What happens when your town loses its only doctor? That is a situation you never want to consider, but unfortunately for residents of the Finger Lakes, we may likely find out.

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A Beech Island man says his father was dropped by his primary care doctor the day before a scheduled appointment — leaving him scrambling to find a new provider while running low on insulin.

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Less than three-quarters of the nation’s young adults have a primary care provider, a trend that researchers from the Ohio State University Wexner Medical Center say could impair patient engagement and care coordination down the road.

According to a survey of just over 1,000 U.S. adults, only 71% of those aged 18-29 reported having a primary care provider. That’s compared to 97% of those over age 65 who said the same.

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The primary care relationship, long treated as a fixed feature of American medicine, is thinning on two fronts for the country’s youngest adults: They are less likely to have a physician, and even when they do, most are not walking through the door.

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• Primary care shortages are driving longer wait times. Experts say fewer doctors are choosing primary care careers, while many communities—especially underserved areas—face shortages of physicians, nurses, and specialists, creating bottlenecks for routine appointments

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Recently, we got feedback from the residents in our [primary care outpatient teaching] program. We heard how frustrated they are by their lack of administrative time, lack of supportive staff, the volume of patients they’re expected to see in such a short amount of time, and the general chaos that exists at the practice.

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Access to primary care remains elusive for many Rhode Islanders, particularly lower-income families and Hispanics, according to a report from the Office of the Health Insurance Commissioner.

The report, released Monday, June 1, underscores the importance of primary care in the state’s health care system.

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On Wednesday, May 20, the House Energy & Commerce Subcommittee on Health held a hearing entitled, “Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms.” It marked the fourth hearing in the Committee’s health care affordability series—and primary care took center stage at the hearing.  

Witnesses included: 

• William Fox, MD, MACP, Chair Emeritus, American College of Physicians Board of Regents, Fox & Brantley Internal Medicine  

• Steven Furr, MD, FAAFP, Family Medicine Physician and Former President of American Academy of Family Physicians 

• Dana Smetherman, MD, MPH, MBA, FACR, Chief Executive Officer, American College of Radiology  

• Rick Snyder, MD, President, HeartPlace  

• Farzad Mostashari, MD, Chief Executive Officer and Co-Founder, Aledade 

Representatives and witnesses emphasized the critical role primary care plays in improving the health of Americans. Yet despite its importance, primary care remains chronically underinvested in and continues to face a growing workforce shortage. Lawmakers repeatedly sought solutions to better incentivize and support medical students and practicing primary care clinicians in entering and remaining in the field. 

A recurring theme throughout the hearing was the idea of primary care serving as the “quarterback” of the American health care system. Speakers highlighted primary care as a critical entry point, providing chronic disease prevention, care coordination and lifestyle medicine through trusted, long-term patient-clinician relationships. Witnesses and members alike noted that stronger investment in primary care is associated with improved health outcomes and lower overall health care costs. 

Five major themes emerged from the hearing: 

Primary Care as the Backbone of a Healthy America 

Ranking Member Diana DeGette (D-CO-01) emerged as a champion for primary care during the hearing. In her opening statement, she described primary care as “the backbone of a healthy population.” Drawing from her personal experience as the mother of a primary care physician, Rep. DeGette emphasized the need to strengthen primary care through increased investment and improved reimbursement for primary care services. 

Other members, including Representatives Kelly (D-IL-02) and Carter (D-LA-02), also highlighted the integral role primary care plays in supporting seniors living with one or multiple chronic conditions. 

Greater Investment in Primary Care & Hybrid Payment Models  

Representatives from across the health care field emphasized that Medicare Physician Fee Schedule reimbursement rates have failed to keep up with inflation. When asked how best to support primary care clinicians in serving complex patient populations, Drs. Fox and Furr stressed the importance of both greater investment in primary care and expanded access to hybrid payment models. 

They argued that upfront per-member-per-month payments (PMPM), coupled with fee-for-service reimbursement, gives clinicians greater flexibility to manage patient needs, build care teams, invest in technology and deliver more comprehensive whole-person care.  

Representatives John Joyce (R-PA-13 ) and Gus Bilirakis (R-FL-12) also emphasized the need to strengthen the primary care workforce by incentivizing medical students to enter the specialty and by modernizing the Medicare reimbursement system to better support independent primary care practices.

