Improving health care access showing rays of hope

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One of the most vexing problems with our nation’s health care system is getting a timely doctor’s appointment. Our primary care network is overwhelmed.

More than 100 million Americans lack a primary care provider. A quarter of those are children and the problem is worsening, according to the National Association of Community Health Centers.

Our country has a growing and aging population that will need more care. Combined with an aging workforce of physicians nearing retirement, the United States is facing a severe shortage of doctors, the Association of American Medical Colleges (AAMC) reports.

The gap is expected to grow in the next decade. More than 40% of active physicians in our country will be 65 or older within the next decade. By 2034, the U.S. is projected to face a shortage of up to 124,000 physicians, 48,000 of which will be in primary care.

Across Washington state, the average primary care physician to access score is 10 physicians per 10,000 people. However, 21 neighborhoods have less than one physician per 10,000 people, according to the Washington Dept. of Health.

Wait times for appointments are growing as well. According to USA Today, a recent survey by a physician staffing firm found it now takes an average of 21 days just to see a doctor of family medicine.

Primary care doctors are critical. They are the patients’ entry point to our health care system. It is the practice in which people receive regular physical exams, basic medical tests, prescriptions and treatment for mild illnesses. They are also “gatekeepers” who refer patients to specialists if their problems are serious.

AAMC added: “This significant gap in access to primary care is concerning, as it plays a crucial role in managing day-to-day health needs, preventing chronic illnesses, and identifying risk factors for serious conditions.”

Factors contributing to the shortage also include rural hospital closures and unequal distribution of clinics and providers across urban and under-served areas.

However, there are rays of hope on the horizon.

For example, in April, U.S. News and World Report ranked the University of Washington as our nation’s top medical school for primary care. That is great news, especially if its 1,200 medical students become physicians and fan-out across our region.



Washington also has an extensive network of community health centers (CHCs). 

“They are vital providers in the state’s health care safety net, serving as the primary care provider to 35% of Medicaid/CHIP enrollees in 2021,” Washington Association for Community Health reports.

Since the first community health care center was opened in 1969, CHCs served more than 1.1 million residents at over 350 clinic sites annually.

In late 2021 Premera Blue Cross teamed with Kinwell Medical Group to establish primary care clinics in Yakima and Wenatchee. Premera, the Pacific Northwest’s largest health insurer provides comprehensive health benefits to more than 2.5 million people, from individuals and small employers to Fortune 100 companies.

Premera initially invested $58 million to expand Kinwell’s network in rural areas and has rapidly expanded to 17 primary care clinics scattered around our state. The group provides virtual and in-person care and recently opened facilities in major cities in the Puget Sound region as well as Spokane and the Tri-Cities.

Kinwell’s goal is to provide quick access to appointments and treatment.

“More time, less complexity, more comfort, and — perhaps most important — a better relationship with your primary care team. Kinwell is based on the belief that healthcare is a conversation, not a transaction,” Kinwell and Premera advertise.

Hopefully, between the efforts at UW’s Primary Care medical school, community clinics and private provider initiatives such as Premera and Kinwell, patients will have quicker access to primary care.

— Don C. Brunell is a business analyst, writer, and columnist. He retired as president of the Association of Washington Business, the state’s oldest and largest business organization, and now lives in Vancouver, Washington. He can be contacted at theBrunells@msn.com.