The Primary Care Physician Shortage by State: Trends, Challenges, & Solutions

We’ve been hearing it for years — he largest generational population is the baby boomers.

As the boomer generation ages, America’s largest population of healthcare workers is retiring while the need for quality primary care is growing. 

This shift of retiring physicians as society grows older and sicker has created a shortage of primary care physicians faster than the healthcare industry could prepare for.

In this article, we examine the primary care physician shortage by state and look deeper at the trends and challenges primary care physicians face today. Most importantly, we explore how locum tenens staffing can provide the comprehensive solution we need. 

Table of Contents

• Does the US Have a Shortage of Primary Care Physicians?
• What States Have the Highest Physician Shortage?
• Primary Care Physician Shortages by State
• Why Is There a Primary Care Physician Shortage in the US?
• How Locum Tenens Staffing Can Assist States Dealing With the Primary Care Physician Shortage
• Let Trusted Locum Staffing Help Your Facility Combat the Nationwide Primary Care Physician Shortage

Does the US Have a Shortage of Primary Care Physicians?

Yes. Even before the pandemic, Americans were already feeling the effects of the shortage. According to a 2023 National Association of Community Health Centers (NAHC) report, more than 100 million Americans don’t have a primary care physician. That’s roughly one-third of the people living in the United States.

In 2023, the president of the American Medical Association (AMA) said an alarming estimate of more than 83 million people in the U.S. currently live in areas without sufficient access to a primary care physician.

The AAMC released a new report in 2021 with updates in 2024, of projections to 2036 using the same simulation models based on several supply and demand scenarios to develop projections of the physician workforce. From the simulations, the report found that demand for physician services would continue to exceed the number of physicians available.

Statistics About the Primary Care Physician Shortage in the United States

• By 2030, 34 out of 50 states will have extreme physician shortages, most severely in states like Mississippi, New Mexico, Louisiana, and other states in the South and West.
• The United States is predicted to be short up to 139,000 primary care physicians by 2033.
• Primary care physicians are unevenly distributed across the country, with 68 physicians per 100,000 people in rural areas versus 84 physicians per 100,000 people in urban areas.
• More than two of five practicing physicians will reach retirement age (65 or older) within the next decade.
• In 2019, only 45% of internal medicine positions were filled by US medical school seniors. 

What Are HPSAs?

HSPAs, or Health Professional Shortage Areas, are designated by the Health Resources and Services Administration (HRSA) to provide a clearer view of workforce shortage. 

HPSAs can consist of geographic areas, populations, or facilities and require a population-to-provider ratio of at least 3,500 to 1. 

The National Health Service Corps (NHSC) and other federal programs use HPSAs to help distribute participants and resources to where they’re needed most.

What States Have the Highest Physician Shortage? 

The top five states with the highest physician shortage according to HPSAs are:

1. California
2. Texas 
3. Alaska 
4. Missouri 
5. Florida

Is your facility drowning in poor physician ratios due to the primary care physician shortage? Trusted Locum Staffing is here to help you fill the gaps. Our healthcare staffing services can help your facility streamline operations, boost efficiency, and enhance patient outcomes. Call us today, so you can get back to focusing on exceptional patient care. 

Primary Care Physician Shortages by State

To see how each state fares in the physician shortage conundrum, check out this list of rankings from a fourth-quarter 2024 update based on the number of HPSAs per state:

1. California: 633
2. Texas: 373
3. Alaska: 341
4. Missouri: 338
5. Florida: 292
6. Illinois: 262
7. Michigan: 256
8. Kentucky: 234
9. Georgia: 229
10. Arizona: 217
11. Washington: 210
12. Minnesota: 207
13. North Carolina: 195
14. New York: 190
15. Oklahoma: 190
16. Ohio: 173
17. Louisiana: 172
18. Wisconsin: 165
19. Kansas: 162
20. Iowa: 157
21. Mississippi: 153
22. Indiana: 151
23. Oregon: 150
24. Arkansas: 145
25. Tennessee: 142
26. Virginia: 137
27. Pennsylvania: 131
28. Montana: 130
29. Nebraska: 127
30. West Virginia: 121
31. Colorado: 120
32. Alabama: 108
33. New Mexico: 105
34. Idaho: 102
35. South Dakota: 97
36. South Carolina: 93
37. North Dakota: 87
38. Maine: 76
39. Nevada: 74
40. Massachusetts: 61
41. Utah: 60
42. Maryland: 56
43. Connecticut: 46
44. Puerto Rico: 42
45. Wyoming: 41
46. New Jersey: 37
47. Hawaii: 33
48. New Hampshire: 23 
49. District of Columbia: 13
50. Rhode Island: 13
51. Vermont: 13
52. Delaware: 10

Why Is There a Primary Care Physician Shortage in the US?

The cause of the primary care physician shortage is a perfect storm of a combination of factors. 

Americans are facing the unique challenge that a large portion of the population, more than 20% in 2023, are ageing and needing care, while at the same time retiring and exiting the healthcare industry. Combined with the impact of the pandemic and continued strain on primary care physicians, along with funding challenges for new doctors and training programs, it becomes clearer why the shortage of primary care physicians exists in the United States.

Population Growth and Aging

The US population is graying faster than healthcare professionals can keep up with. According to the US Census, the US population aged 65 and over grew from 2010 to 2020 at the fastest rate since 1880 to 1890 and reached 55.8 million, a 38.6% increase in just 10 years. 

