Primary Care: Why is there a shortage, and more importantly, what is MarinHealth doing about it?

Primary care physicians are essential to any healthcare system, including MarinHealth. They provide crucial services such as preventive care and diagnoses and manage acute and chronic diseases. They serve an indispensable role that includes essential factors beyond a patient’s physical health, such as mental, emotional, and social needs — serving as the entry point into MarinHealth and as the continuing focal point for all needed healthcare services.

Primary care demand is up. Number of primary care physicians is down.

Primary care needs are greater than ever, plus America’s population is shifting. By 2035, there will be more seniors aged 65 or older than children aged 17 or younger –-the first time the demographic imbalance has occurred in the nation’s history. This is significant because older people see a physician at three or four times the rate of younger people and account for a highly disproportionate number of surgeries, diagnostic tests, and other medical procedures. According to the U.S. Centers for Disease Control and Prevention, 6 in 10 adults have one or more chronic conditions such as diabetes, cancer, heart disease, lung disease, or Alzheimer’s, all of which must be treated and managed by physicians. The surge in older, sicker patients who are demanding more complex medical care is occurring simultaneously with the aging of the healthcare worker population itself. The urgency for physicians to retire has grown, as burnout rates spiked during the pandemic. According to one study conducted by Merritt Hawkins, 38% of physicians said they would like to retire in the next year. Plus, medical students are choosing specialist positions or hospitalist positions instead of outpatient primary care roles due to better schedules and higher pay.

All of this combined has resulted in an unprecedented number of people without a usual source of care, be it an individual doctor or a specific clinic or practice. According to one study from the Kaiser Family Foundation, there are 83.7 million people in the U.S. who live in a designated primary-care health professional shortage area (HPSA). In 2021, an estimated 117,000 physicians in the U.S. left the workforce. This equates to an estimated national shortage of between 17,800 and 48,000 predicted by 2034. California alone has a shortage of 4,700 physicians today, and is expected to have an additional 4,100 deficit by 2030. So, while there is a shortage nationwide, the shortfall can’t be tied to one specific cause, because there are several contributing factors.

How is MarinHealth addressing the primary care shortage?

The looming physician shortage is multifactorial, there’s no simple answer to fixing it. Instead, a robust and innovative multipronged approach is required.

Despite the funding challenges imposed by the federal government (the government controls the pay structure for employers of physicians), MarinHealth has been working to provide more primary care incentives such as student loan forgiveness and relocation expenses. In addition, MarinHealth has bolstered support for its physicians to include mentoring programs, a wellness program, and a host of services that allow physicians to find better work-life balance. In addition, we’ve extended care teams to include advanced practice providers, including nurse practitioners, advanced registered nurse practitioners, and physician assistants. These providers can see patients face-to-face to help with timely patient access for appointments and conduct routine work – like paperwork, triaging, and prescribing medications — freeing up physicians to focus on more complex patient needs.

The good news is that these efforts are paying off. Over the past 12 months alone, MarinHealth is brought in several primary care providers in 2023 and has four Advanced Practice Providers already scheduled to start in early 2024. That said, there is still a lot of hard work in the short and long term. Despite these best efforts, MarinHealth has also put resources in place to help patients find new solutions for patients, including:

Care with a Physician Assistant or Nurse Practitioner

If you are seeking a primary care physician and the wait time is too long, consider seeing a Physician Assistant or Nurse Practitioner. They can extend a care plan with oversight of a supervising physician, and they can diagnose and treat acute conditions, order diagnostic tests like x-rays or lab work, write prescriptions, and provide education, follow-up, and timelier access to care. MarinHealth has hired several new Nurse Practitioners and Physician Assistants, and MarinHealth has several more starting in early 2024.

A primary care appointment waitlist

MarinHealth has a dedicated team of Patient Scheduling Coordinators who are helping patients secure an appointment, while managing a primary care waitlist. Should an appointment become available, they are calling individuals on the wait list first-come, first-serve to help secure an appointment earlier than the originally scheduled time. To speak with a Patient Scheduling Coordinator or to get on the waitlist, call 1-888-627-4642.

More convenient access to Urgent Care

MarinHealth’s Urgent Care clinic treats most illnesses and injuries unless you are suffering a life-threatening condition. If you need to be referred to a specialist, a medication refill, or need treatment for allergies, cold, flu, sore throat, upset stomach, urinary tract infections, fever (less than 105 degrees), cuts, rashes or burns, or insect bites, consider Urgent Care. We take walk-in patients, or you can schedule a same-day or next-day appointment by filling out our online appointment form or by calling our Urgent Care clinic at 1-415-925-8865. Appointments are available in-person or via telehealth. We encourage you to view a list of insurance plans accepted by our Urgent Care office, in advance. The location of our Urgent Care clinic is:

MarinHealth Urgent Care | A UCSF Health Clinic
4000 Civic Center Drive
Suite 206
San Rafael, CA 94903
Phone: 1-415-925-8865
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If you are experiencing a life-threatening condition, call 911 or go to our Emergency Department.