Waiting awhile for a doctor’s appointment? Lowcountry navigates physician shortage

As health care systems expand medical services in the Lowcountry, finding enough physicians to serve the area’s growing population is a major concern.

Beaufort County is currently short about 70 providers, Beaufort Memorial Hospital president and CEO Russell Baxley said, including specialists in gastroenterology, urology, neurology and rheumatology. These shortages have led to a backlog of appointments for new patients, he said.

It’s a similar situation at Novant Health, which acquired Coastal Carolina Medical Center in Hardeeville and Hilton Head Medical Center last year. Recruiting primary care doctors has been a challenge, physician executive for South Carolina Dr. Robert Harrington said, and the need will likely increase as the area’s population continues to grow.

“We’ve done some market analysis in terms of the primary care deficit in the market, and I would say we’ve got a lot of opportunity there,” Harrington said.

The problem isn’t unique to the Lowcountry, or even South Carolina. The U.S. is projected to face a shortage of up to 86,000 doctors by 2036, according to a 2024 report from the Association of American Medical Colleges. But in South Carolina, an aging and growing population and a scarcity of medical residency programs contribute to the national problem, experts said.

Filling open positions is especially difficult in the Lowcountry, where the cost of living is high compared to other parts of the state.

“Greenville and Columbia are desirable, but have a lower cost of living. That is a bit of a challenge,” Baxley said. “It’s just really competitive. I don’t think you can look to a state or area that isn’t hurting for providers.”

How did we get here

South Carolina is projected to be short by about 3,000 physicians by 2032, Baxley said. That’s roughly the same figure cited by the Cicero Institute, a conservative think tank based in Texas that also ranks South Carolina 36th in the nation for total physician supply.

The state has four medical schools: Medical University of South Carolina, the Edward Via College of Osteopathic Medicine (VCOM), University of South Carolina School of Medicine Greenville and the University of South Carolina School of Medicine Columbia. MUSC’s primary residency program is based in Charleston, but the school also recently said it expanded its Florence residency program for a total of 24 doctors.

The South Carolina Department of Health and Human Services has a physician residency incentive program that gives hospitals Medicaid funding if they train doctors in determined high-need specialties, including obstetrics and gynecology, family medicine, pediatrics, psychiatry and internal medicine.

Those training funds are needed, said Lara Hewitt, vice president of workforce and president of Solvent Networks at the South Carolina Hospital Association. But they don’t address the issue of physician retention. In 2024, just 132 out of 474 South Carolina medical school graduates were placed in an in-state residency, which is a problem because doctors tend to set up their practices close to their residency placement, Hewitt said. Graduates also understandably gravitate towards programs that will help them pay off medical school.

“Debt is a big concern for them, and they need help trying to figure out, ‘am I going to stay in the state of South Carolina, or do I go somewhere where there’s loan forgiveness and establish my practice there?’” she said.

The current generation of medical school graduates also values work-life balance more than their predecessors, Hewitt said. Because of that, replacing a retiring doctor with a new medical school graduate isn’t a one-to-one exchange, she said.

“A lot of them are looking to not be a traditional, more seasoned physician who works 80 hours a week and takes weekend calls. They are looking for employer policies that are going to allow them to be more balanced as human beings,” she said. “It’s not like I have Dr. Jones about to retire and I’m going to replace him with Dr. Lara, because Dr. Lara is not going to want to come in and work the same way Dr. Jones did.”

It can also be tough to recruit physicians to largely rural South Carolina because physicians tend to gravitate towards urban areas, said Brad Wright, professor and chair of Health Services Policy and Management at the University of South Carolina’s Arnold School of Public Health.

“Supply side-wise, you’re always going to see issues with limited workforce in rural areas, and we have a lot of rural areas in the state,” Wright said.

What’s in development?

Both Beaufort Memorial and Novant Health are building new hospitals in Bluffton to expand health care access south of the Broad River. Bluffton’s population grew by about 15,000 between 2010 and 2020, according to the U.S. Census Bureau, and both health care networks have said they’re trying to meet that need.

New South Carolina hospitals must obtain a certificate of need from the state before construction begins, a regulatory go-ahead that prevents too many hospitals from being built at the same time. Beaufort Memorial opposed Novant’s certificate of need, after Tenet Health, the former parent company of Hilton Head and Coastal Carolina hospitals, opposed a Beaufort Memorial hospital plan that was ultimately withdrawn.

Staffing, Baxley said, is a big reason why.

“We were already trying to build a hospital in a location that actually needs a hospital,” Baxley said. “When you have two hospitals within a short radius in a health care professional shortage, unless we double the number of nurses and respiratory therapists, I think we will continue to struggle on the staffing side of things.”

Both health systems are also attempting to address housing as a barrier to recruitment by building workforce units near their facilities.

Beaufort Memorial is building LiveWell Terrace, a 120-unit apartment building for people making up to 80% of the Area Median Income. Novant in January said it is building a 140-unit complex on Hilton Head Island; at least 30% of the units will be set aside for medical staff, according to the company.

The idea is to make it easier for Hilton Head Medical Center staff to get to work, said Joel Taylor, the local market president at Novant Health.

Beaufort Memorial also opened a new on-site childcare facility for its employees last year on the hospital’s main campus.

The hospital is being proactive in its response to the workforce issue, Baxley said, but there’s still a lot to be done.

“How do you balance that rapid and extreme growth, and the need for more health care, but supply the workforce to do it?” he said. “We are really struggling, but trying to make inroads and improvements in partnerships and new facilities.”

This story has been corrected to clarify that it is Beaufort County, not Beaufort Memorial Hospital, that is short about 70 physicians.

This story was originally published September 9, 2025 at 12:30 PM.