#258 - 64% of Rural Health Leaders Expect a Physician Retirement. Only 41% Have a Succession Plan.

Luke Carignan runs this one solo while Bo and Jeremy are in Savannah for the ASHHRA Executive Summit. One theme ties the week together: your move. Every story lands on a decision that sits in an HR office. 🩺 The Physician Succession Crisis Nobody Scheduled New research from MGMA, Jackson Physician Search and LocumTenens.com found 64% of rural administrators expect a physician to retire or cut back within five years, and only 41% have a formal succession plan. Two-thirds of the significant physician vacancies from the past three years are still open searches today. Action: Name the physicians who are five to ten years out, then start the conversation before anyone gives notice. This is succession planning, and succession planning lives in HR. https://jacksonhealthcare.com/new-research-from-mgma-jackson-physician-search-and-locumtenens-com-gives-rural-health-leaders-a-strategy-for-sustaining-specialty-care/ 🪜 91% Believe It. 64% Build It. MedCity News reported this summer that 91% of healthcare employers say internal career laddering improves retention, while 64% actually offer it. Pay is table stakes now and it buys transactions, not loyalty. What holds people is knowing there is a next step with their name on it. Key Takeaway: The gap between 91 and 64 is a decision, not a budget line. Pathways feel like a long-term investment to leaders managing a short-term crisis, and the systems that built them are less short staffed today. https://medcitynews.com/2026/07/healthcare-retention-depends-on-better-pathways-not-just-better-pay/ 📈 The Fragile Recovery Is a Workforce Story Fitch projects median operating margins of 1% to 2% for nonprofit hospitals in 2026. Thin, but up. The systems recovering fastest got labor costs down by keeping people rather than cutting them, because every nurse who walks costs roughly $60,000 to replace and every travel contract raises cost per hour. HR Risk: A CHRO who cannot quantify what retention returned to the margin is arguing from feeling in a room that runs on numbers. https://www.fiercehealthcare.com/providers/nonprofit-hospital-sector-notch-modest-margin-gains-2026-systems-tighten-ahead-medicaid 🔎 This Week's 3 Mission-Critical Moves Put one physician succession conversation on the calendar. Scope one career ladder in one department. Put a dollar figure on what retention saved you this year. Our October Sponsors AP3 This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program. Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise. Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare. No directories. No bidding wars. Just trusted partners proven to perform. Visit AP3.info to learn more and get connected with a partner. Clasp This episode is supported by Clasp — the missing link to lasting talent. You found two great candidates. Made two offers. One took the bigger sign-on bonus from the system across town. The other sta