Increasing the number of practicing primary care physicians has been a serious consideration for the past fifty years. It seemed the training was going quite well until about 15 years ago when it was decided to flood primary care with a bunch of nurse practitioners and physician assistants shifting the emphasis away from overtrained physicians to a cadre of people with limited knowledge who could be trained quicker and work for much less money. Medical schools have been complicit in this trend by placing emphasis on training specialty physicians rather than generalist/primary care practitioners.
“In many parts of the US, only one primary care physician per 2000 people is available….an estimated reasonable size is 1200-1400 people per full-time physician.” (When I retired, I had 2500 people who were “my patients.”) Spending on graduate medical education (residency programs and residency positions) with the intent of increasing the number of family physicians has not kept pace with the need nationwide. Underserved areas feel the pinch more than any. The northeastern states, Ohio to Maine, receive high graduate medical education funding but produce a relatively low number of primary care doctors. Northwestern states receive low funding, but produce a relatively higher number of primary care physicians.
In 2022, only 24.4% of physicians entered primary care. To keep pace with the need, percentages need to increase to the 30% to 50% range, and that depends largely on the ability of the government to fund graduate medical education and change the attitude of medical students and faculty toward more primary care practitioners.
However, the number of family physicians will never catch up with the need as long as the Centers for Medicare and Medicaid Sevices pays physicians less then 10 cents on the dollar, an amount too low to sustain a business.
Reference: Fenster TL, Park J, Huffstetler AN, Topmiller M.Graduate Medical Education Funding Does Not Flow to Primary Care Physician Production Am Fam Phys 2026 April;113(4):321-322.