Supporting Rural Communities  

Supporting America’s rural health communities stood out as a bipartisan priority throughout the hearing. Representative Carter (D-LA-02) emphasized the challenges facing rural populations during his opening remarks, stating: 

“Rural patients are sicker and older, have a higher risk of chronic disease, and are more likely to rely on Medicare and Medicaid. This is a patient population that needs more access, not less, yet they are more likely to face barriers to care because there simply are not enough doctors.” 

Witnesses took the opportunity to stress the importance of training the next generation of clinicians in rural settings, noting that physicians are more likely to practice in the communities where they train. Several witnesses encouraged Congress to increase reimbursement for Graduate Medical Education (GME) training opportunities and expand hybrid payment models that would allow clinicians to build care teams, reduce administrative burden and better support rural patient populations. 

Reducing Administrative Burden for Clinicians  

Reducing administrative burden surfaced as a key priority, with several members focusing their questioning on how streamlining reporting requirements could give clinicians more time for direct patient care and help sustain independent practices. Representative Guthrie (R-KY-02) specifically raised concerns about the burden associated with programs such as MIPS and the disproportionate impact reporting requirements have on rural and small independent practices. 

Both lawmakers and witnesses called for greater standardization and simplification of reporting requirements to reduce administrative burden and allow clinicians to spend more time caring for patients. 

Consolidation of Independent Practices 

Lawmakers sought to better understand both the root causes of vertical integration and its downstream effects on patients and clinicians. Committee members raised concerns about the number of independent practices being bought up by larger health systems and the unintended consequences consolidation can have on patient access and choice. 

Witnesses and lawmakers testified that financial instability, growing administrative burden, clinician burnout and persistent staffing shortages, has contributed to the decline of independent practices. Witnesses also pointed to existing federal incentives that make it easier for hospitals and health systems to acquire smaller practices. 

Dr. Furr explained that operating an independent practice is like running a small business, noting that without stable reimbursement, many practices struggle to remain financially viable while continuing to support the needs of their patient populations. 

Every other week, the Primary Care Collaborative (PCC) gathers major new stories, opinion pieces, research articles, case studies and more covering primary care.

 Want to submit a piece? Feel free to email the piece to PCC Communications Associate Maximilian Sandefer at msandefer@thepcc.org.

New Resource: Trusted Partnerships: How Primary Care Can Navigate Mistrust in Medicine
The PCC
On May 12, the PCC and the ABIM Foundation hosted a webinar exploring how strong, ongoing relationships between Americans and primary care can help overcome challenges created by growing mistrust in health care. Watch a recording of the webinar and read our summary.

Primary Care Access and Investment

The downward spiral of independent primary care: Why the math no longer works
Robert Resnik, Medical Economics
The piece explores the financial pressures driving independent primary care practices toward consolidation or closure. Rising operational costs, reimbursement challenges and administrative complexity are making it increasingly difficult for smaller practices to remain sustainable.

Will Primary Care Physicians Soon Be Prescribing Blind?
Carol M. Mangione and Michael Barry, MedPage Today
In the wake of HHS firing the two remaining chairs of the U.S. Preventive Services Task Force, this commentary discusses the importance of preserving the integrity and independence of the organization which plays a major role in shaping evidence-based preventive care recommendations. The authors argue that weakening trust in preventive screening guidance could undermine primary care’s ability to deliver consistent, patient-centered preventive services and improve long-term population health outcomes.

UCSF doctor has bold plan to achieve better healthcare access
Catherine Ho, Yahoo! News (originally: San Francisco Chronicle)
The article profiles a UCSF physician, Dr. Kevin Grumbach, proposing new approaches to improve health care accessibility and affordability. Many of the ideas center on strengthening primary care delivery and reducing barriers that prevent patients from receiving timely preventive services.

Medicare

MGMA urges Congress to overhaul Medicare physician payment, scrap MIPS tournament scoring
Austin Littrell, Physicians Practice
The Medical Group Management Association (MGMA) urges Congress to reform Medicare physician payment systems and eliminate aspects of the current MIPS scoring model. The PCC also argued in a statement for the record that the existing structure creates unnecessary administrative burden and financial instability for practices, including those in primary care.

Whole-Person Care

OPINION: Integrating mental health into primary care saves lives, money
Marcus Wallace, Tom Wroth, Christoph Diasio
This opinion piece advocates for integrating behavioral health services into primary care settings to improve patient outcomes and reduce costs. Coordinated care models can help patients receive critical early mental health support while also reducing treatment fragmentation.

