Utah has a shortage of primary care doctors and many who are nearing retirement.Some states incentivize doctors in training to go into general practice.Nurses shortages are also causing problems that endanger health.

Even as Utah’s population grows and health care services expand throughout the state, experts are warning that a shortage of family or general practice doctors, including geriatricians, could spell serious trouble for the health of the state’s residents.

The Beehive State also has a shortage of health care providers in other areas, as well, including a well-documented inadequate supply of nurses.

“Utah will need to grow health care capacity across the board, but especially in areas where we already fall short,” said John Poelman, interim executive director of the One Utah Health Collaborative. “Access to primary care, behavioral health and aging-related services are where we should prioritize expansion.”

Poelman and the collaborative have gathered numbers on provider-related shortages, noting that:

Only 78.7% of Utah adults have a dedicated health care provider vs. 84% nationally, putting the state at No. 44 according to 2024 American Health rankings.Utah ranks 47th in primary care provider supply with 231.6 per 100,000 people, per American Health. (Meanwhile, Becker’s Hospital Review put the number even lower, ranking Utah No. 49 with just 96 doctors per 100,000 people. Idaho had a half-doctor less, coming in last.)Nearly a third (32%) of Utahns seeking mental health care couldn’t find the help they needed, according to the National Survey on Drug Use and Health 2022-2023.Utah ranks 38th for geriatric clinicians and 35th for home health workers — “both essential as our population ages,” Poelman said, citing the American Health rankings 2025 senior report. Utah has 31 home health workers per 1,000 adults age 65+ years, based on that American Health report.

Dr. King Udall, a family practice doctor in Salt Lake City for more than 50 years, believes Utahns are in the middle of a public health crisis fueled by an inadequate supply of certain providers, particularly those providing primary care.

But like lobsters in a pot of water that’s getting hotter and hotter, they don’t realize what’s happening or how dire the consequences will be. Others worry about that, too.

“We have to build smarter and not just bigger,” said Poelman, adding that his organization is among those pondering solutions. He said the state helped launch the One Utah Health Collaborative, bringing together hospitals, payers and providers to create a 15-year vision for an affordable, high-quality health system. He likens building a system that works for the long run to urban planning, but for health and well-being.

A national dilemma

The National Center for Health Workforce Analysis in November reported that “better access to and use of primary care has been shown to improve treatment of chronic conditions and increase life expectancy.” But the report noted “shortages and maldistribution of primary care providers, low compensation compared to other health occupations, increasing burnout and job dissatisfaction and an aging workforce.”

It includes in its definition of a primary care workforce physicians, nurse practitioners and physician assistants. And the practice of primary care, the report said, includes family medicine, general pediatric medicine, general internal medicine and geriatric medicine.

The health workforce analysis report said bluntly that “people with better access to primary care live longer.” It concluded: “The importance of primary care cannot be overstated. Primary care is often the first contact a patient will have with the health care workforce and sets the trajectory for a positive or negative patient experience and outcome. A high-functioning primary care system treats illnesses and injuries before they become severe, provides ongoing care to mitigate chronic conditions, identifies when more specialized care is required and connects the patient with a clinician. When primary care does not function as intended, patient issues can compound and become increasingly more difficult to treat and resolve.”

The Association of American Medical Colleges projected last March that by 2036, the U.S. will have an 86,000-physician shortage. Between a quarter and half of that shortage is in general practice doctors. Population growth and aging are driving forces. But the fact that 1 in 5 physicians are 65 or older plays a substantial role, too. A similar number are ages 55 to 64.

The workforce group analysis found that between 2016 and 2021, the primary care physician workforce increased less than 4%, while the specialties workforce increased almost 9%.

The report called out an especially low number of geriatricians, who treat older adults — even as the share of older adults quickly grows.

The doctor pipeline

Utah is home to a ton of excellent medical research, strong health care systems and excellent training grounds that are becoming even more robust with news that Brigham Young University will soon open a new medical school.

