REIMAGINING FAMILY CARE
Originally published in Forbes. Read full article
Remember the primary care physician of yore? The doctor out of a Norman Rockwell illustration who knew you, your parents, your children, who was your trusted confidant, who you turned to for every sore throat and annual physical. Today, that relationship feels like a quaint relic, replaced by rushed visits, rotating clinicians, and an endless amount of paperwork. Today, this backbone of healthcare is facing a hard reboot. Burnout, bureaucratic bloat, and disruptive market forces are testing its resilience. But is this the end of the family doctor — or the birth of a reimagined model?
The perfect storm: A specialty under siege
The numbers paint a dire picture. The shortage of physicians is being driven by an aging population and by aging physicians themselves — over a third of PCPs are over 55 — while fewer than 30% of residents plan to enter traditional primary care, with most opting for better-paying specialty roles. A new AAMC study projects a shortfall of 37,800 to 124,000 physicians by 2034, with primary care physicians (PCPs) bearing the brunt. Compounding the crisis: only 85 PCPs exist per 100,000 Americans, a ratio woefully inadequate for an aging, chronically ill population. What’s more, if you are one of the 50 million Americans who reside in rural areas, only 9% of the nation’s physicians practice in these communities.
The culprit? There are a few. A system that puts paperwork over patients. PCPs spend two hours on paperwork for each hour of direct patient time. This includes time treadmilling on administrative tasks and EHR (Electronic Health Records) event logs and prior authorizations. Add stagnant reimbursements and median student debt exceeding $200,000, and the primary care exodus becomes both understandable and inevitable.
The reinvention game plan
Fortunately, necessity is the mother of invention. Across the country, new thinking is rewriting the rules:
Direct primary care (DPC): Over 2,400 practices now operate on a membership model, swapping fee-for-service for unhurried visits and 24/7 access. The result? A market surging toward $93 billion by 2034 — and doctors rediscovering the joy of medicine.
Hybrid care: Telehealth isn’t replacing the stethoscope — it’s plussing it up. Over half of primary care physicians (PCPs) now blend virtual and in-person care, although the challenge remains: balancing convenience with continuity and an often-poor reimbursement model.
Tech at the helm: AI-powered triage, remote monitoring, and integrated platforms are streamlining workflows and reshaping how primary care is delivered, carving out more time for both doctor and patient.
Physician-led team-based care: More and more, medicine is a team sport, your PCP should make efforts to coordinate with Nursing, Case Management, Care Navigators, Nutritionists, Home Care Organizations, Specialists seen in and outside the office, and more, to help you plan and follow the best course for your care.
Technology at the bedside
New tools promise to offload burdens and personalize care. Under recent Medicare rule changes, physicians can bill for remote patient monitoring and virtual check-ins, opening revenue streams and supporting proactive outreach.
Why retail clinics can’t fill the gap
Big players like CVS and Walmart promised disruption and primary care for everyone with much-touted retail clinics, but many have closed amid disappointing patient engagement. Consumers consider retail health as transactional — a quick fix for a sore throat, perhaps not as long of a wait as urgent care, but not for managing chronic disease or complex care plans. Without the deep, long-term relationships that PCPs cultivate, outcomes suffer, and trust erodes.
What can patients do about all this?
While the system evolves, patients also play a crucial role in preserving and improving primary care. The stakes are high: studies show that patients with a consistent primary care relationship have better health outcomes, lower costs, and fewer hospitalizations. “As a family physician, I’ve seen firsthand how having a trusted primary care doctor can truly change the course of someone’s life,” says Sarah C. Nosal, MD, FAAFP, President-Elect of the American Academy of Family Physicians (AAFP). “When patients have a usual source of care — someone who knows their health history, understands their goals, and can guide their health journey — they’re more likely to stay on top of preventive care, manage chronic conditions, and avoid unnecessary hospital visits. Family medicine is about connection, continuity, and ultimately, better health and longer lives.”
Here’s how you can advocate for your health and your doctor:
Get a PCP — and actually use them
25% of Americans don’t have a primary care doctor. That’s a costly mistake. Having a PCP lowers healthcare costs, ensures preventive care (like physicals and screenings), and leads to better-managed hospital visits.
When in doubt, ask your PCP first. Instead of defaulting to urgent care or Dr. Google, consult your primary care doctor — they know your history best.
Value continuity of care
Fragmented care (seeing different clinicians each visit) weakens trust and coordination. If your practice has multiple doctors, request consistency — seeing the same clinician when possible. You will have better health outcomes and more impactful visits, and it leaves your physician more satisfied, taking better care of you.
Encourage clinicians to communicate directly — not just rely on EHR notes — to close gaps in care.
Location matters
If you split time between multiple places (e.g., snowbirds), choose one “home base” for primary care to maintain a consistent medical record.
Consider setting up a patient portal to communicate with your Primary Care Team, so that even when on the go, you can share your record with other clinicians in an emergency.
Consider specialized primary care when needed
Adolescents, seniors, and those with complex conditions may benefit from age- or condition-focused primary care (e.g., geriatric or adolescent medicine).
Embrace preventative care proactively
Schedule annual wellness visits (not just sick visits) – These are fully covered by most insurers and help catch issues early.
Prepare for appointments – Write down symptoms/questions beforehand to maximize limited time. Bring updated medication lists.
Advocate for your doctor (and yourself)
Push back against rushed visits – Politely say: "I have X concerns today – can we address them or schedule follow-up?" This signals the need for adequate time.
Support PCPs fighting bureaucracy – If your doctor is stuck on prior authorizations or paperwork, ask: "Is there anything I can do to help expedite this?" Sometimes, patient calls to insurers work.
The future of family doctors hinges on both systemic reform and everyday choices. While clinicians and policymakers wrestle with large-scale solutions, patients wield surprising power — by demanding continuity, leveraging technology thoughtfully, and investing in relationships with their PCPs. These small acts compound into transformative change: preserving the human core of primary care while embracing innovation. The result? Better health outcomes today, and a blueprint for a system where the future of family doctors isn’t just secure, but sustainable.