The State of the U.S. Primary Care Workforce
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Primary care is a 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 2025 workforce report, the current supply of primary care providers is not on track to meet future demand. This article breaks down 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.
According to the Health Resources and Services Administration’s 2025 workforce report, the current supply of primary care providers is not on track to meet future demand. This article breaks down 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 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.
Primary Care Workforce
In 2023, there were 340,319 physicians 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.
Active Primary Care Physicians by Specialty
The table below shows the number of active doctors in each primary care field and what percentage of the total primary care workforce they represent according to the latest AMA data.
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View directlyWorkforce growth in these specialties has trailed behind other areas of medicine. Between 2016 and 2023, primary care physician numbers rose just 8.1%, while other specialties expanded by more than twice that rate (16.8%). 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.
Outside of physician roles, nurse practitioners and physician assistants are playing an increasingly central part in delivering primary care.
- In 2024, an estimated 374,970 NPs were practicing in primary care
- In 2024, the number of PAs in similar roles reached 29,433
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.
Primary Care Physician Demographics: Age, Gender, and Representation
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.
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.
Physician Demographics Across Primary Care Specialties
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View directlyIn contrast, the demographics of nurse practitioners and physician assistants show a younger, more female-dominated workforce.
- Among NPs in all settings, 88% are women, with a median age of 43.1. Roughly 78% identify as non-Hispanic White.
- The PA workforce is also majority female (66%), with 71% identifying as non-Hispanic White and nearly 59% under the age of 40.
These shifts point to a younger, more diverse group entering the workforce, especially in roles outside of traditional physician pathways.
Where Access Falls Short: The Geography Problem
In 2023, 7.2% of U.S. counties had no primary care physician at all. This is a widespread issue, especially in nonmetropolitan areas.
Forecasted 2038 Shortage of Primary Care Physicians by Specialty
The table below outlines the projected 2038 primary care physician shortage, showing both total volume gaps and the percentage of demand met
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.
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View directlyEven 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.
Primary Care Physicians per 100,000 population by U.S State
The table below depicts the number of primary care doctors per 100,000 residents in each state, based on the most recent AMA and U.S. Census Bureau data
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.
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View directlyThese 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.
Health Professional Shortage Areas (HPSAs): Where the Gaps Are Greatest
Even beyond state-level disparities, a more urgent picture emerges in areas officially designated as Health Professional Shortage Areas (HPSAs). As of December 2025, 8,466 regions across the country meet the federal criteria for a primary care shortage. Together, these areas are home to roughly 92 million people — approximately 27% of the U.S. population.
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 15,628 additional primary care physicians.
Are PAs and NPs the Future of Primary Care?
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 2038, projections show that nurse practitioners in primary care will exceed demand by over 72,910 full-time equivalents. Physician assistants are also expected to see a surplus, with a projected excess of about 6,660. 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 areas, a critical factor in expanding access where it’s needed most.
Looking Ahead: Forecasting the Future of the Primary Care Workforce
By 2038, the United States is expected to face a shortage of 70,610 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.
- Family Medicine: Supply projected to meet only 76% of demand
- Pediatrics: Supply expected to meet only 86% of demand
- Internal Medicine: Supply expected to meet only 83% of demand
- Geriatrics: Supply expected to meet only 84% of 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.
