To the Editor: The April 2026 Graham Center Policy One-Pager highlighted one of the most pressing issues in our health care system: the primary care physician shortage.1 Although this problem is widely recognized, its cause and potential fixes are more controversial.
The authors cite “stagnation in training opportunities” as an exacerbating factor over the next decade, but the 2026 National Resident Matching Program tells a different story. The number of family medicine residency positions has increased by 50% since 2018.2 Unfortunately, the number of filled positions has remained relatively flat over the past 5 years, despite consistent yearly increases in available positions.
The proposed solution of allocating a percentage threshold of new residency funding to primary care specialties is a good idea, but it is not specific enough to meaningfully change the primary care landscape. For example, internal medicine residency funding would be included, even though most of those graduates pursue practice outside primary care.3
Truly moving the needle would require incentivization for students to choose primary care. Financial incentives (eg, scholarships, stipends, loan repayment) would be most appealing, in exchange for a time-based commitment to practice primary care in areas with high need. This would improve state and community health and provide tangible benefits to pursuing a career in primary care. Tying incentives to a binding commitment to practice primary care for a duration commensurate with their financial award would help achieve the desired outcome of successfully directing students to primary care.
Primary care is the backbone of our health care system. We must ensure a steady pipeline of qualified, caring, and committed physicians who are willing and able to fill these important roles.
Editor’s Note: This letter was sent to the authors of “Graduate Medical Education Funding Does Not Flow to Primary Care Physician Production,” who declined to reply.
