What is the specialty care gap in U.S. healthcare?

The specialty care gap refers to a growing mismatch between where specialist physicians are needed and where they actually practice. In urology, for example, there are roughly 1,100 open positions but only about 400 new specialists trained each year, leaving many communities underserved.

How can physician entrepreneurs help close the specialty care gap?

Physician entrepreneurs can develop innovative care delivery models—such as telehealth, mobile clinics, or group practice expansions—that bring specialty services to underserved markets. By combining clinical expertise with business strategy, they can create scalable solutions that traditional healthcare systems have failed to implement.

Why is urology used as an example of the specialty care crisis?

Urology illustrates the broader specialty care shortage because its supply-demand imbalance is especially stark and well-documented. With far fewer new specialists entering the field than open positions require, it serves as a clear, measurable case study for systemic workforce and access challenges across specialties.

Specialty Care Gap: How Physician Entrepreneurs Are Fixing Access

A Physician Entrepreneur’s Playbook for Fixing America’s Specialty Care Gap

The U.S. specialty care sector faces a widening gap between demand and supply, with urology alone showing 1,100 open positions against 400 new specialists trained annually. Dr. Joe Pazona, CEO of VirtuCare, discusses how physician entrepreneurs can address this crisis through team-based, hybrid care delivery models that improve access while enhancing clinician autonomy and quality of life.

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By Kevin Stevenson · May 11, 2026, 6:00 AM UTCDr. Joe PazonaHealthcare OperationsPhysician EntrepreneurshipRural Healthcare

Key takeaways

healthcare system is facing a quiet but accelerating crisis: a widening gap between where specialists are needed and where they actually practice.

In urology alone, there are roughly 1,100 open positions but only about 400 new specialists trained each year—a mismatch that’s only getting worse.

As physician burnout rises and more clinicians…

The U.S. healthcare system is facing a quiet but accelerating crisis: a widening gap between where specialists are needed and where they actually practice. In urology alone, there are roughly 1,100 open positions but only about 400 new specialists trained each year—a mismatch that’s only getting worse. As physician burnout rises and more clinicians seek autonomy and flexibility, traditional care delivery models are being pushed to their limits. The stakes aren’t abstract—they show up in delayed diagnoses, long travel distances, and communities left without access to care.

So how do you deliver specialty care differently in a system that no longer fits how physicians want to work?

On this episode of I Don’t Care, host Dr. Kevin Stevenson sits down with Dr. Joe Pazona, CEO of VirtuCare, to unpack a deeply personal and highly practical journey: from clinical frustration to entrepreneurial innovation. The conversation explores how one physician turned systemic gaps into scalable solutions—rethinking how specialty care can be delivered across underserved communities while improving physician quality of life.

Top insights from the talk…

The physician workforce shortage is no longer just a rural problem—it’s spreading into urban markets due to shifting lifestyle priorities and structural inefficiencies.
“Top-of-license care” and team-based models are essential to scaling access without overburdening physicians.
Entrepreneurship in medicine isn’t glamorous—it’s messy, risky, and full of failure—but it may be one of the most viable paths forward.

Dr. Joe Pazona is a board-certified urologist and CEO of VirtuCare, where he develops scalable, team-based specialty care models that expand access and drive revenue for rural hospitals through hybrid care delivery. He has over a decade of clinical and leadership experience, including launching robotic surgery programs, building private practices, and pioneering telehealth-enabled service lines. As an entrepreneur, he specializes in healthcare innovation, physician workforce optimization, and aligning clinical operations with sustainable business models to address systemic gaps in specialty care.

Article written by MarketScale.

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