Across the country, health care faces persistent clinician shortages. Retirement, burnout, illness, family responsibilities, and career changes all take skilled professionals out of the workforce — sometimes temporarily, sometimes for years. Yet when these professionals want to return, the process in medicine is often opaque, inconsistent, and unnecessarily punitive.
Other high-stakes professions — commercial aviation, attorneys, firefighting, law enforcement, even railroad operations — have developed clear, structured, return-to-duty pathways. They recognize that bringing back experienced professionals benefits safety, quality, and the profession as a whole. Health care has yet to match that clarity or commitment.
In a recent professional reentry needs assessment I conducted, clinicians spoke candidly about the barriers they face. While the sample was small, the themes were strikingly consistent: cost, inconsistent rules, adversarial boards, and stigma for those in recovery. These responses echo findings from the literature: inconsistent policies, lack of formal reentry programs, and financial and logistical hurdles remain significant barriers.
What Other Professions Do Right
From my recent review of return-to-duty practices in other industries, several common elements emerged:
A clear, standardized pathway. Steps are defined from day one, with timelines and criteria spelled out. Pilots in the Human Intervention Motivational Study program, for example, know exactly what’s required before they can fly again.
Ongoing monitoring and support. These professions don’t just “clear” someone and walk away — they integrate regular check-ins, peer mentoring, and wellness resources.
A shared belief in the value of returnees. Experienced professionals are seen as assets worth reinvesting in, not risks to be managed out of the field.
Railroad engineers, firefighters, lawyers, airline pilots, and law enforcement each have versions of these principles. None of these industries are risk-free; they simply manage reentry risk through structure and support, rather than by defaulting to exclusion.
Where Health Care Falls Short
Medicine remains fragmented. State boards, specialty boards, and local institutions each have their own requirements — often without coordination. There is no uniform definition of “clinical inactivity,” and no standard retraining curriculum.
The burden of proof lies entirely with the clinician, who must meet licensure, certification, and credentialing requirements separately, often with little guidance. Formal reentry programs are few and costly, and many physicians try to return without structured retraining, which can undermine both safety and confidence.
Health care can learn from other professions, but it will require coordinated action:
Specialty societies should lead on standardization. Develop specialty-specific reentry guidelines that define inactivity thresholds, outline retraining requirements, and set clear timelines.
State boards should harmonize requirements. While licensure is inherently state-based, boards can collaborate on shared policies to reduce confusion and variability.
Hospitals and health systems should view reentry as workforce preservation. Create credentialing policies that integrate returnees with appropriate supervision and support, rather than defaulting to denial.
Expand affordable, accessible reentry programs. Many existing programs are excellent but cost-prohibitive. Grants, scholarships, and employer-sponsored training could open doors for more clinicians.
Address stigma directly. Boards, employers, and colleagues must recognize recovery and remediation as signs of resilience and commitment, not permanent disqualifiers.
In recent months, I’ve had the honor of working with clinicians navigating the reentry maze. I’ve seen the determination it takes to face multiple boards, track down decades-old documentation, complete assessments, and still keep the passion to return to patient care alive. These professionals are not asking for shortcuts — they are asking for clarity, fairness, and the same evidence-based approach to workforce reintegration that other high-stakes, safety-sensitive industries already use.
Reentry should be a standard, supported career pathway in health care. Until we make it one, we will continue to lose skilled clinicians to confusion, cost, and stigma — at a time when we can least afford it.
What are your suggestions for how health care can improve reentry? Share in the comments.
Dr. Edward Rose is a family medicine physician based in Novi, MI. He earned his MD from the University of Michigan Medical School and practiced family medicine for 30 years. He currently serves as the president and owner of Twenty Poms, LLC and president of Re:Entry Consultants.
Image by Anton Vierietin / Getty Images