Between 2020 and 2023, the working-age population only grew by 0.2% nationally, and only a narrow majority of U.S. metro areas (about 52%) saw an increase. At the same time, the young population declined in many metro areas, leaving a gap in care.

The near-universal increase in the older population for metro areas across the country is credited to increased longevity and the large baby boomer generation born from 1946 to 1964.

Current PCPs Reaching Retirement Age

At least two of five practicing physicians will reach retirement age (65 or older) within the next decade. Another one in five physicians surveyed during the COVID-19 pandemic said they planned to leave practice within the next two years, while one in three said they’d cut back on their hours.

The American Medical Association (AMA) reports that nearly half of all practicing physicians in the U.S. today are over age 55. Though medical school applications are up, it can take a decade or more to educate and train physicians to fill the widening void. 

A report estimating the residency expansion necessary to eliminate the projected primary care physician shortages in 2035 calculated that primary care residency production must increase by 21%. The annual number of residents needed to address shortages varies by year, peaking at 2,710 in 2025, then declining to 1,700 by 2035.

Physician Burnout

The AMA defines physician burnout as a long-term stress reaction characterized by depersonalization. This can include:

• Cynical or negative attitudes towards patients
• Emotional exhaustion
• A feeling of decreased personal achievement, and 
• A lack of empathy for patients

We saw the emotional videos from hospital physicians and nurses who were distraught and overworked during the pandemic. According to an open letter written by the President of the AMA in 2023, approximately two in three doctors admitted to experiencing burnout during the pandemic, the highest ever recorded by the AMA.

Today, nearly 50% of our family physician colleagues reported at least one symptom of burnout, and 20% said they were depressed, as reported by the Medscape National Physician Burnout & Suicide Report, compared to last year’s rates of 53% and 23%, respectively. The results reflect a concerning jump from 26% since 2018. 

The report also revealed that 83% of doctors surveyed attributed professional stress as the primary contributor to their burnout and/or depression. Work-related bureaucratic tasks were cited as the primary reason for burnout. Spending too many hours at work and a lack of respect from administrators, employers, and co-workers were also contributing factors.

Funding Issues

Since 1997, the Balanced Budget Act has sought to restrict the number of positions for which teaching hospitals can receive direct Graduate Medical Education (GME) funding. While medical schools have increased the number of doctors they are training to meet the demand of caring for a growing elderly population, the number of US-trained medical school graduates greatly exceeds the number of available residency slots.

It’s during residency that graduates participate in the care of patients and study in supervised educational programs based in teaching hospitals, without which they cannot obtain licenses to practice medicine.

In addition, many young doctors face an insurmountable debt after medical school and training programs, often totalling more than $170,000. This debt load forces many aspiring physicians to bypass primary care in the less populated, rural areas in favor of specialties in or near large cities with the promise of higher pay.

It’s no wonder the AAMC projects a national physician shortfall over the next decade. The small, independent practices lucky enough to get a residency and go on to care for the patients in rural areas are rewarded with a shrinking Medicare reimbursement rate for physicians. This declining federal reimbursement for care, in turn, jeopardizes care for millions of America’s seniors.

How Locum Tenens Staffing Can Assist States Dealing With the Primary Care Physician Shortage

Access to a Wider Talent Pool 

Locum tenens staffing has access to a wide talent pool of locum primary care physicians from diverse geographical locations. With an extensive network of physicians across the country, a locum tenens staffing agency can easily fill positions in the acute rural locations most affected by the shortage.

Improved Cost-Effectiveness

Many facilities, especially those hit hardest by the primary care physician shortage, also face budget constraints. Hiring new full-time staff is chock-full of additional costs, from benefits to malpractice insurance. Hiring permanent staff to fill short-term gaps can quickly become even more costly. Locum tenens staffing offers a more cost-effective solution to fill in short-term gaps and keep the facility running smoothly while assessing the long-term staffing budget. 

Greater Continuity of Care

Attentive management is the bridge between locum tenens staffing and continuity of care. Even in the absence of full-time physicians, patients can receive reliable and consistent care. All it takes is strategic collaboration between the facility and staffing agency based on the needs of both the patients and the facility. 

Staffing Flexibility

Working with locums offers flexibility to hire for short-term or long-term assignments. A locum tenens agency works with the healthcare facility to create a staffing plan based on the facility’s needs. Whether it’s for one position or multiple roles to fill gaps left by the physician shortage, locums can provide a flexible solution. 

Faster Hiring Process

With an already established pool of vetted candidates ready to start immediately, locum staffing allows for a much faster hiring process compared to the traditional recruitment process of full-time physicians. Locum agencies can often get positions filled within days or even hours. The quick response time means healthcare facilities don’t have to wait weeks or months to fill a gap.  

Let Trusted Locum Staffing Help Your Facility Combat the Nationwide Primary Care Physician Shortage

With Trusted Locum Staffing, you gain a partner to help meet your staffing needs and ensure your facility doesn’t succumb to the primary care physician shortage. 

Trusted Locum Staffing works in three simple yet effective steps:

1. Assessing your staffing shortcomings – In an introductory call with our dedicated team, together we identify and assess your problem and discuss your staffing needs.
2. Getting organized – Our team creates a personalized comprehensive plan that includes access to our network of the brightest healthcare talent across the country, ensuring your facility receives the highest quality of care possible.
3. Supporting you every step of the way – Communication is our strong suit. We stay dialed in with your team to be sure we consistently provide staffing solutions for your workforce.

Let Trusted Talent streamline your healthcare recruiting process and make your concerns about a primary care physician shortage a thing of the past.