A few weeks back, I welcomed a baby in the morning and spent the afternoon with a grandmother nearing the end of her life. I adjusted insulin for a patient whose journey to quit smoking I first aided a decade ago. I provided guidance to a teenager preparing to leave home for college. This is the beauty of family medicine: accompanying individuals through all phases of life. Yet, far too often, that beauty is eclipsed by a system that undervalues the vital work sustaining it.
For nineteen years, I have been a family doctor, trained residents for sixteen of those years, and acted as a program director for nine. Working together with colleagues in pediatrics and internal medicine, I’ve witnessed how primary care fortifies communities. We identify diseases early, promote mental well-being, navigate families through crises and celebrations, and establish the trust that enables care. Robust primary care is not merely significant; it is the foundation of a functional, compassionate, and cost-effective healthcare system.
Currently, that foundation is under threat.
The 2025 Residency Match showed yet another decline in U.S. seniors opting for primary care, even as training positions reached unprecedented levels and the nation confronts serious primary care workforce shortages. Fifteen percent of family medicine roles offered in the Main Match went unfilled. Pediatrics and internal medicine also saw downward trends.
This is not just a workforce dilemma; it’s a clarion call. In the absence of a strong primary care workforce, patients must endure longer wait times, increased ER visits, deteriorating outcomes, and escalating costs. Most critically, we face the risk of losing the kind of care that regards patients as individuals, not billing codes.
Medical students enter school fueled by a passion for service and health equity. They aspire to make a difference. However, by Match Day, too often they find themselves subtly steered away from primary care.
They witness the lengthy hours, substantial debt, and lower compensation. They absorb the unspoken curriculum that values subspecialty prestige and trivializes primary care as “too broad” or “too basic”—when, in reality, it demands mastery of breadth, resilience, and relationship. They observe a healthcare system that relies on primary care yet refuses to nurture it.
If we genuinely care about health equity, physician well-being, and innovation, then primary care must not linger on the margins. It has to be integral to our mission.
One of primary care’s greatest assets is continuity. I have delivered babies and cared for them into their teenage years. I have stood by patients through addiction, recovery, grief, and healing. I have treated multiple generations within a family. These connections foster trust, enhance outcomes, and support physicians in a profession often marred by burnout.
Yet, many students never experience this form of care. As educators, we hold the power to change that. Academic institutions should develop more extensive longitudinal primary care experiences early in the curriculum, broaden community-based collaborations, and ensure students interact with primary care practitioners not just in clinics, but in leadership and scholarship positions.
Consider AI that manages documentation, prior authorizations, and inbox clutter, allowing us to reclaim precious time for patient care. Imagine predictive tools that help identify patients at the highest risk of being lost to follow-up, or simulation platforms that improve how we train residents. These tools are emerging swiftly. However, no algorithm can substitute for the profound impact of knowing your patient over many years. That’s why primary care physicians must play a role in shaping these innovations.
Reversing the decline in interest and capacity for primary care necessitates more than mere words. It requires action. We need:
– **Visibility:** Elevating primary care clinicians as leaders, mentors, and innovators in research, education, and policy.
– **Support:** Funded programs to facilitate the pipeline, partnerships for residencies, and primary care departments.
– **Reform:** Payment systems that reward comprehensive, relationship-centered care, not just procedures.
– **Employment alignment:** Health systems that recruit physicians for roles that allow them to utilize their full skill set.
At this pivotal moment, when trust in medicine is tenuous and disparities are growing, primary care presents a pathway forward. It is genuine, relational, and vital.
After nearly twenty years, I can affirm without hesitation: family medicine is the most rewarding profession in the world. It is challenging, yes (but also deeply meaningful and joyful). I have educated students and residents who have gone on to revolutionize care in rural communities, urban clinics, academic health institutions, and community hospitals. But we need more.
We need institutions (from my home institution Stanford to health systems nationwide) to not only make primary care feasible but to celebrate it. And we need physicians to continuously reveal to students the beauty of continuity, the strength of breadth, and the joy of relationships that endure over years.
Primary care is not an afterthought. It is the frontline, the safety net, and the very essence of health care. If we wish for health care to truly heal, we must keep it robust.
Grace Yu is a contemporary “old-fashioned family doctor” who takes pleasure in caring for patients throughout their lives. She serves as a clinical associate professor at Stanford University in the Division of Primary Care and Population Health and has directed the