The shortage of skilled healthcare workers is real. It must not become a blanket explanation for every vacancy and resignation; employers also control pay, leadership, workload and development.

The labor-market shortage is real

Germany’s Federal Employment Agency identified 157 shortage occupations for 2025, with nursing and other medical professions among the affected fields. Outpatient providers therefore compete in a genuinely constrained labor market.

At the same time, an organization should separate factors it cannot control from working conditions it directly shapes.

The labor market cannot explain every internal problem

An MVZ influences remuneration, scheduling, communication, onboarding, task design, leadership behavior and conflict resolution.

When employees leave early, vacancies remain open or a team is permanently overloaded, leadership should examine those internal causes instead of stopping at a general reference to labor shortages.

Pay is a foundation, not the whole offer

The national median monthly full-time gross pay for medical assistants was EUR 3,329 in the 2025 Employment Atlas. The figure does not define the right salary for every person or region, but it provides a current labor-market reference.

A positive team climate cannot compensate for systematically inadequate pay. Conversely, higher pay alone will not retain people who face unreliable schedules, unmanaged conflict and permanent overload.

Reliability matters

Outpatient care will always require some short-term adjustment. Improvisation should not become the normal operating model.

Reliable schedules, protected breaks, transparent leave rules and fair coverage distribute pressure more sustainably. Repeatedly relying on the same people creates a cycle in which shortages generate overload and overload creates more turnover.

Workload often has a process component

The Zi Practice Panel reported broad dissatisfaction with the time and energy spent on administrative work. This burden is not solved by motivational language.

Responsibilities, interruptions, duplicate documentation, poorly designed digital tools and avoidable physician tasks should be reviewed systematically.

Leadership is daily behavior

Retention depends on whether expectations are clear, feedback is timely, conflicts are addressed and good work is recognized. Development opportunities and meaningful delegation also expand the value of skilled roles.

Employers should therefore track turnover, absence, time to fill, early exits, overtime and recurring exit reasons.

Conclusion

Policy must improve workforce supply and training conditions. Employers remain responsible for the working environment they create.

A credible response to staff shortages combines competitive pay, dependable organization, respectful leadership, useful development and better processes.

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