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Washington advisory committee flags workforce and residency declines as barriers to strengthening primary care
Summary
The Primary Care Advisory Committee reported workforce stresses to the Health Care Cost Board, noting declines in family medicine residency matches and uneven primary‑care supply despite rises in nurse practitioner and physician assistant numbers; the committee will finalize policy recommendations in August.
Dr. Judy Zirzhan Bull, reporting for the Primary Care Advisory Committee, told the board July 22 that workforce trends are a central barrier to strengthening primary care in Washington. The committee’s three priority areas for near‑term work are quality metric alignment, primary‑care spending analysis, and streamlining prior authorization.
Bull reviewed slides showing family medicine residency positions and match rates have declined in recent years, that internal medicine trainees are increasingly subspecializing, while nurse practitioner and physician assistant licenses are rising but only a fraction enter primary care. "There is more work to do here," Bull said, noting unfilled residency slots and recent hospital decisions to scale back family medicine programs.
Committee presenters summarized five potential policy actions under consideration, including payment‑system reform to reduce administrative burden, targeted residency support and recruitment strategies, revisiting student loan programs, and leveraging international medical graduates to boost the primary‑care pipeline. The committee plans to finalize and hand off policy recommendations in August for the board’s consideration.
