Medical assistant (MA) still ranks as the hardest staff role to hire in medical practices today, according to a May 6, 2025, MGMA Stat poll.
Nearly half (47%) of medical practice leaders noted that they have the hardest time recruiting MAs over other staff roles, such as nurses (15%), billers (10%), coders (9%), and “other” (18%). The poll had 420 applicable responses.
The prolonged competitiveness in the labor market for these roles comes after:
- More than one-third of practice leaders budgeted more than usual for 2025 staff cost-of-living and merit increases for 2025.
- More than four medical groups in 10 (43%) hired alternative staff to cover MA vacancies in 2024.
- Only 22% of medical groups reported improved recruiting/hiring efforts for nurse roles in 2024.
Part of this issue is the competition facing physician practices for these workers. Over the past four years, MGMA DataDive benchmarks showed a marked spike in nurse compensation in hospital-/IDS-owned practices compared to independent ones, outpacing even the Consumer Price Index for All Urban Consumers (CPI-U) thanks to the deeper pockets supported by subsidies from parent organizations.
- Read more about shifts in recent years on MA recruitment, retention and in-house training from our June 2023 data story.
Projecting demand
The Bureau of Labor Statistics’ Occupational Outlook Handbook’s latest data reflects the job market for these and many other job roles across several industries. In particular:
- MA roles are expected to grow at 15% (much faster than the average for all jobs) between 2023 and 2033, with about 119,800 job openings each year. Accounting for MAs expected to exit the labor force in that period, the number of MA jobs would jump from 783,900 in 2023 to about 901,900 in 2023.
- Registered nurse (RN) roles are estimated to grow at 6% from 2023 to 2033, with about 194,500 job openings each year. All told, this would bring the total RN jobs nationwide from 3.3 million in 2023 to almost 3.5 million in 2033.
- Medical records specialist roles are expected to grow at 9% in that period, with about 15,000 job openings each year. This would put the total jobs for these roles at 208,200 in 20233, up from 191,500 in 2023.
How to respond
Hiring patterns have shifted due to these staffing challenges. Many medical groups report time-to-hire has increased for many positions, pushing practice leaders to start recruitment much earlier — often anticipating two months or more just to fill an MA vacancy. But even then, wage pressure is acute, especially for practices located near a hospital where MAs are lured away by a few dollars more per hour or large sign-on bonuses.
Ongoing economic pressures — from stagnant reimbursement to margins squeezed by rising expenses — are forcing practices to be much more selective in hiring, scrutinizing each role. Hiring for positions such as receptionists or aides might be delayed to prioritize “revenue-critical” roles such as nurses or billers. In many settings, it’s harder for practice owners to justify swiftly filling roles if they do not directly contribute to care or revenue.
Many organizations are showing a willingness — or recognizing the necessity — to hire less experienced candidates and provide internal training, or to expand their candidate pools by hiring nurses or EMTs to fill roles traditionally held by MAs or RNs.
Additionally, many medical groups are emphasizing career pathways to improve retention. Offering tuition assistance or flex time for MAs pursuing nursing degrees is a common strategy to help build a pipeline of nurses. Some practices have also explored cross-training coders and billers to ensure backup coverage when vacancies occur.
Aren’t automation and AI supposed to help?
Advances in AI and automation are reshaping the duties for some medical support roles, but in most ambulatory practices the focus is more on eliminating or streamlining certain tasks rather than replacing human staff outright. Small practices typically lack the capital or tech stacks to implement enough solutions to fully automate many staff roles, and patient care still requires a human touch.
This presents an opportunity for practice leaders to redefine some job descriptions to reflect how automation can make teams more efficient.
AI and medical coding
The implementation of third-party coding software to assist or even autonomously code many routine encounters can shift coders from doing rote coding to quality control.
Rather than eliminating coding jobs, these solutions raise the skill threshold: Coders who upskill to manage high-complexity cases, ambiguous documentation, and corrections will be in higher demand. Meanwhile, entry-level coders will increasingly need on-the-job training to review AI-coded encounters and handle errors flagged by software.
The rapid adoption of virtual scribes and ambient AI solutions has largely aimed to free physicians from documentation burdens, but it should have similar impacts on MAs and nurses who had been typing up charts or scribing for a doctor.
Billers and robotic process automation (RPA)
While the 2024 Change Healthcare outage caused severe disruptions in claims processing and forced many medical billers back into manual work in medical practices, the pre-existing trajectory of automating more routine tasks (e.g., data entry of claims, simple reconciliations) through practice management (PM) systems and AI seems to be restored.
As more practices outsource to cloud-based billing platforms and remote billing services, the role of medical billers is shifting toward higher-value work. Billers are increasingly focused on addressing claim denials and appeals, answering patient billing questions, and navigating other complex payer issues.
Higher-education institutions now recommend mastering advanced billing software, analytics tools, and interpreting AI-generated denial pattern reports. Much like medical coders, tomorrow’s billers will increasingly focus on managing higher-level exceptions as automation eats into their traditional workload.
Looking ahead
Many practices will likely need to continue evolving their staffing models and operating strategies, though exactly what that looks like is as unpredictable as the nation’s short-term policy and economic future.
Ultimately, the most likely shifts we will see in the years ahead will come from emerging trends with demonstratable results, including:
Staffing model shifts
Tiered clinical teams that use fewer RNs but more MAs or licensed practical nurses (LPNs) are likely to become more common — particularly if organizations can fill MA vacancies more easily, focusing on top-of-licensure work for each staff member.
Cross training and multi-role positions
Hiring today is all about versatility, and flexible staffing models where roles blur are necessary if staffing levels remain less than ideal. Practices may favor candidates with multiple skill sets — for example, a certified MA who is also a phlebotomy tech, or a nurse who is also certified in care management. Job descriptions could broaden (e.g., “Medical Assistant/Front Desk Coordinator,” combining clinical and administrative duties). This reduces the need to hire separate individuals for each narrow role while also providing backup coverage.
Increased use of part-time and per diem staff
Hospitals already tap into per diem or float pools to access trained staff as needed, and many primary care groups might explore coordinating with health systems or independent physician associations (IPAs) to do likewise — especially as roles shift due to automation or as practices work to accommodate workers’ preferences for flexibility.
New roles
- Health coach and care coordinator roles may be added in practices with deeper embrace of value-based care and closer management of chronic disease populations.
- A scribe specialist role might become the designated “human in the loop” to oversee AI documentation tools.
- Patient navigator and insurance specialist roles may evolve from today’s medical biller role, especially in specialties with very complex insurance requirements. As more technical claim filing is automated this role will increasingly focus on helping patients with coverage and financial issues.
- Technologist roles focused on remote monitoring tools and patient wearable data could emerge, aligning with some of the skills already found among MAs.
Overall, the worst staffing crises seem to be easing with automation, but plenty of challenges remain. Practices will need to be innovative in staffing — through technology, cross-training, and/or partnerships — to build a leaner, more skilled workforce that continues providing quality care without burning out their employees or going bankrupt.
