97% of hospitals are locking in APP staffing for good; where does that leave physicians?

Ninety-seven percent of hospitals plan to hold onto their advanced practice providers (APPs) or expand their ranks even more in 2026 — and physicians are starting to notice what that shift really means for the shape of their own workload. A new national survey of 327 health care facility leaders shows APPs have quietly crossed a threshold: They're no longer a stopgap for open positions; they're being treated as permanent infrastructure. The data points to measurable gains across nearly every corner of a practice, but it also surfaces some uncomfortable tension — including a role-specific staffing crunch that's hitting rural facilities especially hard, and a burnout story that isn't as clean as leadership might hope.

There's also a geographic split forming that could reshape how — and where — physicians and APPs end up working together, with urban and rural facilities now moving in opposite directions on their staffing investment. It comes as retention strategy is already a growing focus for physician recruitment leaders trying to keep both physicians and APPs in the building.

Here are the key findings: