By Susanna Vogel

More than three years after the onset of the COVID-19 pandemic, only 1% of primary care clinicians surveyed believe their practice has fully recovered from its impacts, and 61% characterize U.S. primary care as “crumbling.”

Nearly 80% of respondents felt the current workforce is undersized to meet patient needs, and just 19% of clinicians report their practices are fully staffed.

The results are emblematic of a “larger national crisis” and policymakers must act to reinforce primary care, said Rebecca Etz, co-director of the Larry A. Green Center, in a statement. “ ... It is not a matter of if, but when there will be another pandemic … If we don’t act soon, primary care won’t be there when it happens.”

Though the COVID public health emergency ended in May, researchers found that burnout is still lingering among primary care providers — 32% percent of clinicians reported feeling high levels of burnout, stress and moral injury.

Sustained staffing shortages are also contributing to providers’ stress, the report found.

In 2023, fewer clinicians reported their practices were fully staffed compared to the year prior, according to the survey. The national physician shortage worsened during the pandemic, as providers left the field due to burnout, or after financial troubles forced facilities to conduct layoffs. Unchecked, the staffing shortage will grow to a deficit of between 17,800 and 48,000 primary care physicians by 2034.

Remaining providers often have more to do. Staffing shortages have led clinicians’ administrative tasks to increase by up to 15%, according to The Council for Affordable Quality Healthcare. According to the Larry A. Green Center survey, patient volumes have also increased, both from backlogs of care and from new patients whose former providers’ practices may have shuttered during the pandemic.

While the vast majority of providers in the survey report pessimism about the industry’s future, other clinicians are seeking alternate forms of employment.

A report released earlier this month outlined an increase in private practice consolidation. The report found the percentage of physicians working in practices at least partially owned by a hospital or health system increased by almost 8% between 2021 and 2022, driven in part by providers hoping to negotiate higher payment rates with payers.

“This is, perhaps, not surprising given that physician payment in the Medicare program declined greatly between 2001 and 2023 after adjusting for inflation in practice costs and that a large majority of physicians describe the burden associated with prior authorization as high or extremely high,” the report noted.

Though working with a hospital or a healthcare system may be a salve for the immediate wound of administrative and regulatory woes, consolidation can lead to decreased physician earnings and increased costs for patients seeking care.