Physician Shortage by State in 2026: Where the Need Is Worst

Most writing about the physician shortage quotes a national projection. This piece uses a different number: the one the Health Resources and Services Administration (HRSA) maintains designation by designation, which is the number that decides who qualifies for National Health Service Corps loan repayment, which employers can sponsor J-1 physicians, and where federal recruiting money goes. It is smaller than the projections, because it counts only the areas and groups HRSA has formally designated, and it is more useful, because it is specific to a county, a population, or a facility near you.

Primary care shortage areas

8,767

Geographic, population-group, and facility designations

People living in them

101.8 million

30% of residents

Mental health providers needed

7,680

Across 7,030 mental health shortage areas

Community health center sites

17,851

FQHC and look-alike service sites

What HRSA counts, and what it leaves out

A health professional shortage area, or HPSA, is a federal designation for a place or a group with too few providers. A geographic primary care HPSA has at least 3,500 people for every primary care physician; a population-group designation (a county's low-income residents, say, or a migrant farmworker population) or a high-need area qualifies at 3,000 to 1. Facilities can be designated too: every federally qualified health center, rural health clinic, and tribal facility is designated automatically, and correctional facilities and state mental hospitals qualify on their own ratios. Each designation gets a score, 0 to 25 for primary care and mental health, that sets its priority for federal programs.

Three things to hold onto when reading the tables. First, HRSA's primary care formula counts physicians only, so the figure for physicians needed does not credit the nurse practitioners and physician assistants already working in the area; the real gap in care is smaller than the number, and the hiring that closes it is usually a mix. Second, the people counted in a shortage area are the residents of a geographic designation or the members of a designated group, not every resident of the county. Third, a designation stays on the books until HRSA withdraws it in a Federal Register notice, usually once a year, so the counts include areas proposed for withdrawal.

The most intense shortages: physicians needed per million residents

Dividing HRSA's physicians-needed figure by each state's population puts a small state and a large one on the same footing. Delaware leads at 140 additional primary care physicians per million residents, against 51 for the country as a whole; Washington D.C., Washington, and New Mexico follow. At the other end, New Jersey (4), Vermont (5), and Pennsylvania (9) have the thinnest designated gaps, which says as much about how much of each state has sought designation as about its supply of physicians.

Where the most residents live in a shortage area

A second way to read the same data: what share of a state's people live in a designated primary care shortage area or belong to a designated group. Nationally it is 30%. In Washington it is 70%, the highest in the country, and in Alaska (60%), Arizona (55%), and New Mexico (54%) it is more than half or close to it. A high share with a modest physicians-needed figure usually means many small designations that are each a few physicians short; a low share with a large figure means a few deep ones.

The biggest absolute gaps

In raw numbers the large states dominate, as they would. Texas needs 1,658 more primary care physicians to clear its designations, Florida 1,276, and California 1,248. Together the ten states below account for 55% of the national figure. These are also the states where a national search has the most ground to cover: a shortage area in Texas and one in Delaware are recruiting from different candidate pools at different pay, and the state pages linked in the table below carry each one's compensation benchmarks and licensed-provider counts.

The mental health shortage by state

HRSA designates mental health shortage areas separately, on the ratio of population to psychiatrists or to core mental health providers (psychiatrists, clinical psychologists, clinical social workers, psychiatric nurse specialists, and marriage and family therapists). Most current designations rest on psychiatrists alone. Across the 50 states and D.C. that is 7,030 designations and 7,680 more providers needed, led by Florida (710), California (673), and Texas (631). We rank these by providers needed rather than by share of residents: mental health designations overlap more than primary care ones, enough that in at least one state the overlapping populations add up to more than its residents.

For the psychiatry side of this, our psychiatrist recruiting page covers the settings and the pay, and where the psychiatrist jobs are maps our open searches against it.

Every state, ranked

What the numbers mean if you are hiring

A shortage designation is not only a description of the problem; it is the key to most of the tools that solve it.

• Loan repayment. A practice in a shortage area can apply to become a National Health Service Corps site, and NHSC loan repayment goes first to clinicians at the highest-scoring sites. For many physicians, and most nurse practitioners, that outweighs a higher base salary somewhere without it.
• International physicians. Employers in shortage areas can sponsor physicians finishing U.S. residency on J-1 visas through their state's Conrad 30 waiver program, which requires three years of full-time service at the site. Each state gets 30 waivers a year; your state primary care office can tell you how many remain and when the next application window opens.
• Your site's score. Look it up on HRSA's HPSA Find. A score in the high teens or above is a recruiting asset and belongs in the first conversation with a candidate, next to the schedule and the pay.
• The pitch changes. In a designated area the employers that win are the ones that lead with the designation's benefits rather than base salary. Our FQHC recruiting playbook lays that pitch out.

Sources and method

Shortage figures are from HRSA's Health Professional Shortage Area detail files for primary care, mental health, and dental health, and its Health Center Service Delivery and Look-Alike Sites file, all as of October 15, 2026. We count a designation while its status is Designated or Proposed For Withdrawal, count each designation once, and take population and practitioners needed from geographic, population-group, correctional, and state hospital designations, the same rules HRSA uses in its quarterly state tables; our totals match those tables for every state except where HRSA has added designations since its last quarterly report. Population denominators are the U.S. Census Bureau's Vintage 2025 state estimates for July 1, 2025. Puerto Rico and the other territories are left out of the ranking, as they are in HRSA's. Health center sites are active service delivery sites of federally qualified health centers and look-alikes.