As the industry increasingly feels the impact of the physician shortage, the projections regarding primary care are perhaps most concerning. The latest data from the Association of American Medical Colleges predicts a shortage of between 20,200 and 40,400 primary care physicians by the year 2036. However, according to a 2023 report from the National Association of Community Health Centers, more than 100 million Americans are already without a primary care physician. While this figure isn’t wholly due to the shortage — misconceptions about the importance of a primary care provider (PCP) may also contribute — it’s fair to assume that unless significant changes are made, the number of Americans without a PCP will only grow.
What can be done to solve the primary care shortage? I suspect it starts with legislation at the national level to fund more primary care residencies and student loan assistance programs, but I think we must also find ways to make careers in primary care more attractive. As Regional Vice President of Recruiting for Jackson Physician Search, I work closely with organizations to help them recruit and retain primary care physicians, and our first step is crafting the job description to make it as appealing as possible. How we achieve this is unique to each organization. Sometimes, it means enhancing the compensation package, reducing patient loads, accommodating flexible schedules, or providing support from APPs, medical scribes, and management. The goal is always to make the primary care job ad stand out as an ideal opportunity.
Keep reading for strategies to recruit and retain primary care physicians in this competitive market.
The Challenge within Primary Care
Countless think pieces have been written about the reasons for the broader physician shortage — a population that’s both aging and expanding, Baby Boomer physicians retiring en masse, fewer students applying to medical school, and, specific to primary care, fewer medical graduates opting for primary care residencies. Speculation about what’s driving the latter abounds. One obvious reason is the physician compensation gap between primary care physicians and non-primary care specialties. It’s highly likely that medical school graduates, facing an average of $200 thousand in student loan debt, are making a financially driven decision to pursue higher-paying specialties.
In addition to the compensation discrepancy, primary care doesn’t always lend itself to a healthy work-life balance. A recent study found primary care physicians would need to work 26.7 hours per day to provide the recommended levels of care for a typical patient panel of 2,500. This includes 3+ hours of “documentation and inbox management,” which refers to updating charts and responding to emails and patient portal inquiries (work that is typically not compensated). Needless to say, this is a less attractive option for a generation that places great value on mental health and work-life balance.
Shifting Expectations
Adding to these obstacles is that those choosing primary care don’t want to work the same hours as the retiring physicians they are replacing. The younger generations of physicians often prioritize having time outside of work to spend with family and friends. They are less willing to work long hours, so I estimate that it takes one and a half millennial physicians to replace a retiring primary care physician.
As I explained to journalist Rosie Hopegood in a recent Oprah Daily article, this is due to some positive reasons. Increased awareness about the dangers of physician burnout has led many organizations to offer physicians reduced patient panels and hybrid schedules. This is designed to make physicians happier in their jobs, which is an excellent retention strategy. However, in the short term, it means organizations need to hire more physicians to manage the caseload of a single retiring physician, which brings us back to the question, “How can we make primary care jobs more attractive?”
Maximize Primary Care Recruitment Incentives
Perhaps the most obvious way to make primary care physician jobs more attractive would be to pay them higher salaries. However, healthcare administrators cannot justify paying physicians more than the revenue they generate. Under the current model, the procedure-based treatment provided by specialists is reimbursed at significantly higher rates than the typical primary care visit generates.
While the current reimbursement model may not allow for a significant increase in primary care physician salaries, a generous one-time recruitment bonus can make a big difference for primary care recruits. This is especially true for those coming out of training, who often face massive student loan debt and may have young families to support. A six-figure signing bonus that can be used to offset debt or help with a home purchase can make a big difference in how attractive they view an opportunity.
Offer Modified Schedules
Many organizations are reevaluating physician workloads due to physician burnout. In fact, a four-day workweek has almost become the norm in primary care. Generous paid time off — typically five or more weeks — is also standard. In my experience, this is essential to attracting physicians. However, as noted earlier, it often means more primary care physicians are needed to see the same number of patients once treated by a single physician.
Leverage Primary Care Teams
To reduce individual physician workloads, we’ll need to rely on advanced practice providers to fill in the gaps. This strategy is already used in many organizations, especially in rural areas. According to data from the National Rural Health Association, nearly half of all rural primary care practices employ at least one NP, and one in four rural healthcare providers are nurse practitioners.
A team of providers practicing at the top of their licenses will certainly provide more comprehensive care to a large panel of patients than a single primary care physician. This may be the only way to ensure patients have adequate access to high-quality care without overloading individual providers.
There is no easy fix for the primary care physician shortage, but at the organizational level, there are things leaders can do to make jobs in primary care more worthwhile. Increased compensation, reduced workloads, hybrid schedules, and more support are all important considerations as you craft the primary care physician job description. It’s also important to remember that individual physicians have unique needs, so remain flexible in what you are willing to offer in terms of recruitment incentives, flexibility, hybrid schedules, paid time off, etc. Get to know the candidate and craft an offer that appeals to his or her specific values. Only by making the primary care jobs more appealing will organizations be able to attract and retain the talent they need to provide comprehensive care for the communities they serve.
Is your organization seeking primary care providers? The recruitment team at Jackson Physician Search has the access and expertise to help you hire primary care physicians who will fit, succeed, and stay. Reach out today to learn more.
As the daughter of a physician and an Iowa native, Helen has witnessed firsthand the impact a great physician can have on a community. She joined Jackson Physician Search at the company’s headquarters in Alpharetta, GA, as an entry-level Research Consultant in 2012. Through her consistent success as an individual contributor and manager, Falkner progressed quickly to Partner in 2018 and assumed her role as Regional Vice President of Recruiting for Jackson Physician Search’s Western Division in October 2020. In January 2021, she relocated to the firm’s Denver office, leading a team of successful physician recruiters while actively continuing to recruit for her clients.
