S1 Ep119: The staffing squeeze, with Rihan Javid, D.O., J.D., of Edge

Rising minimum wages, fierce labor competition and persistent turnover are reshaping how physician practices operate — and higher pay alone isn’t solving the problem.

Rihan Javid, D.O., J.D., a psychiatrist and co-founder and president of Edge, a remote staffing organization, about how staffing pressures are landing inside medical practices in 2026.

Javid explains why small practices and rural hospitals are feeling the impact first, which roles are hardest to replace, and how frequent turnover quickly turns into operational and financial strain for physicians. He also shares practical guidance on retention, budgeting for the year ahead, and why flexibility — including remote staffing — is becoming essential as practices adapt to a changing labor market.

Music Credits:
Super Vibe Vlog by Elonix - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com

Editor's note: Episode timestamps and transcript produced using AI tools.

0:00 — Cold open
Why increasing salaries alone isn’t enough to solve staffing challenges.

0:22 — Intro
Austin Littrell introduces the episode, the Practice Academy note, and previews the discussion with Rihan Javid.

1:34 — Interview begins
Austin welcomes Javid and kicks off the conversation.

1:40 — Minimum wage increases hit practices
How rising minimum wages are affecting physician practices and rural hospitals.

1:53 — Tight margins, big jumps
Why sudden wage increases can blow up practice budgets.

2:55 — Why higher pay isn’t stopping turnover
Competing with large health systems, universities and public-sector benefits.

4:13 — The hardest roles to replace
Why patient-facing staff and billing roles create the biggest bottlenecks.

5:30 — The salary arms race
How pay increases turn into a cycle that practices can’t win.

5:48 — Building a core workforce
Why long-term retention matters more than constant replacement.

7:15 — P2 Management Minute
Keith Reynolds shares a quick note for practice leaders.

8:05 — When turnover hits daily operations
How staffing shortages push more work onto physicians.

8:42 — Budgeting for 2026
Why flexibility matters more than precision.

9:38 — One piece of retention advice
Treat employees well, pay competitively and be clear about expectations.

10:07 — Responding when staff leave
Why practices need to look inward — and outward.

10:22 — Thinking beyond local hiring
How remote staffing is filling gaps practices can’t solve locally.

11:39 — Roles that can go remote
Deciding which positions need to be in-person and which don’t.

12:27 — Closing thoughts
Final takeaways on flexibility and planning.

12:36 — Outro
Wrap-up, subscription reminder and Practice Academy note.