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# Clinicians Shortages, Drivers
- URL: https://marginsofcare.com/clinicians-shortages-drivers/
- Published: 2026-08-12T20:15:22.000Z
- Updated: 2026-08-14T11:25:33.000Z
- Author: Eva Worst

To continue the [cost of care](https://marginsofcare.com/cost-of-care-drivers/) thread from yesterday, the second big [capacity constraint](https://marginsofcare.com/capacity-constraints/) is around clinicians. 

Here is a quick recipe for how to think about this problem:

1\. First we take specialists such as radiologists and dermatologists (in-patient care) vs GPs (out-patient care).

2\. Second we consider the differences between metropolitan and rural areas.

3\. When we put those two together we end up with a [GP shortages](https://medical-scope.de/blog/aerztemangel-deutschland-2026?ref=marginsofcare.com) everywhere and [specialists shortages](https://www.tagesschau.de/inland/gesellschaft/aerztemangel-178.html?ref=marginsofcare.com) in rural areas.

4\. Next we add the trend towards [part-time work](https://www.it.nrw/nrw-krankenhaeuser-anstieg-von-teilzeitbeschaeftigung-beim-aerztlichen-und-nichtaerztlichen?ref=marginsofcare.com), especially for female physicians, which make up close to half of the workforce.

5\. And finally we layer the fixed [3-5 hour](https://www.iamexpat.de/expat-info/germany-news/german-doctors-being-suffocated-bureaucracy?ref=marginsofcare.com) administrative burden per clinician, independent of workday length.

The outcome is high clinician density per 100,000 people, but low actual patient-facing availability. In other words, it’s a bloated and inefficient model.

There is a push to change that [on a systems level](https://marginsofcare.com/khvvg-goals-maslows-pyramid-clinical-workflows/) on one hand by bundling care into bigger, more centralised facilities, which is supposed to ease that administrative burden; and on the other by changing how healthcare is reimbursed.

Add [technology](https://marginsofcare.com/ai-drug-development-bottlenecks-the-workflow-middleware-layer/) to the mix and we might indeed be able to achieve more with less, which is increasingly becoming the standard in the [progressively older society](https://marginsofcare.com/capacity-constraints/) we successfully managed to pull off. More on that [tomorrow](https://marginsofcare.com/healthcare-demand-drivers/).