Jamie Shipman (Image credit: Frampton Construction)
As the U.S. population ages and more Americans, particularly older adults, migrate to the Southeast for warmer climates and lower costs of living, demand for healthcare facilities is rising rapidly. The Massachusetts Institute of Technology (MIT) AgeLab, a research institute focusing on improving the quality of life for older people, projects that the 65+ population will increase by roughly 40 percent over the next 25 years, driving the need for additional hospital beds, outpatient centers, and specialty clinics. Health systems are responding by expanding ambulatory networks, upgrading aging campuses, and addressing long-deferred infrastructure needs.
Jon Wood (Image credit: Frampton Construction)
Meeting that demand is becoming increasingly difficult as the construction industry faces persistent labor shortages, particularly in mechanical, electrical, and plumbing (MEP) trades. Associated Builders and Contractors, a national construction industry trade association, estimates the construction industry will need nearly 500,000 additional workers this year to meet growing construction volume, with MEP roles ranking among the hardest positions to fill. With fewer workers entering the trades and retirements accelerating, available labor is not keeping pace with the volume or complexity of healthcare construction.
Healthcare construction feels this pressure more acutely than many other sectors. These facilities rely on complex systems, redundant infrastructure, and strict environmental controls that directly support patient care—from medical gas piping and critical power to emergency backup systems and rigorous air-change requirements. This level of specialization narrows the pool of experienced trade partners and raises the stakes for coordination, sequencing, and execution.
Why the labor gap is especially visible in fast-growing regions
While MEP labor shortages affect healthcare construction nationwide, fast-growing regions offer a clear view into how demand and workforce constraints collide. The Southeast U.S., in particular, is experiencing pronounced tension between rising healthcare facility demand and limited MEP trade capacity. Several states in the region rank among the fastest growing in the country, driven by retiree migration and population growth. As communities expand, health systems are investing in hospitals, medical pavilions, and specialty facilities to meet patient needs closer to home.
Even when highly qualified healthcare trade partners exist in larger cities, growing demand across the industry has made those firms more selective about where they deploy resources. Workforce availability, backlog considerations, and long-term commitments increasingly shape which projects trade partners are able to pursue. This dynamic leaves project teams with a narrower pool of viable partners and places greater emphasis on how those relationships are established and supported.
Solving trade partner shortages in MEP for healthcare design
Solving trade partner shortages requires a shift in mindset. The challenge is no longer simply finding fully specialized healthcare trade partners, though that pool is limited and increasingly competitive. Instead, project success depends on identifying partners with strong foundational skills—such as process-driven execution, active field management techniques, and disciplined quality control—and then actively helping them grow into healthcare work.
In previous market cycles, healthcare projects often relied on a relatively small group of highly specialized trade partners who moved from job to job within the sector. That model no longer scales as the healthcare market volume has increased faster than the supply of specialized labor. Competition for the same limited pool of healthcare-experienced trades has intensified, and waiting for “perfect” partners to become available can delay projects before construction even begins.
As a result, teams need to evaluate trade readiness differently. Rather than focusing solely on past healthcare resumes, consider prioritizing strong technical fundamentals like high-purity piping installation, complex conduit routing, and experience working in live, mission-critical facilities. In many markets, capable trade partners exist, but their healthcare experience may be limited. Closing that gap requires deliberate integration, training, and in-the-field support throughout delivery.
How to provide on-the-job upskilling
The most effective way to expand healthcare-capable trade capacity is through active, on-the-job upskilling. Once trade partners are engaged, healthcare projects often demand a higher level of coordination early in construction to reinforce sequencing, life-safety requirements, and system integration.
This means setting clear daily and weekly production expectations, holding frequent coordination check-ins, and maintaining close alignment between field supervision and project management. While this approach requires additional attention from the project team, it helps stabilize performance early and reduces downstream disruptions as trade partners gain familiarity with healthcare-specific demands.
