Opinion/guest column: Rx for state's primary care shortage

The United States is facing a primary care crisis that hits hardest where people can least afford it: rural communities, underserved urban neighborhoods, and the states that depend most on Medicaid.

A new guest column from a coalition of physicians and health policy experts argues that the solution isn't just more doctors — it's a fundamental restructuring of how primary care is delivered, reimbursed, and valued in the American healthcare system.

The numbers are stark. According to the Association of American Medical Colleges, the U.S. could face a shortage of up to 86,000 physicians by 2036, with primary care bearing the brunt. In states like Mississippi, New Mexico, and West Virginia, entire counties have no practicing primary care physician at all.

The column proposes several interventions: expanding loan forgiveness programs for doctors who practice in underserved areas, allowing nurse practitioners and physician assistants to practice to the full extent of their training, investing in telehealth infrastructure, and restructuring Medicaid reimbursement rates that currently make it financially unsustainable for many providers to accept public insurance patients.

The authors also point to international models — particularly in Australia and the Netherlands — where primary care is treated as the foundation of the health system rather than an afterthought, resulting in better outcomes at lower cost.

What This Means For You: If you've ever waited weeks for a doctor's appointment or driven an hour for basic care, you're already experiencing the primary care shortage firsthand. The policy decisions being made right now — about Medicaid rates, telehealth rules, and scope of practice laws — will determine whether things get better or worse in your community. This isn't abstract policy; it's the difference between having a doctor and not having one.