Primary Care Access in the U.S.: Why It's Getting Harder to See a Doctor

Access to a primary care provider is one of the most important parts of staying healthy, but for many Americans, it is becoming harder to get an appointment. Whether it's a long wait for a new patient visit, a shortage of doctors in rural areas, or difficulty affording care, primary care accessibility is facing serious challenges.

A Growing Shortage of Primary Care Providers

One of the biggest problems is that there simply are not enough primary care doctors. According to a national study, over 7% of Iowa's population had no access to a primary care physician within a 30-minute drive. That number dropped to just 2.5% when nurse practitioners and physician assistants were included, highlighting how nonphysician providers are helping close the gap (Young et al., 2020)

Geographic differences are also a major issue. Urban areas generally have more providers, especially in counties with medical schools, where accessibility was found to be 70% higher. In contrast, many rural and low-income areas struggle with extremely limited access to both doctors and healthcare facilities (Naylor et al., 2019)

Increased Demand, Limited Supply

The demand for primary care continues to grow as the population ages and more people are diagnosed with chronic illnesses like diabetes, heart disease, and high blood pressure. In Georgia, for example, researchers found that by 2025, the number of people needing primary care visits could increase by 20%, but the number of providers is expected to grow by only around 10% (Gentili et al., 2016)

Even under Medicaid expansion, which aims to improve access for low-income individuals, the study predicted that there would still be significant unmet needs, particularly in terms of appointment availability and long wait times.

Barriers Beyond Geography

In some areas, access is limited not just by location, but also by logistics. A study in Brooklyn, New York found that office hours, walk-in availability, and weekend scheduling had a big impact on whether people could actually use primary care services. In many underserved neighborhoods, these options were either unavailable or very limited, making it harder for working families to get care without missing work or school (Sollenberger, 2014)

Physical access is also a problem for people with disabilities. A large review in California found that fewer than 10% of primary care clinics had accessible exam tables or scales, creating yet another layer of inequality in the system (Mudrick et al., 2012)

Expanding the Team-Based Approach

To improve access, many healthcare systems are now relying more on nurse practitioners, physician assistants, and team-based care. These professionals can handle routine checkups, screenings, and even manage chronic conditions, allowing doctors to focus on more complex cases.

In rural areas especially, nurse practitioners are often the primary source of care. One study showed that even though most nurse practitioners work in urban areas, their presence had the biggest positive impact on access in low-density, rural regions (Young et al., 2020)

The Bottom Line

Primary care is the foundation of a healthy population, but right now, that foundation is under stress. Long wait times, provider shortages, and uneven distribution across regions make it harder for many people to get the care they need. New models like team-based care and expanded roles for nurse practitioners are helping, but more investment and planning are needed to ensure that everyone can access timely, high-quality primary care.