⁄Spotlight⁄ BY HANNAH WALLACE TWO YEARS AGO Connie Cloyed was living in Corbett when she finally found a primary care physician she liked who was covered by UnitedHealthcare. Cloyed, who is almost 70, had been on Medicare a few years at that point and had changed insurance providers each year because she was unhappy with a lack of transparency on costs and coverage. But this time, she really liked her PCP. She was relieved. “Years and years ago, I had cancer, and I was not going to just go to any old doctor,” Cloyed says. “The next year, I get this letter that she’s going to the VA, so she no longer exists as a PCP, and there’s not another PCP in my clinic,” Cloyed says. She called the office, and the receptionist said she could see a nurse practitioner or a physician’s assistant. “I don’t mind seeing either one for a specific need…but I don’t want that as my PCP. I want an actual doctor. And there just isn’t anyone.” If you haven’t heard, there’s a shortage of primary care doctors in Oregon. As primary care doctors age and retire, it’s become exceedingly hard for patients to find new ones—especially in rural areas. But it’s a challenge even in the Portland metro area. In April The Oregonian/Oregon Live polled 600 Portland-area voters and found that more than half found it harder to get an appointment with a primary care doctor than they did three years ago. This is partly because from 2014 to 2019, there’s been a 13% decline in the total number of primary care clinicians in Oregon, according to the Primary Care Collaborative’s Evidence Report from 2023. And according to the latest data from the U.S. Department of Health and Human Services, almost the entire state is in what it calls a Health Professional Shortage Are (HPSA). “Regardless of the source that we look at, we know that the demand for primary care generally exceeds the number of clinicians available to provide it,” says Clare Pierce-Wrobel, the Oregon Health Authority’s Health Policy and Analytics Director. In fact, this is true for many types of health care workers in the state, including dentists, nurses and dermatologists. But primary care doctors in particular increasingly report high burnout rates and dissatisfaction with work-life balance as a reason for going part-time—or taking early retirement. Every two years, the Oregon Health Authority publishes a Health Care Workforce Needs Assessment. The latest one shows that Oregon has a total of 9,584 primary care providers (PCPs), for an average ratio of 17 per 10,000 residents. (This number includes both M.D.s and D.O.s; naturopathic doctors; nurse practitioners; and physician associates who work in family medicine, internal medicine, geriatrics, pediatrics and obstetrics/gynecology.) The shortage is worse in rural areas of the The Doctor Is Out The number of primary care providers in Oregon is flatlining — especially in rural areas. But experts say the problem is curable. “…We know that the demand for primary care generally exceeds the number of clinicians available to provide it.” CLARE PIERCE-WROBEL, HEALTH POLICY AND ANALYTICS DIRECTOR, OREGON HEALTH AUTHORITY Connie Cloyed in her Netarts home PHOTOS BY JASON E. KAPLAN 22
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