Our Nov. 3, 2026, MGMA Stat poll asked medical practice leaders how long their longest-open administrative position had been vacant. About four in five reported an opening, and 16% said it had been vacant for six months or longer.

Among 186 applicable respondents, 18% reported a vacancy of less than 30 days, 26% one to three months, 20% three to six months and 16% six months or longer. The remaining 19% reported no open administrative job. [Editor's note: Percentages total 99% because of rounding.]

Respondents with openings were asked to name the position and explain why it had been hard to fill. Those without an opening were asked about their last administrative vacancy.

Which jobs were mentioned

Front-office and leadership openings each made up about two in five jobs named in the follow-up comments. Front-office jobs included receptionists, patient access staff and schedulers; leadership positions ranged from practice managers and nursing directors to senior executives. Because some respondents named multiple positions, these proportions describe jobs mentioned, not shares of practices.

Among jobs open one to three months, nearly half involved reception, scheduling or phone work. For openings lasting six months or longer, most jobs mentioned were leadership positions. One respondent described a system director vacancy approaching two years, while another said all directors resigned after a restructuring. The comments suggest a difference by job type, though the sample is too small to draw broader conclusions.

Why positions remain vacant

More than half of vacancy-related comments pointed to applicants: too few candidates, missing qualifications or insufficient experience. About one in four cited pay, and roughly one in seven mentioned location. Workload, remote-work expectations and internal hiring delays also appeared. Respondents could name more than one obstacle.

Some longer vacancies involved specialized jobs. “Nobody has the necessary knowledge and skills,” one leader wrote. Others cited difficulty finding a clinical operations director with a nursing background or attracting candidates to an operations director role. Two described internal bottlenecks: delayed board involvement and limited HR screening capacity.

Pay was absent from comments about openings less than a month old but surfaced in older searches. A respondent with a receptionist vacancy of more than six months said, “Pay is too low to be competitive with other industries.” Remote-work expectations also affected billing roles: “WFH has become an expectation in RCM,” one leader wrote.

What practices without an opening reported

Even among practices without a current administrative opening, about two in three comments recalled difficulty finding qualified applicants. Pay, location and benefits also came up. One small-town practice needed bilingual employees; another said it could not offer medical insurance.

Other replies described stable staffing or routine searches. One leader viewed a one-to-three-month search as normal, another was taking time to find the right fit, and one practice said it develops staff from within. Vacancy length alone does not tell whether a search is stalled.

What earlier polling and the labor market show

MGMA's other 2026 polls show the staffing pressures surrounding these openings.

• In May, 56% of respondents said medical assistant hiring had become harder, and 29% reported higher staff turnover than in 2025. 
• In July, 63% said their support-staff-to-physician ratio was unchanged. 
• That July article cited 2026 MGMA DataDive Management and Staff Compensation data showing median medical assistant pay rose 4.3% in 2025 and receptionist pay rose 4.8%.

Pay pressures also meet tight budgets. In September 2025, 64% of respondents planned a 1% to 3% base-pay increase for staff in 2026. At the 2026 MGMA Annual Conference, MGMA Chief Customer Success Officer Andy Swanson told Physicians Practice that across-the-board raises in that range may not retain top performers. He pointed to turnover among medical assistants, front-desk schedulers, billers and coders, with skilled staff moving between medical groups.

Earlier polls show how work may change when practices cannot fill every seat, although this week's follow-up did not ask who covers an open position. 

• In June, more than two-thirds of practice leaders said they had not redesigned a role or adjusted staffing with AI; among the 26% who had, examples included automating front-office and revenue cycle tasks and leaving some positions unfilled. 
• In September, more than half of practice leaders reported adding at least four functions to their own jobs in two years. 
• In October, 71% said someone was designated to handle other providers' portal messages, often without added time or pay.

The broader labor market gives the numbers another point of reference. The Bureau of Labor Statistics' Employment Situation report for September 2026, released Oct. 2, found that healthcare added about 17,000 jobs that month, versus an average of 33,000 per month over the preceding year. Ambulatory healthcare services added about 13,000.

What practice leaders can do

The comments suggest five practical checks before extending a search:

1. Review the requirements and posting. Applicants were the most frequently named obstacle, especially qualifications and experience. Check whether the skills listed as required are truly necessary on day one and whether the pay range matches the work.
2. Decide where the job can be done. Remote-work expectations arose in billing, while other respondents described location barriers. If the work can be done remotely, consider widening the search. If the position requires on-site coverage, make that clear in the posting.
3. Recheck pay against the market. Pay was mentioned frequently in the vacancy and unassigned comments. Compare the offer with current local market rates and the 2026 MGMA DataDive benchmarks; a budgeted 1% to 3% raise may not keep pace for every role.
4. Give leadership searches an owner and timeline. Eight of 14 jobs mentioned in the longest-vacancy group were leadership positions. Name an interim decision-maker, identify who must approve a hire and set dates for screening, interviews and a decision.
5. Prepare an internal candidate before the vacancy. One respondent credited developing people from within. Identify staff interested in advancement and give them supervised management experience. MGMA's recent guidance on developing leaders from within offers a practical starting point.

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Sources

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