-equivalent registered nurses in 2038, 3% of projected demand, and 245,950 LPN and LVN FTEs, with LPN supply meeting just 70% of demand.

The national RN figure hides the geography. HRSA projects an 11% registered nurse shortage in nonmetropolitan areas in 2038, against 2% in metropolitan areas. A 3% national gap is a scheduling problem. An 11% gap is the difference between staffing a unit and closing beds, and that is the rural hospital's version of the same projection.

Rural hospital staffing: what changes in the hiring plan

• Widen the map before raising the budget. A rural hospital's labor pool is a commuting radius, not a town. In a compact state, a nurse holding a multistate license from another compact state can start without a new license; the map is on compact nursing states. Meta employment ads require a minimum 15-mile targeting radius anyway, which suits a rural catchment better than a dense metro one.
• Price the agency alternative honestly. In New York's published agency data, set out on this page, hospital RNs were paid $52 an hour against a $92 bill rate. Every shift a rural hospital covers that way carries that spread; the full comparison is on nurse staffing agency costs.
• Advertise the unit and the schedule, and keep the form short. Registered nurse campaigns in our 2026 Social Job Advertising Benchmark ran a $19.08 median cost per applicant at an 11% apply rate. With a small local audience, every abandoned application is a larger share of the market you can reach.

Staffing minimums add a compliance edge to the same problem; see nurse-to-patient ratios by state, and for recruiting outside metro areas generally, rural hiring.

The healthcare staffing shortage and the agency bill are the same problem seen from two ends

There is a version of the shortage that shows up in workforce projections, and a version that shows up on an invoice. The second is the one finance asks about, and it is now measurable, because two state governments publish the numbers.

New York requires temporary health care staffing agencies to register and file quarterly financial disclosures, and its Department of Health publishes the aggregates. In 2024, agencies billed $2.6 billion to New York health care entities and workers were paid approximately 62% of the amount billed — a gross margin near 38% across all categories. Its first-quarter 2025 report puts hospital registered nurses at $52 an hour paid against a $92 bill rate. Massachusetts comes at it from the other direction and caps the price outright, with maximum hourly charges for temporary nursing services set in regulation.

Set that beside the occupational figures in the table above and the shortage stops being an abstraction. A hospital paying $92 an hour for an RN whose own occupational median is $46.90 is paying roughly double the employed rate for the same clinical hour, and of that $92 the nurse is paid $52: the other $40, about 43% of the bill rate, is the intermediary's margin rather than the nurse's pay. So the shortage does two things at once: it makes roles hard to fill, and it moves a measurable share of the payroll to agencies.

That arithmetic is what decides whether recruiting is worth funding. An agency-covered vacancy costs the premium every hour it stays covered that way; a vacancy filled from your own applicant pipeline costs the advertising once. The full comparison — the state caps, the category-by-category margins, and the conversion fees that never appear on a rate sheet — is on the nurse staffing agency costs page.

One caution on language. “Staffing crisis” is the phrase used when a facility is covering shifts with agency labor and overtime, and it usually describes a local condition rather than a national one: the same role in the same state can be a crisis in one building and unremarkable in another twenty miles away, because staffing is a distribution problem before it is a supply problem. HRSA's own projections make that point numerically — it expects an 11% RN shortage in nonmetropolitan areas against 2% in metropolitan areas by 2038. Before treating your own vacancy as a symptom of a national shortage, check whether it is a symptom of your catchment, your shift pattern or your rate.

The radiology, surgical and sterile processing technician shortages

Three technical roles keep an operating room and an imaging department running, and they behave differently enough to take one at a time. The figures for the first two are in the therapy, imaging and surgical table above; the third is not, because BLS counts it under a different name.

The radiology technologist shortage

Radiologic technologists and technicians are a refill problem: 5% projected growth from 2025 to 2035, about 13,000 openings a year, and about 91% of those openings replacing someone who left (table above). What makes the seat hard to fill is the credential, not the headcount. BLS lists an associate's degree as the typical entry education, and the American Registry of Radiologic Technologists says more than 75% of states have licensing laws covering the practice, with some but not all of them requiring ARRT certification and registration before a state license is issued. Screen for the state license and ARRT registration in the application, not after the interview. In the Boostpoint 2026 Social Job Advertising Benchmark, the Allied health / imaging family ran a median of $54.37 per applicant at a 10% apply rate, so a short form matters more here than for most roles. The posting is on our radiology technologist job description.

The surgical technologist shortage

Surgical technologists look the same on paper: 5% projected growth, about 7,100 openings a year, about 92% of them replacements, and a May 2025 median wage of $64,650. BLS lists a postsecondary nondegree award as the typical entry education. The rules are looser than for imaging: the Association of Surgical Technologists states that surgical technologists are not regulated in most states, while it advocates graduation from an accredited program and the Certified Surgical Technologist credential. Requirements vary by state, so check yours before writing "CST required" into the ad, because an unnecessary requirement removes applicants you could hire. The most direct pipeline is the accredited program nearest you, through clinical rotations in your own operating rooms. See our surgical technologist job description.

The sterile processing technician shortage

BLS counts sterile processing technicians inside medical equipment preparers, an occupation with 79,900 jobs in 2025, projected to grow 10.8% to 88,600 by 2035, with about 10,700 openings a year and a median wage of $47,700 in May 2025 (BLS Employment Projections 2025-35). That is faster growth than either technologist role above, yet by the same arithmetic as the tables on this page about 92% of the openings are still replacements. BLS lists a high school diploma and moderate-term on-the-job training as the typical entry, which makes this a role you can hire for aptitude and train. The catch is certification law: the Healthcare Sterile Processing Association lists seven states where certification is required to work in sterile processing (Connecticut, Delaware, Minnesota, New Jersey, New York, Pennsylvania and Tennessee). In those states, check what the law requires of new hires before you advertise the role as entry level. We do not cite a benchmark family for this role, because none of our fifteen families clearly contains it. The interview side is on sterile processing interview questions.

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