Academic Medical Centers Could Ease the IHS Physician Shortage

Two recently published research papers provide concrete evidence that dedicated pathways must be carved into Tribal facility staffing serving Our Relatives, and that clinicians need a healthy ecosystem to stay. Academic medical center partnerships can help ease the Indian Health Service physician shortage, though recruitment alone will not solve it for Indian Country.

A New Partnership Model For Understaffed Facilities

A September 12, 2026 perspective in the New England Journal of Medicine by Matthew Tobey, M.D., and Allison Kelliher, M.D., argues that the Indian Health Service has limited recruiting options for its most understaffed sites, and that dedicated academic medical center partnerships could offer a more reliable staffing pathway for IHS and 638 facilities.

Academic systems already employ physicians, residents, and specialists able to rotate into IHS facilities. A 2018 Government Accountability Office report found an average vacancy rate of 25 percent across IHS physicians, nurses, and providers, and temporary contract staff cost more with less continuity of care.

Retention Depends On More Than Recruitment

Filling a position does not guarantee a clinician stays in it. A study published September 2, 2026 in BMC Health Services Research, led by Graham Ambrose and Wendee Gardner with coauthor Jessica Leston, interviewed 17 providers working in Indian Health Service and Tribally operated settings.

Those who stayed described strong relationships with the Indigenous communities they served, supportive coworkers, and autonomy paired with backing from supervisors. However, inadequate staffing and poor work-life balance pushed the other direction, feeding intention to leave.

Tribal Health Leaders Should Weigh Every Option

No single fix closes every vacancy across Indian Country. Federal employees, Tribally employed clinicians, contract staffing, telehealth, and academic partnerships each cover different gaps, and none replaces the others.

Ellsworth, an ISBEE certified Native owned small business serving IHS and Tribal 638 facilities in Arizona and New Mexico, has seen that clinicians stay longer when they are welcomed by elders and Our Relatives and supported as part of the care team, not dropped in as a temporary fix! Facilities weighing how partnerships fit into a longer-term workforce plan are welcome to talk with Ellsworth.