It will join the University of Utah Medical School, Noorda College of Osteopathic Medicine and Rocky Vista University College of Osteopathic Medicine. The University of Utah also has a physician assistant training program.

Udall believes that Utah’s medical schools old or new should increase their commitment to training physicians for primary care roles. Doctors in training are drawn, he believes, to practices that have a procedure code, where billing rates are higher, which means general practice medicine gets underemphasized. Hence a shortage, he said, of some types of medicine, including geriatricians and primary care providers, among others.

The National Center for Health Workforce Analysis reported the same thing. It noted, for instance, that the average family medicine doctor makes not quite half what the average orthopedics specialty doctor makes annually. “The substantial gap in compensation between primary care physicians and specialist physicians may be one of the explanatory factors for medical students choosing residency in specialties other than primary care.”

Udall said that another reason for the emphasis on specialties rather than general practice may be that more research is done within specialties, which helps earn medical schools and their affiliated health systems accolades as top research facilities.

He also believes that Utah needs more residencies for family practitioners. Those are typically funded by Medicare and the inadequate number available in Utah increases the chance that the medical residents who do choose a general practice will go elsewhere and probably stay there, he said.

What lawmakers could do

Udall notes that while the dearth of primary care doctors is a national one, some communities fare better than others. And some state legislatures are trying to solve the challenge of too-few general practitioners, as well.

He would like to see Utah offer strong incentives to medical students to choose general practice fields and stay in Utah.

KSL TV recently reported that other states do that: New York pays primary care physicians up to $120,000 over three years for sticking with primary care. Texas pays its new primary care physicians a total of $160,000 over four years.

In Utah, primary care doctors can earn as much as $75,000 in student loan repayment over three years if they practice in rural or underserved communities. But Udall said that many urban communities don’t fit those categories, though they don’t have enough primary care doctors, either, while they do have more potential patients.

Expensive ripple effects

Dr. Randy Pilgrim, an emergency room doctor for SCP Health, an emergency medicine provider working across 31 states, said health care shortages often lead to emergency department overload, “especially for those lacking primary care.” Emergency departments, he added, have become hubs for primary care, inpatient care, specialists, outpatient care, social services and mental health.

Pilgrim said requirements that emergency departments take all who come in is coupled with “a relative lack of primary care, insufficient to meet the patient care demands.”

Add in the unavailability of timely primary care if you can’t get in during a family practice’s normal operational hours and emergency departments can be swamped, while financial resources to support them are not keeping up. Sometimes emergency departments fold.

A study by RAND found that emergency departments are under increasing strain for a lot of reasons, including reduced reimbursement from commercial and government-sponsored health plans. Pilgrim said stable funding and thoughtful health policy are important to prevent a crisis in emergency care, too.

When RAND analyzed 50 million emergency department claims between 2018 and 2022, it found that in-network reimbursement had dropped more than 10%, out-of-network payments fell by almost half and uncompensated care climbed to almost $47 billion in 2020 alone.

Money issues contribute to all kinds of care shortages, Deseret News was told.

Nursing shortage no joke, either

The Utah Governor’s Office of Economic Opportunity has reported that while nurses make up half the global health care workforce, over the next decade the world’s going to need 13 million new nurses “to slow the growing shortage.”

In the U.S., that shortage has closed units, delayed surgeries and rationed care, that report said, noting that in 2022 the U.S. shortage was projected to be up to 450,000 nurses by 2025.

It called Utah’s existing shortage “massive,” with close to 3,000 job openings for registered nurses, based on a report from McKinsey, a consulting firm. To compound the problem, retirement age is nearing for 1 in 5 Utah nurses.

Nursing shortages diminish patient safety and can lead to hospital and clinic closures, per the report.

The Utah Health Care Association and the Utah Center for Assisted Living reported that Utah has fewer than seven nurses per 1,000 people, which is among the lowest in the nation. It, too, noted 3,000 unfilled registered nursing positions. That report also said that it’s hard to retain nurses in Utah: “52% of Utah nurses are considering leaving their job primarily due to insufficient staffing, work negatively affecting health and well-being, and inability to deliver quality care.”