Written by Babatunde Carew
Spoon Feed
The burden of nonclinical administrative tasks is a major contributor to primary care physician burnout and workforce decline. We need systemic reforms to restore primary care’s viability and central role in healthcare.
Are primary care physicians a dying breed?
Primary care in the United States is under threat, with the Association of American Medical Colleges estimating a national shortage of between 20,200 and 40,400 primary care physicians by 2036. This NEJM Perspective highlights the nonclinical demands that are at least partly to blame for the field’s decline. Excessive documentation, frequent requests from nonmedical entities, and disproportionate administrative burdens placed on primary care physicians have caused burnout, salary dissatisfaction, and waning interest among medical students. The authors call for systemic reform – reducing unnecessary paperwork, improving collaboration between specialties, and reorienting EHRs toward patient care rather than billing – as critical steps to prevent the collapse of primary care and restore its foundational role in delivering equitable, high-quality healthcare.
How does this change my practice?
This article really made me stop and reflect on the state of primary care in the U.S. I’ve seen colleagues turn to concierge medicine to escape unsustainable workloads. Others retire early, feeling they’ve reached their wits end. The number of students entering primary care has certainly declined; I personally meet maybe one student per year interested in the field.
Though I love what I do, I understand exactly why primary care is in free fall. It is getting harder and harder to make a convincing case to stay in or join a primary care practice when other fields offer better pay, work-life balance, and job satisfaction. If we want enough PCPs to care for our nation, something has to change – and fast.
Source
Death by a Thousand Cuts – The Crushing Weight of Nonclinical Demands in Primary Care. N Engl J Med. 2025 May 8;392(18):1771-1773. doi: 10.1056/NEJMp2415431. Epub 2025 May 3. PMID: 40323310
