I’ll be honest with you.
When I bring up 2035 in conversations with healthcare leaders, I get blank stares. Not because they think I’m wrong. Because nobody is thinking that far ahead.
Most healthcare leaders are planning five years out, maybe. Things change too quickly, they tell me. Leadership shifts. Policies change. Reimbursement models evolve. Why plan for a decade away when next quarter feels uncertain?
I get it. I really do.
But here’s what keeps me up at night: the healthcare workforce of 2035 will look nothing like today’s, and we’re not preparing for it.
The Future Nobody’s Planning For
While healthcare leaders focus on filling today’s RN positions, something fundamental is shifting beneath our feet.
The U.S. faces a projected shortage of over 187,000 full-time physicians by 2037. The registered nurse workforce will reach 4.56 million by 2035, but nonmetropolitan areas—like much of the Midwest—will face an 11% shortage while metro areas experience only 2%.
Those numbers tell one story. But there’s another story unfolding that matters more.
Healthcare is moving toward holistic, preventive care models that focus on the whole person—diet, nutrition, social determinants of health, and mental wellness. Leaders recognize this shift. They talk about it in strategy meetings.
But when it comes to hiring? They post another Home Health Nurse position.
The Roles That Don’t Exist Yet
I had a conversation recently with a healthcare leader who needed Home Health Nurses and Home Health Care Aides. Urgent needs. Today’s problems.
Most of their clients were geriatric seniors. But those seniors have family members who could benefit from Holistic Health Care Coaches—professionals who guide lifestyle changes, develop prevention plans, and address health before it becomes illness.
I could see it clearly. The leader could see it too.
So I asked: why not focus on both? Address today’s needs while building relationships with professionals who see value in these emerging roles?
Silence.
Not disagreement. Not pushback. Just silence.
That silence told me everything. It’s not that leaders don’t understand what’s coming. They just can’t figure out how to act on it while drowning in today’s crises.
The Workforce Model Nobody’s Funding
Here’s the tension: the future healthcare workforce will require roles that current reimbursement models don’t support.
Health and Wellness Coaches to guide preventive lifestyle changes.
Population Health Managers to analyze community data and develop proactive strategies.
Behavioral and Mental Health Specialists integrated into primary care teams.
Community Health Workers who bridge clinical facilities and community resources, addressing food insecurity and housing instability.
Integrative Practitioners trained in both biomedical science and natural, preventative approaches.
The demand for holistic nursing alone is expected to grow 6% from 2022 to 2032, faster than average for all occupations. Community health worker positions will grow 13% between 2023 and 2033.
These aren’t hypothetical roles. They’re emerging now. But who’s going to pay for them?
Social determinants of health account for 60% of health outcomes, yet most delivery models lack resources to address these factors. U.S. employers lose $36.4 billion annually on employee absenteeism from preventable conditions.
The need is clear. The business case is clear. But the reimbursement model remains stuck in reactive treatment rather than preventive intervention.
What I Don’t Have Figured Out
I’m transparent about this: I don’t have all the answers.
I’m uncertain about the gap in workforce supply. I’m uncertain about whether we can develop the right skill sets fast enough. I’m uncertain about pay alignment—how do we attract talent to roles that aren’t fully funded yet?
I’m uncertain about the same things healthcare leaders are uncertain about.
But here’s what I know: waiting for certainty means waiting too long.
The organizations that start planning now—even imperfectly, even with incomplete information—will be the ones thriving in 2035. The ones waiting for clarity will spend the next decade scrambling.
The Smallest Step Forward
If bandwidth and budget are stopping you from long-term planning, start here:
Conduct a targeted data inventory.
Compile what you already know:
- Current staffing levels and turnover rates by department
- Employee demographics and retirement eligibility
- Existing skill sets and certifications
- Current data collection tools you’re already using
Then identify what you don’t know:
- Can you predict retirement trends over the next decade?
- Can you track emerging skill requirements for new care models?
- Do you know which roles will become critical as delivery models shift?
This step requires minimal budget—just internal staff time. It doesn’t demand new software or consultants. It gives you immediate clarity on your planning maturity without overcommitting resources.
Pick one gap. Make it your focus for the next quarter.
That’s how you start building for 2035 while surviving 2026.
The Conversation Nobody’s Having
Here’s what I’ve realized: this isn’t a problem any single person can solve.
Healthcare leaders can’t solve it alone. Recruiters can’t solve it alone. Neither can educators, community leaders, insurance providers, government officials, or nonprofit organizations.
But together? We might have a shot.
If I could get all those people in one room talking about 2035, I’d ask one question:
What’s the best cross-sector integrated funding model that leverages pooled public and private investment, governed by a shared vision and community input?
Because that’s the question nobody can answer alone. And it’s the question we need to answer if we’re going to build the workforce healthcare actually needs.
You’re Not Alone in This
If you’re a healthcare leader thinking about 2035 while everyone around you focuses on 2026, you’re not crazy.
You’re strategic.
The discomfort you feel about planning for an unclear future? That’s not a weakness. That’s the tension between what you know needs to happen and what current systems allow you to do.
I feel it too.
The difference between organizations that thrive and organizations that struggle won’t be perfect predictions. It will be the willingness to start planning despite uncertainty.
To build flexible systems instead of perfect ones.
To acknowledge that the workforce of 2035 demands preparation now, even when reimbursement models haven’t caught up.
To collaborate across sectors instead of waiting for someone else to solve the problem.
I’m collecting data. I’m gathering insights. I’m having conversations with healthcare leaders throughout the Midwest who are wrestling with these same questions.
Because being transparent about real challenges is how we establish trust. And trust is how we build solutions together.
The organizations planning now will be the ones thriving later.
The question is: are you solving for 2035, or just surviving 2026?
