Shortage of Primary Care Workers in California

Over the past 16 months, Healthforce Center at UCSF has gathered information to help policymakers, consumers and leaders of health care delivery organizations and education institutions better understand California's primary care workforce needs. As the project has progressed a singular question has risen to the forefront: "Is California prepared to meet a growing demand for primary care?" To answer this questions and others, a series of reports, developed with funding from the Kaiser Foundation Health Plan, Inc., has been released.

The presented forecasts consist of supply and demand for allopathic physicians (MDs), NPs, and PAs in California through 2030. Forecasts were not generated for osteopathic physicians (DOs) due to the limited amount of data available about them. For purposes of this report, primary care encompasses family medicine, general internal medicine, general pediatrics, and obstetrics/gynecology. Forecasts presented in this report were developed for the state as a whole and for five regions: Greater Bay Area; Sacramento, Sierra, and Northern counties; Central Valley and Central Coast; Los Angeles, Orange, and Inland Empire; and Southern Border.

The first report presented the most current information on the supply of medical doctors (MDs), doctors of osteopathic medicine (DOs), nurse practitioners (NPs) and physician assistants (PAs) who provide primary care in California. It asserts that previously identified deficits in California's primary care workforce persist and will be exacerbated in the coming decade because large percentages of MDs and NPs are reaching retirement age. The second report published projections of a statewide primary care clinician shortfall in the next 15 years, with the most severe shortages in the Central Valley, Central Coast and Southern Border areas. It also laid out implications and next steps for closely monitoring the supply of primary care clinicians and developing strategies to fill potential gaps.

“California faces a looming shortage of primary care clinicians in the coming decades,” said Healthforce Research Faculty Member Janet Coffman. “If we continue along our current path, more and more Californians will need to visit the emergency room for conditions like asthma, ear infections or flu because they lack a primary care provider.”

The third report focuses on providing concrete and specific examples of strategies for addressing the imminent primary care shortage and which questions policymakers should be asking when weighing these strategies. Even though there are some legislative options already being proposed, our researchers believe that none are holistic or extensive enough to deal with the projected shortage. We hope that these reports enable stakeholders to asses the adequacy of the current workforce, anticipate future gaps and identify effective policies for addressing these needs.