The Primary Care Workforce Is Transitioning Away from a Physician-Dominated Model

Arch G. Mainous III, PhD

Fam Med. 2025;57(8):532-534.

DOI: 10.22454/FamMed.2025.348227

https://journals.stfm.org/familymedicine/2025/september/guest-editorial-mainous/

Key points of interest: According to the US Department of Health and Human Services, in 2022 there were 279,194 primary care physicians in the United States and 270,660 NPs delivering primary care. ¹² In 2023, 28,282 PAs worked in primary care. ¹² The proportion of visits delivered by NPs and PAs now accounts for one-quarter of all health care visits. ¹³ The transition away from a physician-based primary care workforce has already begun and every indication is that this transition will accelerate. 52% of primary care is provided by the NP and PA in the US. 48% is provided by physicians. The NP and PA numbers continue to rise. The physician numbers continue to decline. There are now more non-physician providers than physician providers providing primary care in the US.

Executive Summary: Rethinking the Primary Care Workforce

• The U.S. healthcare system is undergoing a fundamental shift away from a physician-centric model of primary care toward team-based care that increasingly relies on nonphysician providers and emerging technologies like artificial intelligence (AI).

• Market forces and cost pressures are driving healthcare systems to favor faster, less expensive workforce solutions:

  • NPs and PAs now deliver one-quarter of all healthcare visits.

  • Their numbers are rapidly approaching parity with primary care physicians with the shift to more NPs and PAs delivering care than physicians. (52% vs. 48%)

  • Employers increasingly prefer advanced practice providers due to lower training costs and quicker deployment.

• The assumption that primary care will remain physician-led is outdated.

• The National Academy of Medicine now emphasizes building primary care teams, not just increasing physician numbers.

Role of Artificial Intelligence

• AI is emerging as a disruptive force in clinical care, potentially replacing or augmenting tasks traditionally performed by physicians.

• The Society of General Internal Medicine warns against rapid displacement of human clinicians but acknowledges AI’s growing role.

• The future may involve advanced practice providers working alongside AI to deliver efficient, scalable care.

Conclusion

• The healthcare workforce must adapt to societal and technological changes.

• Rather than asking how to train more physicians, the better question is

  
  

  “Where does the family physician fit in the new world order, and how do they remain relevant?”