Universal HealthcareBy NextBestFit
Problem · Workforce

Physician shortage, especially in primary care

AAMC projects a shortage of up to 86,000 physicians by 2036. Residency slots funded by Medicare have been largely capped since 1997, and primary care pays far less than procedures.

Evidence

  • Projected shortage of up to 86,000 physicians by 2036.
    Sources: AAMC (2024)
  • Family medicine physicians average about $255,820 vs. anesthesiologists about $360,570 (BLS mean wages).
    Sources: Bureau of Labor Statistics (2026)

Who's affected

Who is hurt
Who gains while it lasts

Under your mix of paths

Paths that create or worsen it
Paths that fix or soften it
Using your saved plan. 0 paths picked.Edit all picks
Root causes
  • Residency cap
  • Fee schedule that undervalues primary care
  • High cost of training

Related costs

Open questions

  • How many residency slots should be funded, and in which specialties?
  • Should primary care be paid more relative to procedures?

Caused or worsened by these paths

This problem only matters if one of these paths is chosen.

Every person registered with a primary care homeMedical errors and poor care coordinationChosen

Registering every resident with primary care requires enough primary care clinicians.

Supervised transition period before independenceQuality concerns when non-physicians practice independentlyChosen

Requiring supervision before independent practice creates a supervision bottleneck.

Solution paths (3)

Open a path for what it fixes, what it creates or worsens, who gains and who loses, precedents, and how it connects to other paths. See all paths as a decision tree.

Fund more residency slotsChosen

Fund more residency positions, prioritizing primary care, psychiatry, and rural sites.

  • +Physician shortage, especially in primary care
  • +Longer waits if demand grows faster than capacity
  • −Takes years, or money up front, before it pays off
  • −Raises spending or loosens control over it
Raise primary care pay relative to specialtiesChosen

Shift fee-schedule dollars from procedures to primary care.

  • +Physician shortage, especially in primary care
  • +Worse outcomes than peer countries despite the highest spending
  • −Reduces income or business for affected groups
  • −Takes years, or money up front, before it pays off
Easier licensing for foreign-trained physiciansChosen

Let experienced international physicians practice without repeating residency, under supervised pathways.

  • +Physician shortage, especially in primary care
  • −Medical errors and poor care coordination

Also addressed by paths for other problems

Shorter training: combined undergrad/medical programsMedical education debt shapes specialty choiceRejected

Shorter programs beginning after high school allow physicians to start practicing earlier.

Full practice authority for NPs, PAs, pharmacists, dental therapistsScope-of-practice limits waste capacityChosen

Letting other professions use their full training adds care capacity quickly.