Family Physician Shortage Could End With Targeted Policies that Value Primary Care

Thursday, March 13, 2014


LEAWOOD, Kan. —— The United States could end the shortage of family physicians by increasing family medicine residency training positions to 4,475 by 2025, according to the recently issued Family Physician Workforce Reform: Recommendations of the American Academy of Family Physicians. In order to reach that goal, the graduate medical education system would need to add 65 family medicine training positions each year over the next 10 years, the policy says.

“To support efforts to ensure health care access for all Americans, the primary care workforce needs to grow from 209,000 to approximately 261,000,” the policy says. “Since family physicians currently make up about 38 percent of the primary care workforce, a conservative estimate is that an additional 21,000 family physicians are necessary to meet their share of the increased need. The annual production of new family physicians would have to increase by an average of about 65 each year, increasing from 3,500 today to 4,475 by 2025.”

The policy has wide-ranging implications for medical school expansion, graduate medical education funders, patient access to care and physician payment systems, according to Reid Blackwelder, MD, president of the AAFP.

“There is no single solution to the primary care physician shortage,” Blackwelder said. “It must be comprehensive. It must start with medical school recruitment and continue through to an improved practice environment that gives patients access to timely, comprehensive and high quality care.”

Stan Kozakowski, MD, director of medical education at the AAFP, agreed. “We are the only developed nation in the world that doesn’t have a national health care workforce plan, and as a result, we remain challenged in meeting the health care needs of the population,” he said.

In addition to increasing the number of family medicine residency positions, the revised AAFP policy calls for:

  • encouraging medical schools to develop admissions policies that identify and recruit students most likely to pursue primary care careers;
  • setting aside a portion of expanded medical school openings for students who plan to choose family medicine or other primary care careers, particularly in rural or underserved areas;
  • measuring medical school output of primary care physicians by graduates’ specialty practice five years after graduation rather than by their first-year residency choice;
  • enlisting all public and private health care payers to pay the costs of medical education;
  • increasing funding for Title VII, Section 747 Health Professions Training Grants to medical schools that produce more primary care physicians and emphasizing collaborative rural training sites under the expanded Title VII funding;
  • increasing support for the National Health Service Corps for scholarships and loan repayment programs that eliminate medical school debt as a barrier to choosing primary care practice;
  • preparing family medicine residents for practicing in high-functioning teams within the patient-centered medical home; and
  • reforming payment for health care so the patient-centered medical home model of health care — with team-based care, open access scheduling, extended office hours and comprehensive, coordinated care that results from paying for quality of care not volume of services — is available to all patients.

The policy incorporates the recently released Four Pillars for Primary Care Physician Workforce Reform: A Blueprint for Future Activity(, published by the AAFP and the Council of Academic Family Medicine(

“If Americans are to have access to the care they need, we must have a system that recruits medical students into primary care, supports the schools that produce more primary care graduates, expands community-based residency programs in communities that need services, and establishes a patient-centered practice environment that rewards the quality of care, not the number of tests or procedures,” Blackwelder said. “The AAFP’s new workforce policy reflects the comprehensive approach that must be taken if patients across the country are to have access to the care they need.”

# # #

Founded in 1947, the AAFP represents 136,700 physicians and medical students nationwide. It is the largest medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.  To learn more about the specialty of family medicine, the AAFP's positions on issues and clinical care, and for downloadable multi-media highlighting family medicine, visit For information about health care, health conditions and wellness, please visit the AAFP’s award-winning consumer website,