Becker’s Healthcare Podcast: Addressing the Primary Care Shortage with AAFP’s Shawn Martin

Release Date: August 5, 2025

In this enlightening episode of the Becker’s Healthcare Podcast, host Scott Becker engages in a critical conversation with Shawn Martin, CEO of the American Academy of Family Physicians (AAFP). The discussion centers on the alarming shortage of primary care physicians in the United States, exploring its causes, implications, and potential solutions to ensure the sustainability of primary healthcare.

1. Introduction to the AAFP and Its Role in Primary Care

Scott Becker opens the episode by introducing Shawn Martin, emphasizing the crucial role of family physicians in the American healthcare system. Martin provides an overview of the AAFP, highlighting its representation of approximately 130,000 family physicians and learners across the United States.

Shawn Martin [00:37]: "We are a big organization, both in size and in scale. We have a family physician practicing in about 95% of U.S. counties, and on any given year, about 200 million unique individual visits are made to a family physician somewhere in the country."

2. The Current State of the Primary Care Shortage

The conversation delves into the stark reality of the primary care shortage, with Martin presenting sobering statistics.

Shawn Martin [02:49]: "Our primary care physicians to population is at historic lows. It's at very dangerous lows as compared to other countries around the world that have, you know, what we would consider to be comparable or highly functioning healthcare systems."

Martin cites that as of 2023, there are about 67 primary care physicians per 100,000 people in the U.S., a significant decrease from previous years and notably lower than countries like Canada, which boasts approximately 116 primary care physicians per 100,000 people.

3. The Team-Based Approach to Primary Care

Becker and Martin discuss the evolving landscape of primary care, emphasizing the importance of a team-based approach that includes nurse practitioners (NPs) and physician assistants (PAs) alongside family physicians.

Shawn Martin [05:27]: "Primary care is a team sport. There are unique roles that family physicians and general internists and pediatricians play that are unique to their skills and training. But NPs and PAs are an important part of that team."

However, even when including NPs and PAs, the total number of primary care clinicians remains insufficient, underscoring structural issues in the U.S. primary care infrastructure and financing.

4. Graduate Rates and Workforce Projections

The discussion shifts to the pipeline of new primary care physicians and the gap between supply and demand. Martin outlines the current and projected needs for primary care physicians.

Shawn Martin [09:57]: "We need somewhere between about 45 and 80,000 primary care physicians over the course of the next decade."

With approximately 450,000 full-time primary care physicians currently in the U.S. and around 5,000 new family physicians graduating annually, there is a significant shortfall projected to worsen without substantial intervention.

5. Alternative Models: Direct Primary Care vs. Concierge Medicine

A substantial portion of the conversation addresses emerging models in primary care practice, particularly Direct Primary Care (DPC) and concierge medicine.

Understanding Direct Primary Care (DPC):

Shawn Martin [16:00]: "Direct primary care is a direct financial engagement between an individual patient or family and a primary care physician through what I will refer to as a membership or subscription model."

In this model, patients pay a monthly or annual fee for comprehensive primary care services without involving insurance companies. This arrangement aims to reduce administrative burdens and foster a closer physician-patient relationship.

Distinguishing Concierge Medicine:

Shawn Martin [17:16]: "Concierge tends to be a financial arrangement that provides some access and asynchronous connectivity with the patient, but the financial arrangement is still largely insurance-based."

Unlike DPC, concierge medicine involves an access fee while still billing insurance for primary care services. This model often results in physicians managing smaller patient panels, thereby enhancing access and personalized care.

6. Innovations and Legislative Support

Martin highlights the growing optimism around DPC, driven by legislative changes and shifts in the healthcare financing landscape. He notes that provisions in recent legislation have made DPC more attractive to both patients and physicians by simplifying financial relationships and reducing administrative complexities.

Shawn Martin [15:14]: "Direct primary care is really creating that opportunity for physicians to spend more time with patients and less time on paperwork."

7. Addressing the Administrative Burden

The administrative burden in primary care is identified as a significant barrier to physician satisfaction and efficiency. Martin references a Health Affairs study indicating that primary care physicians spend a considerable portion of their time on administrative tasks rather than patient care.

Shawn Martin [15:14]: "Most primary care physicians will spend 30 to 40% of a patient visit actually engaged with the patient and they will spend 40 to 50% of that visit engaged with some administrative function."

DPC models, by minimizing insurance-related paperwork, offer a potential solution to this pervasive issue.

8. Call to Action and Resources

In closing, Martin encourages listeners to engage with the AAFP to support and enhance the primary care workforce. He provides resources for further information and emphasizes the importance of community and legislative support in addressing the primary care shortage.

Shawn Martin [18:25]: "AFP is a wonderful organization. I'm really proud of the incredible work our members are doing every day across the country and really looking forward to building a better workflow and a better opportunity for them to take care of people and communities."

Conclusion

This episode of the Becker’s Healthcare Podcast offers a comprehensive exploration of the primary care shortage in the United States, underscoring the urgent need for systemic changes in healthcare financing and practice models. Shawn Martin’s insights into the challenges and innovative solutions present a roadmap for sustaining and enhancing primary care delivery in the nation.

For more information about the American Academy of Family Physicians and to support primary care initiatives, listeners are encouraged to visit familydoctor.org or connect with Shawn Martin on social media platforms.