US primary care access: Where it’s bad
Exercise patience when trying to be a new patient
In my home market, Clark County / Las Vegas, primary care is notoriously hard to come by for many health consumers. Just moved here? Good luck finding a doctor. Your most likely outcome? You can get regular care from a nurse practitioner (and I love them, by the way) or you may have to default to telehealth (a superb option for many common healthcare needs). But if you want an MD-level primary care physician for in-person visits, expect static.
Some major U.S. markets mirror Las Vegas / Clark County on primary care access. The common thread tends to be rapid population growth that has outpaced physician supply, high uninsured or underinsured populations, or both.
It ain’t easy getting healthcare in many parts of America. When it comes to major markets, here are the most comparable:
Phoenix / Maricopa County, Arizona
The closest parallel to Las Vegas. Explosive population growth, a large retirement-age demographic, and a primary care workforce that simply hasn't kept up. Maricopa County consistently ranks among the worst major metros for primary care physician-to-population ratios. Wait times for new patient appointments routinely stretch beyond three weeks.
Riverside / San Bernardino, California (Inland Empire)
One of the most severe physician shortages in the country. The region has roughly 40 primary care physicians per 100,000 residents — well below the recommended 60 to 80. Massive geography plus low reimbursement rates from Medi-Cal make it hard to attract and retain providers. Patients routinely drive an hour or more for a 15-minute visit.
Miami-Dade / South Florida
High population density, a large elderly population, significant language and cultural barriers, and a high percentage of uninsured patients. The result is an overstressed primary care system where clinics are overloaded and specialty access is bottlenecked by PCP shortages. Concierge medicine has exploded here precisely because traditional access is so broken.
Houston / Harris County, Texas
The highest uninsured rate of any major US city, combined with sprawling geography and immense population growth. The Texas Medical Center is world-class, but primary care at the neighborhood level is a different story. Federally qualified health centers carry an enormous load here and still can't meet demand.
Atlanta metro, Georgia
Chronic primary care shortages in both urban and suburban areas, with particularly brutal access issues in South Fulton, DeKalb, and Clayton counties. Georgia's decision not to expand Medicaid has compounded the problem. Specialist wait times cascade from PCP shortages, and the situation has been well documented in health policy research.
Orlando / Central Florida
Similar to Vegas and Phoenix — tourism-driven economy, rapid growth, large retiree population, and a primary care infrastructure that lags behind need. AdventureHealth and Orlando Health dominate the market, but independent practices and direct primary care models are growing as patients get fed up with wait times.
Denver / Aurora, Colorado
Colorado has one of the worst primary care-to-population gaps in the Mountain West. The Denver metro's growth has far exceeded its clinical capacity, and rural referral patterns from the Western Slope funnel even more demand into the city. Practices here increasingly use advanced practice providers to fill the gap.
Thinking of moving to one of these areas? Know the healthcare situation before you go. And if you’re thinking of avoiding these metro and suburban areas, keep in mind that the landscape in rural America is even worse. Sorry. If you don’t already have a regular medical practice looking after your longitudinal health, consider telehealth. Several telehealth options, like HealthTap (a company I used to work for and still believe in) offer nationwide MD-level primary care.
Healthcare shortages, yet practices suffer from lack of visibility
Despite the high demand, many primary care and specialty care practices are desperate for visibility and patient acquisition, but most are doing nothing systematic about it. Quite the conundrum.
It’s time to bridge the gap.
If you are a small medical practice that needs to better manage your outreach or business communications with patients and prospective patients, contact The Jooj. We know your pain points and we can help connect you with patient needs.