Without this level of support, gaps can surface quickly. For example, trade partners transitioning into healthcare environments may be unfamiliar with the intensity of above-ceiling coordination, the sequencing required to maintain infection control standards, or the documentation rigor associated with life-safety systems.
On a recent project, a mechanical trade partner new to healthcare work initially struggled with above-ceiling congestion, where medical gas, electrical, plumbing, and low-voltage systems converge in tight interstitial spaces. The team addressed this by holding targeted model-based coordination sessions before rough-in began and then sequencing installations by system priority. This prevented rework in patient corridors and allowed crews to maintain production while adapting to healthcare-specific constraints.
Early engagement plays an important role in this process when it’s used as a foundation for training, not as a standalone solution. When applied intentionally, early coordination of project teams creates time and context for learning, allowing teams to introduce healthcare requirements, identify knowledge gaps, and reinforce expectations before work accelerates.
Tools and delivery models that support MEP training and stability
As trade partners build healthcare-specific capability, tools such as Building Information Modeling (BIM) and prefabrication play a critical stabilizing role. BIM provides a shared visual framework that allows teams to understand complex systems before installation begins, reducing uncertainty and rework. For partners newer to healthcare work, BIM coordination can shorten the learning curve by clarifying how building systems are physically laid out in shared space before crews encounter them in the field.
Prefabricated assemblies, such as multitrade corridor racks and in-wall rough-in systems, further reduce on-site logistics complexity by shifting work into controlled environments. Repetition and consistency reinforce correct installation methods while reducing variability, a practical advantage when skilled labor is limited. Together, these approaches help maintain schedule reliability while healthcare-specific skills continue to develop.
Collaborative delivery models play an equally important role in stabilizing workforce capacity at the project level. In design-build, the construction team is contractually integrated with the designer from the outset, allowing early alignment on constructability, sequencing, and labor availability. In design-assist, key trade partners join the design team during preconstruction to inform system layouts and installation strategies before documents are finalized. Both models improve workforce stability by enabling earlier trade engagement and more predictable manpower planning.
Case study: Building capability in a constrained market
Even with strong preconstruction planning, limited skilled labor can challenge healthcare projects. On a recent medical pavilion project in a smaller Southeastern community, the local workforce included plumbing and electrical partners with limited healthcare experience. The available labor pool was constrained, and bringing in specialized teams from larger cities was not feasible.
Rather than replacing those partners, Frampton Construction made a deliberate decision to focus on integration and support. Daily coordination meetings reinforced sequencing expectations; regular model reviews helped translate design intent into field execution; and dedicated on-site team members closely monitored material readiness, coordination needs, and daily production milestones to keep crews productive.
Over time, this approach shifted the dynamic on site. As trade partners became more comfortable with healthcare-specific requirements, coordination became more proactive, and fewer issues required escalation. The project maintained momentum despite labor constraints while strengthening regional trade partners’ healthcare delivery capabilities.
That investment extended beyond the project itself, contributing to a stronger regional trade base for future healthcare work.
Meeting tomorrow’s healthcare construction needs
Labor shortages in MEP trades reflect broader demographic and educational shifts reshaping the construction workforce. Long-term workforce development efforts remain necessary, but they will take time to expand the pool of healthcare-capable trades.
Construction firms cannot wait for that pipeline to catch up. Addressing current constraints requires an active role—identifying trade partners with strong fundamentals, investing in hands-on upskilling, and reinforcing performance through tools such as BIM, prefabrication, and collaborative delivery models. These approaches help maintain control, coordination, and schedule reliability while healthcare-specific capability is built in the field.
Early collaboration and sustained partnering are also laying the groundwork for growth. By developing regional trade capacity now, construction teams are better positioned to scale and respond as healthcare demand continues to increase across the Southeast U.S.
Teams that take ownership of this challenge will be better positioned to deliver complex healthcare facilities reliably, even in constrained labor markets.
Jamie Shipman is a project executive at Frampton Construction (Ladson, S.C.) and can be reached at [email protected]. Jon Wood, CHC, is general superintendent at Frampton Construction and can be reached at [email protected].
