The Era of Primary Care by Physicians is Coming to an End 7-14-25

Summary

Becker Private Equity & Business Podcast Summary
Episode: The Era of Primary Care by Physicians is Coming to an End
Host: Scott Becker
Release Date: July 14, 2025

---

Introduction and Anecdote

In the opening segment of this episode, Scott Becker sets a contemplative tone by sharing a personal experience that underscores the central theme of the discussion. He recounts attempting to reschedule a primary care appointment with his long-time physician, only to be informed that the next available slot for a routine annual physical was not until April 2026. This anecdote serves as a poignant illustration of the growing strain on the primary care system.

Scott Becker [00:00]: "I have a primary care appointment set for this week, July 17th... When I go to reschedule the appointment and they essentially tell me that the next available appointment is April of 2026."

Current State of Primary Care

Becker delves into the systemic issues plaguing primary care in America. He emphasizes that the current state is unsustainable, highlighting the overwhelming demand placed on a limited number of physicians. This segment lays the groundwork for understanding why the traditional model of physician-led primary care is becoming untenable.

Scott Becker [02:30]: "Our primary care system is so overwhelmed and I'm afraid there's no way of turning back."

Statistics and Numbers

To provide a quantitative perspective, Becker presents key statistics that illustrate the mismatch between the supply of primary care professionals and the needs of the population. He cites annual production numbers for doctors, nurses, nurse practitioners (NPs), and physician assistants (PAs), juxtaposed against the United States' population.

• Annual Production:
  • Physicians: ~25,000
  • Nurses/NPs/PAs: ~190,000 - 200,000
• Population: 340 million

Scott Becker [03:15]: "We produce in our country about 25,000 doctors a year... if we produce something like 8,000 primary care doctors a year, that is a drop in the bucket compared to our population and our needs."

The Shift to Nurse Practitioners and PAs

Becker anticipates a significant transformation in primary care delivery, forecasting a shift from physician-centric care to one predominantly managed by NPs and PAs. He likens this evolution to the dental field, where dental hygienists handle routine cleanings while dentists focus on more complex procedures.

Scott Becker [04:00]: "I'm moving to the same place with primary care, where you're going to see nurse practitioners and PAs for the vast, vast majority of your care."

He acknowledges that while this change may maintain care accessibility, it diverges from the intended structure of the healthcare system and raises concerns about the quality and comprehensiveness of care.

Possible Solutions and Systemic Issues

Addressing the root causes, Becker points to self-inflicted systemic problems that exacerbate the primary care shortage. He advocates for expediting and accelerating medical education for physicians, drawing parallels to the more streamlined training pathways for NPs and PAs.

Scott Becker [04:45]: "We could go back to expediting and accelerating medical school... shorter medical school right after high school residencies being shorted and so much more."

Becker suggests that reforms in medical education could alleviate some of the pressures by increasing the number of practicing physicians more rapidly.

The Role of AI and Technology in Medical Education

Innovative technologies, particularly Artificial Intelligence (AI) and the Internet, are highlighted as potential game-changers in medical education. Becker contends that modernizing educational approaches with these tools could enhance learning efficiency and better prepare physicians for contemporary healthcare challenges.

Scott Becker [05:10]: "Particularly in the age of AI and the age of the Internet where so much of our medical education was developed prior to the era of the Internet and prior to AI."

Conclusion: The End of Primary Care by Physicians

In wrapping up, Becker reiterates his thesis that the era of physician-led primary care is nearing its end. While he refrains from labeling this transition as inherently positive or negative, he underscores the inevitability of this shift given current trends and resource constraints. Becker expresses concern over the long-term implications for healthcare quality and accessibility.

Scott Becker [05:40]: "The era of primary care by physicians is over. I think that's probably largely the case."

He invites listeners to share their thoughts and engage in the conversation, emphasizing the importance of collective reflection on this pivotal change in the healthcare landscape.

---

Key Takeaways:

• Primary Care Shortage: The number of new primary care physicians each year is insufficient to meet the growing demand.
• Shift in Care Delivery: A move towards primary care managed by NPs and PAs is anticipated, mirroring the dental industry's structure.
• Educational Reforms Needed: Accelerating and reforming medical education could help address the shortage of physicians.
• Technology as a Solution: AI and the Internet hold promise for modernizing medical training and practice.
• Future Implications: The transition away from physician-led primary care raises important questions about the future quality and structure of healthcare services.

Listeners are encouraged to reflect on these insights and contribute their perspectives to the ongoing dialogue about the future of primary care in America.

Transcript

[A]

This is Scott Becker with the Becker Business Podcast and the Becker Private Equity Podcast. Today's discussion is the era of primary care by physicians is over in America. So here's the discussion and again, I don't mean to be too, too dramatic in the title of this podcast, but I'll give you an anecdote and then we'll talk about some of the stats behind this and we'll see what people think and would love to hear your feedback. You can always Give feedback at 773-766-5322. This is Scott Becker, publisher, founder, Becker's Healthcare, Becker Business, et cetera, et cetera. You can always text that number and give me your feedback and we'd love to hear it. So here's the issue. I have a primary care appointment set for this week, July 17th. Great primary care doctor. I've had them forever, just as good as they come. So I go to reschedule the appointment and they essentially tell me that the next available appointment this April of 2026, that's for a regular annual physical. And again, this is not a knock on the primary care doctor. And it's also obviously a recognition of success, that if I want physician as a great friend, I've known him forever, I know I could skip the line and get in. But really the point, the point is that our primary care system is so overwhelmed and I'm afraid there's no way of turning back. So here's the sort of discussion in this. We produce in our country about 25,000 doctors a year, about 190 to 200,000 nurses, nurse practitioners, PAs a year, something along those lines. We have 340 million people in our country. As far as I could tell, if we produce something like 8,000 primary care doctors a year, that is a drop in the bucket compared to our population and our needs and so forth. So for better or for worse, my perspective is that primary care is going to become highly triaged. It's like going to the dentist where you see the dental hygienist and then you see the dentist for a few moments and you hope the dentist is clued in enough and zoned in enough to tell if anything serious has to be done. I think we're moving to the same place with primary care, where you're going to see nurse practitioners and PAs for the vast, vast majority of your care. And again, this may work out okay, but it's not the system that we were intending to have or wanted to have. But it might be no way around it, given the population that we have in our country versus the number of doctors that we're producing. And again, a lot of these are self inflicted problems by the system. We could go back to expediting and accelerating medical school. We've done an incredible job of accelerating and expediting education for nurse practitioners and PAs. I was actually shocked at the stats recently that we're back to producing 175,000 to 200,000 nurses a year in the physician category. We're still stuck in a spot where physicians aren't ready to practice till 30, 31 or so. And so much of that could be improved as they do it in other countries through shorter medical school, medical school right after high school residencies being shorted and so much more. Particularly in the age of AI and the age of the Internet where so much of our medical education was developed prior to the era of the Internet and prior to AI. In any event, those are some of the things that we're seeing. And again, the headline here is that the era of primary care by physicians is over. I think that's probably largely the case. Let's see how this plays out. And what are your comments and thoughts? I'm not saying it's a good thing. I'm also not saying it's absolutely a bad thing. It's probably just where we're going. But it is sort of a shame that we won't have the number of doctors that we need to serve our population. In the long run, I think that probably is very problematic. Thank you for listening to the Becker Business Podcast and the Becker Private Equity Podcast. Love to hear your thoughts. Thank you very, very much.