California’s Physician Shortage: A Growing Concern
California is facing a significant shortage of physicians, one of the highest in the U.S. A recent analysis from the Kaiser Family Foundation highlights that around 6 million residents live in areas lacking adequate primary care providers. Alarmingly, less than half of the state’s primary care needs are being met.
The demographics are troubling. In the Inland Empire, there are only 35 primary care physicians for every 100,000 residents, a number that falls short of the federal benchmark of 60 to 80. In the San Joaquin Valley, it’s slightly better at 39 per 100,000.
In response, Sacramento’s typical solution seems to revolve around increasing the “pipeline” of medical professionals—essentially adding more slots in medical schools and residency programs, as well as expanding loan forgiveness initiatives for exhausted, often retired, physicians.
A report from February indicated that prominent residency programs in California, like Song Brown and CalMedForce, are only making minimal progress in creating new residency slots. Currently, California is grappling with a staffing crisis that appears to be a deeper issue than mere shortages. If lawmakers fail to address this, the influx of new doctors may remain insufficient.
As someone who has firsthand experience, I can relate to the struggles in healthcare here. I’m an ENT surgeon who left clinical practice last year, which was quite a decision after five years of training and establishing my own practice. What pushed me out? A multitude of issues that are contributing to a significant healthcare decline in California.
Data reveals a concerning trend. A 2025 study published in the Annals of Internal Medicine examined a sample of over 712,000 physicians and found an increase in turnover from 3.5% in 2013 to 4.9% in 2019—a staggering 40% rise in six years. The researchers attributed this spike mainly to excessive administrative burdens, challenges with electronic medical records, prior authorizations, and insufficient staffing. Gaps in the medical pipeline also remained unnoticed.
A survey conducted in early 2025 involving over 1,100 physicians indicated that about 35% of them are considering leaving clinical medicine. Furthermore, certain analyses predict that within five years, around 35% are likely to retire, with many opting to exit clinical practice entirely.
These are the very doctors California has invested years in training. We really cannot afford to lose them. If you ask retired doctors about their frustrations, the term “prior authorization” will likely come up at least twice.
Current findings from the American Medical Association suggest that a single physician spends roughly 12 hours a week on just paperwork related to insurance pre-authorization—time that could be better spent with patients. It’s no surprise that 95% of doctors feel this contributes to burnout, leading nearly 40% of clinics to hire specific staff solely for dealing with insurance-related paperwork.
Another significant factor is private equity involvement in healthcare. A study showed that practices acquired by private equity firms saw an increase from 816 to 5,779 between 2012 and 2021, substantially increasing their market share, particularly in specialty areas.
In fact, years ago, Governor Newsom vetoed AB 3129, which would have imposed stricter oversight on private equity acquisitions in healthcare. Although new laws regarding prior authorization have been signed, they hardly solve the problems at hand.
Patients, particularly vulnerable groups like farmworkers in Tulare or seniors in Fresno, are bearing the brunt of this retention crisis. Families in San Bernardino often cannot afford the lengthy trips needed to see specialists. A genuine retention crisis is unfolding, affecting many communities.
So, what is the real solution? A few measures come to mind, such as reforming prior authorization protocols to ensure timely responses and introduce consequences for insurance companies denying necessary care. Implementing antitrust oversight on private equity mergers could also help, alongside providing meaningful protections for whistleblowers alerting about unsafe conditions or staffing.
This isn’t just about emotions; it’s quite logical. If we want doctors to stay and practice in California, the state must become a more appealing environment for healthcare professionals. It’s essential for sustainability.
Unless we give retention the same urgency as creating new medical pipeline opportunities, the situation will remain dire. We could build as many medical schools as needed, but if graduates keep leaving for better conditions elsewhere, it’s all for naught.
