Workforce pressure

Across the state—and across the country—the demand for healthcare services is rising faster than the supply of providers available to deliver that care. Physician shortages are accelerating, driven by retirements, burnout, training bottlenecks, and consolidation within healthcare systems.

These pressures are not evenly distributed. Rural and underserved communities feel them first and most severely, where recruiting and retaining physicians can take years, if it happens at all. In many counties, residents already face limited provider options and long wait times for routine care.

What the data shows

North Carolina–specific workforce projections confirm what patients and providers are already experiencing.

NC Nursecast data shows that workforce shortages are expected to worsen in the coming years, particularly in primary care, behavioral health, and maternal health services. Even under optimistic assumptions, provider supply is not projected to keep pace with population growth, aging demographics, and increased utilization.

Why waiting won’t solve the problem

Training new physicians is essential—but it is not a short-term solution. Medical education, residency placement, and practice establishment take many years.

Relying solely on long-term pipeline solutions leaves current access gaps unaddressed, particularly in communities that already struggle to attract providers.

An existing workforce underutilized

Advanced Practice Registered Nurses are already part of North Carolina’s healthcare workforce and are disproportionately more likely to practice in rural and underserved areas.

However, outdated regulations limit how effectively this workforce can respond to growing demand. Restrictions on practice authority reduce flexibility, constrain care delivery models, and prevent the system from adapting to workforce realities.

Workforce modernization as a pressure release valve

Modernizing APRN practice authority does not replace physicians or diminish the importance of physician-led care. It complements the existing workforce by allowing providers to practice to the full extent of their training.

This approach:

• Expands access more quickly than training new providers alone
• Improves care availability in rural and high-need areas
• Reduces burnout by distributing care more effectively
• Strengthens team-based care models
• Helps stabilize the healthcare workforce overall

Why workforce pressure makes action urgent

Workforce shortages are not a future problem—they are a current constraint on access to care.

Without action, shortages will deepen, access gaps will widen and costs will continue to rise. Modernizing workforce policy now allows North Carolina to respond to today’s pressures while continuing to invest in long-term workforce development.