The Impact of an Aging Physician Workforce on Urology and Healthcare Staffing Needs
The field of urology finds itself at a crossroads, driven by the dual forces of an aging physician workforce and intensifying demand for specialized healthcare services. According to the American Urological Association (AUA), over half of practicing urologists are 55 years or older, with nearly 30% aged 65 or above.
These figures highlight a looming challenge on the horizon—retirements and reduced clinical productivity among aging urologists are set to create significant workforce gaps, impacting patient access to care and placing immense pressure on healthcare administrators seeking solutions.
This crisis isn’t just hypothetical—it's already becoming a reality for practices across the U.S. With a projected deficit of 3,630 urologists by 2025, policymakers and healthcare organizations must take urgent and strategic steps to mitigate the repercussions of these demographics. This article will explore how this trend affects urology and healthcare staffing, while offering strategies for navigating these challenges and attracting the next generation of specialists.
How an Aging Workforce is Reshaping Urology
Decreasing Workforce Capacity Amid Growing Demand
The aging physician workforce means more than just impending retirements; it also translates into lower output from practitioners still in the field. Statistics show that older urologists—those over 65—tend to reduce their patient loads significantly. Only 8.2% of urologists in this age group manage workloads of 100+ patient visits per week, compared to 24.3% of physicians aged 55–64. This decline compounds the capacity gap even before retirement occurs.
Meanwhile, the patient demographics who most frequently require urological care—adults aged 65 and older—are growing rapidly. By 2030, nearly 19% of the U.S. population will fall into this category, and their need for advanced care is anticipated to continue escalating. Conditions such as enlarged prostate, kidney stones, incontinence, and bladder cancer are prevalent among these older patient populations, demanding expertise that younger generalists or non-specialists cannot always provide.
Geographic Maldistribution Amplifies the Crisis
Approximately 72% of U.S. counties have either one or no practicing urologist, according to the AUA's latest census. While rural and economically disadvantaged regions have long struggled to attract medical specialists, the aging workforce makes this maldistribution even more pronounced. Younger urologists and female physicians entering the field—who now make up 22% of those under age 45—are less likely to practice in rural settings, further intensifying access disparities.
What It Means for Healthcare Staffing
Putting Pressure on Advanced Practice Professionals
Given the limited number of new urologists entering the workforce annually—only 329 residents completed training last year—many health systems are relying more heavily on advanced practice professionals (APPs) like physician assistants (PAs) and nurse practitioners (NPs). APPs can provide essential support by managing routine care, performing low-complexity procedures, and assisting with inpatient consults. However, while APPs are invaluable additions to care teams, they cannot fully replicate the expertise of board-certified urologists, particularly when addressing highly specialized surgical cases or rare conditions.
Increased Competition for Talent & Rising Costs
Urology is now one of the most difficult specialties to recruit for, ranking third in "absolute demand" according to AMN Healthcare’s 2024 Physician Recruiting Report. With fewer available candidates, healthcare organizations must craft highly appealing offers to attract urologists and differentiate themselves from competing employers.
Starting salaries for urologists can range from $425,000 to $525,000 for recent residency graduates, while experienced practitioners may command upwards of $650,000 annually. Signing bonuses, flexible schedules, and robust support resources (such as access to advanced technology like robotic systems) are becoming standard expectations.
Attracting the Next Generation of Urologists
The survival of urology as a robust specialty hinges on attracting younger professionals to step into the shoes of retiring physicians. Here are some ways healthcare systems can rise to meet this need.
1. Develop Competitive Recruitment Strategies
Healthcare organizations must approach urology recruitment with creativity, speed, and persistence. To appeal to younger candidates, offers should focus on work-life balance, minimal administrative duties, and access to cutting-edge tools such as robotic-assisted surgery and advanced imaging systems. Residency stipends, student loan repayment programs, and accelerated partnership tracks can further strengthen recruitment packages.
2. Encourage Diversity in the Workforce
While still a male-dominated specialty, female representation in urology is rising steadily, with predictions indicating this demographic will grow to 18.6% of the workforce by 2035. Encouraging diverse candidates—both in terms of gender and international medical graduates (IMGs)—will be essential to offsetting shortages and expanding access to care for underserved communities.
3. Leverage APPs for Workforce Optimization
While APPs cannot fully replace urologists, integrating them into care teams can help bridge gaps in areas with severe physician shortages. Upskilling these professionals to handle more complex cases under urologist supervision is a cost-effective, patient-centric solution.
4. Expand Urology Residency Opportunities
The bottleneck of training new specialists, driven in part by the 1997 cap on graduate medical education funding, remains a critical obstacle. Advocacy is needed at federal and state levels to expand residency slots in urology and other high-demand specialties. Without growth in this area, any efforts to meet future demands will fall short.
5. Strengthen Professional Mentorship
Mentorship from experienced urologists can play a crucial role in attracting and retaining younger professionals. Beyond technical skill-building, mentors can provide guidance on navigating the pressures of the specialty, advancing within academic medicine, or transitioning into private practice.
Turning Challenges into Opportunities
The aging physician workforce in urology presents a formidable challenge, but it also offers an unprecedented opportunity to reimagine the field. By fostering collaboration, leveraging technology, and prioritizing recruitment innovation, healthcare organizations can not only mitigate the immediate effects of workforce shortages but also lay the groundwork for sustainable, patient-centered growth.
Meeting this challenge head-on requires bold, vision-oriented leadership. That’s where organizations like AMN Healthcare step in. Leveraging decades of expertise, AMN Healthcare provides targeted recruitment, strategic workforce planning, and actionable solutions to ensure your organization's success in a rapidly evolving landscape.
Our latest white paper, Urology: Supply, Demand, and Recruiting Trends, delves deeper into the effects of an aging urology workforce and offers key strategies to help your organization build a promising future.
