By Harry S. Jacob, MD

President, Primary PartnerCare Physicians, PLLC

Date:  January 30, 2024

As a practicing internist in Long Island, New York, I never imagined I would see a shortage of primary care physicians. With the plethora of internal medicine and family medicine training programs, doctors were never in short supply in our marketplace.

Over the last couple years, it is common for a new patient to the practice to tell us they came to our practice because their doctor retired, moved out of New York or after being acquired by a larger entity, it is difficult to get appointments.

A recent article published in Medical Economics, August 15, 2023, by Peter Bonis, MD explores the growing shortage of primary care physicians, especially in certain geographies, and shockingly states that over 30% of patients who received medical services between 2016 and 2022 did not visit a primary care provider, suggesting that primary care is regularly bypassed.

According to the U.S. Department of Health & Human Services, as of September 2022 97.6 million people lived in what is defined as a Health Professional Shortage Area (HPSA). And the situation is worsening; the Association of American Medical Colleges forecasts a primary care physician shortage of between 17,800 and 48,000 by 2034.

Whether or not you live in a HPSA, you’ve likely witnessed how health care is changing. The one doctor-one patient, single point of coordination is vanishing. New care delivery models are evolving based on teams of health care professionals, within retailers (such as CVS, Walgreens, Walmart, and others), and using various digital options. The doctor-patient relationship is giving way to relationships with advanced practice providers (such as nurse practitioners and physician assistants), institutions, apps, self-monitoring technologies, and telemedicine services.

Who is coordinating all this to ensure safe, consistent, high-quality care? We already know that primary care doctors have too few hours in the day to deliver all the guideline-recommended care, much less adopt approaches to advance precision and preventive care that consumers want.

Will this evolving system give a boost to patient-friendly, affordable, accessible, high-quality care, harm it or both? And how should patients navigate the changes?

Finally, what is being lost when the covenant of a long-term, human-to-human care delivery model yields to a more modularized and distributed one? We do not yet have answers to these questions, but the industry is already responding.