Primary care is an vital part of the healthcare system but fewer physicians are choosing primary care specialties, and many of those who do are approaching the end of their clinical careers. These shifts are already being felt especially in rural communities, where access to care is becoming harder to maintain.

According to the Health Resources and Services Administration’s 2024 workforce report, the current supply of primary care providers is not on track to meet future demand. This article breakdown who makes up the primary care workforce today, how access varies across regions, and the demographic trends that will shape care delivery in the years ahead.

For the purposes of this report, the primary care workforce includes physicians, nurse practitioners (NPs), and physician assistants (PAs) practicing in family medicine, internal medicine, general pediatrics, or geriatrics. Although hospitalists often train in these specialties, they are not included in the data here, as their work is focused on inpatient care and does not meet the standard definition of primary care.

In 2022, more than 279,000 physicians were actively practicing in core areas of primary care, including family medicine, internal medicine, pediatrics, and geriatrics. Despite the scale of that number, it represents less than one-third of the total physician workforce nationwide, a figure that has remained relatively flat in recent years.

Workforce growth in these specialties has trailed behind other areas of medicine. Between 2016 and 2021, primary care physician numbers rose just 3.6%, while other specialties expanded by more than twice that rate. One of the clearest warning signs is the small number of geriatricians in practice, especially as the population of older adults continues to grow rapidly.

Outside of physician roles, nurse practitioners and physician assistants are playing an increasingly central part in delivering primary care.

While their presence has helped expand access in many communities, especially in non-metropolitan areas, they’re also stepping into a landscape shaped by uneven growth, shifting demographics, and rising demand.

The primary care workforce reflects a mix of experience levels, generations, and backgrounds, but those characteristics differ significantly by specialty. While men still make up a larger share of providers in family medicine and internal medicine, the picture looks different in pediatrics and geriatrics, where women now account for the majority of physicians.

Beyond gender, age distribution also signals a challenge. A sizable share of physicians across all primary care specialties are over 55, and many are nearing retirement. Younger physicians make up a relatively small percentage, which poses risks for long-term continuity and future workforce stability. Geriatrics has both a small overall headcount and an older age profile, compounding the concern as the aging patient population expands.

In contrast, the demographics of nurse practitioners and physician assistants show a younger, more female-dominated workforce.

These shifts point to a younger, more diverse group entering the workforce, especially in roles outside of traditional physician pathways.

Looking at national averages, primary care coverage might appear stable, but those numbers quickly fall when a closer look is taken. In 2022, nearly 8% of U.S. counties had no primary care physician at all. This is a widespread issue especially in nonmetropolitan areas.

Even state-level differences underscore the imbalance. Massachusetts, Vermont, and Hawaii have among the highest ratios of primary care physicians per 100,000 residents. Meanwhile, states like Mississippi, Nevada, and Oklahoma fall well below national averages, leaving significant portions of their populations with limited access to consistent, frontline care.

These gaps matter, not just for health outcomes, but for the stability of entire health systems. When patients in lower-access regions go without regular primary care, downstream costs rise, and health issues that could have been managed early become far more complex. This geographic divide is one of the clearest indicators that the challenge is not just how many providers exist, but where they are practicing.
 

Even beyond state-level disparities, a more urgent picture emerges in areas officially designated as Health Professional Shortage Areas (HPSAs). As of 2024, more than 7,500 regions across the country meet the federal criteria for a primary care shortage. Together, these areas are home to roughly 75 million people — nearly one in every five Americans.

These shortage areas are found most in rural communities, where recruiting and retaining providers has been a longstanding challenge. Without consistent access to primary care, residents often rely on emergency departments or go without care altogether, which leads to higher costs and worse outcomes over time. To fully address these shortages, current estimates suggest the U.S. would need more than 13,000 additional primary care physicians.

As more primary care physicians approach retirement, nurse practitioners and physician assistants are playing a larger role in maintaining access. Primary care has a higher percentage of aging providers than many other fields, and fewer new physicians are entering the pipeline to replace them.

By 2037, projections show that nurse practitioners in primary care will exceed demand by over 66,000 full-time equivalents. Physician assistants are expected to maintain a closer balance, with a projected surplus of about 460. Many of these providers are also willing to work in areas that struggle to attract physicians. Nearly 44% of PAs have expressed interest in rural practice, and over half are open to working in federally designated shortage area, a critical factor in expanding access where it’s needed most. 

By 2037, the United States is expected to face a shortage of 87,150 full-time primary care physicians. All core specialties — family medicine, internal medicine, pediatrics, and geriatrics are projected to fall below what’s needed to meet patient demand.

The current state of the primary care workforce reflects both progress and persistent strain. While the number of practicing physicians remains steady, growth has not kept pace with demand, and large portions of the workforce are nearing retirement. Geographic disparities continue to limit access in many parts of the country, particularly in rural and underserved areas. At the same time, nurse practitioners and physician assistants are playing a larger role, helping to extend care where physician shortages are most acute.

Together, these trends reveal a system that is still in transition. Understanding who is delivering care, where gaps remain, and how roles are shifting provides valuable insight into how primary care is functioning today, and where it may be headed next.