Pediatric mental health diagnoses rise in primary care visits, claims study finds
Sydney Jennings, Patient Care
A new claims study found rising rates of pediatric mental health diagnoses occurring during primary care visits. The findings highlight the increasingly important role that primary care clinicians play in identifying, managing and coordinating behavioral health services for youth.

Why US life expectancy continues to trail peer nations
Julia Bonavitacola, AJMC
The article examines factors contributing to lower U.S. life expectancy compared to other developed countries, including chronic disease burden and a lack of care access. Strengthening primary care and preventive health services is presented as a key strategy for improving long-term population health outcomes.

Research and Data Hub

Primary care physician shortage strategies
Gigen Mammoser, Healthgrades for Professionals
The article outlines strategies that health systems and policymakers can use to address the growing shortage of primary care physicians across the United States. Recommendations include expanding workforce pipelines, improving retention efforts and leveraging team-based care models to improve access.

States with the highest, lowest PCP shortages in 2028
Mariah Taylor, Becker’s Clinical Leadership
This report compares projected primary care physician shortages across states through 2028. The data underscores regional disparities in access and highlights the urgent need for workforce planning and investment in underserved areas.

State Watch

Wyoming’s healthcare struggles explained to lawmakers
Noah Zahn, Wyoming Tribune Eagle Via Wyoming News Exchange
As Wyoming lawmakers held over two days of testimony, health care leaders outlined workforce shortages, access gaps and infrastructure challenges facing the state’s health care system. Rural communities continue to face significant barriers to accessing consistent primary care services, particularly in frontier regions.

Oregon committee to focus on bolstering primary care
David Raths, Healthcare Innovation
Oregon policymakers are forming a committee focused on strengthening the state’s primary care system through investment and reform initiatives. The effort reflects growing recognition that primary care is essential to improving health outcomes and lowering health care costs.

Mass. health centers push for legislation to strengthen primary care and funding
Avery Bleichfeld, The Bay State Banner
Massachusetts community health centers are advocating for various pieces of legislation, including ones aimed at increasing funding and strengthening primary care infrastructure. Supporters say greater investment is necessary to sustain services for underserved populations and address workforce shortages.

OPINION: NY kids need better access to primary care
Jeff Kaczorowski, Special to the USA TODAY Network
The article highlights barriers children in New York face when trying to access timely primary care services. Expanding pediatric primary care access through The Primary Care Investment Act (Senate Bill S1634A) could improve preventive care utilization and long-term health outcomes for New York families.

OPINION: NJ’s physician burnout crisis is pushing doctors to leave
Moishe B. Singer and Soumitra S. Bhuyan, NJ.com
In this op-ed, Moishe B. Singer and Soumitra S. Bhuyan argue that physician burnout is worsening workforce shortages across New Jersey. The authors attribute administrative burden, untenable staffing shortages and increasing patient demand as contributing factors to the mounting stress that is impacting frontline primary care clinicians.

Artificial Intelligence (AI)

The administrative burden on primary care is staggering. Technology can help—if we get it right
Sean Hogan, for the PCC
This column from PCC Board Chair Sean Hogan examines the growing administrative demands placed on primary care physicians and the impact those burdens have on patient care and clinician burnout. It argues that thoughtfully implemented technology solutions could streamline workflows, reduce documentation strain and allow clinicians to focus more fully on patients.

AAFP launches Primary Care Innovation Network and advisory committee to guide AI in frontlines of care
American Academy of Family Physicians (AAFP)
AAFP announced a new initiative focused on guiding the responsible use of artificial intelligence in frontline care settings. The effort aims to ensure AI tools support primary care clinicians without increasing burden or disrupting patient relationships.

3 fixes for primary care access in the ChatGPT era
Payam Zamani, KevinMD.com
This piece explores how technology and changing patient expectations are reshaping primary care access. The author proposes solutions including digital tools, workflow redesign and new care delivery models to help practices meet growing demand.

This compilation was created with support from an AI tool.

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AI conversations are quietly becoming the front door to American health care, and clinicians are seeing the printouts arrive every day. The most important question is not whether ChatGPT is right.

Instead, what we should be asking is: Why are so many patients turning to AI before reaching out to us? The rise of AI self-diagnosis is not a technology story. It is an access story, and clinicians need to read it that way.

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