Endangered species: Primary Care Doctors
You have probably heard of “the Primary Care shortage,” an impending healthcare crisis facing the U.S. population as our country ages. The number of doctors needed to care for our population falls far short of the numbers we are graduating amidst an already scant healthcare landscape post COVID-19. But the shortage is further fueled by primary care doctors leaving the field or getting out of direct patient care activities even mid career. Seasoned doctors are retiring early and/or cutting back hours significantly. Practicing Primary care Physicians are mysteriously vanishing from the ecosystem!
Unfortunately, the primary care physician shortage has been in the making for a long time, and there hasn’t been enough focus on the unsustainable nature of primary care or how the practice environment has changed for the worse over the years. When I was in medical school, the big question was, “What are you going to specialize in?” Lets just say, it was a small crowd at the Family Medicine interest group meetings. I first noticed the loss of natural habitat of the primary care doctor when I attended a Family Medicine Interest Group panel discussing how women family physicians can have a career and a family. The unsaid bottom line was, “you can’t really do both and make a living in primary care.” I walked away feeling shocked and discouraged. Wasn’t Family Medicine the greatest advocate for Families?
Most of us pursued primary care because we love the work, the mission, the patients. Everyone has to get creative to find work/life balance. Over the years though, the appointment volumes have increased with less time with each patient. There are more hoops to jump through, and we have less of a say in how we practice. The joy of the speciality has become harder and harder to feel each day. The most compassionate, selfless, and driven people I know are primary care providers, but the rate of burnout is becoming shockingly high. An article in JAMA in 2026 reported burnout among PCP’s at 43% in the US of those surveyed. Primary care doctors are at a breaking point when they lose the ability to take great care of their patients and are unable to adequately care for their own needs because of a flawed system they are powerless to change.
At the same time, healthcare costs to patients are skyrocketing. Health insurance is becoming unaffordable for many people. Layoffs and job uncertainty result in volatile health coverage. Combine that with the escalating cost of living, and it is unsurprising how much pressure patients are under to make the tough decision to forego medical care.
It feels overwhelming and at times hopeless to think about the mismatch of physician supply and the need in the community. So what can be done to fix this mass exodus from primary care when patients need primary care doctors the most?
Direct Primary Care! Patients and doctors working together directly allows the restoration of the mission, and this model curbs cost escalations from the start giving patients back the ability to make informed financial medical decisions. And while it seems a little backwards, I do believe doctors need meaningful patient relationships to heal from burnout. We need to see the good we are doing, and have professional space to invest in our patients while still having space for ourselves and our families. It is time to put the right people at the center of the Family Doctor-patient relationship; the doctor, the family, and the patient!
Check out some great reading and work from some DPC pioneers who have been inspiring to me, and paving the way for more doctors to make a change.
Sparks Start Fires by Dr. Julie Gunther
https://www.trivasfamilymedicine.com/
https://jamanetwork.com/journals/jama/article-abstract/2842899
