Primary care is suffering more than most under the ongoing physician shortage.
The U.S. was forecast to see a shortage of up to 64,000 physicians by the end of 2024 and a shortage of 86,000 by 2036, according to a McKinsey survey of physicians’ view of the shortage. Of the 631 physicians surveyed, 35% indicate they are likely to leave their current roles in the next five years. Of these, 60% expect to leave clinical practice entirely.
“It does feel pretty doom and gloom,” Pradnya Mitroo, MD, president of Fresno (Calif.) Digestive Health, recently told Becker’s. “It’s really affecting us, especially since we’re in a rural and underserved area. It’s already difficult to recruit physicians here, and it can take months for patients to find a primary care doctor.”
In Medscape’s recent “Striving for Balance in Your Specialty: Medscape Family Physician Mental Health & Well-Being Report 2025,” family physicians also reported declining overall mental wellness. Of the 5,741 physicians surveyed in the report, few family physicians felt that their personal lives have improved over the last three years. Only 24% said their overall happiness had improved in the last three years, while 40% said it stayed the same and 35% said it worsened. Additionally, about half of family physicians in the survey said they felt burned out and about one-quarter experienced depression.
One Tennessee physician, Rahul Iyengar, MD, is looking to change the current cycle of long wait times for appointments, overburdened patient loads and high burnout that many primary care physicians and their patients are facing.
He told News Channel 5 Nashville in a recent report that when he first graduated medical school, he encountered primary care physicians seeing 30 to 40 mostly sick patients per day,
“You’re on that hamster wheel day to day. In the system, doctors don’t get to make their schedules. You’re an employee, and insurance is really what dictates your scheduling,” Dr. Iyengar told the publication.
He founded Members Health Co. in July 2024, a direct-pay primary care model in which members pay a set monthly fee for “comprehensive preventive care” and direct access to their physicians, operating outside of insurance entirely.
The practice is currently limited to 300 patients. A standard membership costs $189 per month for an adult under 50 years old, and slightly more for an older patient. According to the report, Health Insurance Marketplace rates for a single, healthy 35-year-old man in Nashville making $65,000 a year who is eligible for employee health insurance, Medicare or Medicaid started at $408 a month for high-deductible plans and $518 a month for low-deductible plans.
According to Dr. Iyengar, his membership includes extensive preventative blood work, muscle and fat assessments, massage therapy and wellness services. If imaging is needed, members pay a “fraction” of insurance-based prices.
“Insurance is great. It has a role, but it’s not designed to keep you healthy. It’s designed for when something breaks. So I compare it to car insurance, where even if you have the best car insurance, you still end up paying for gas, oil changes, car washes, tires and all the maintenance. That’s what I do for health,” Dr. Iyengar said.
