TUESDAY, Sept. 22, 2026 (HealthDay News) — Lynn Ramirez, 65, takes maintenance medications common to many older Americans.
And like her fellow Americans, Ramirez finds that her shaky access to a family doctor sometimes gets in the way of obtaining her meds.
Ramirez’s ability to see the same doctor regularly hinges on her insurance, and “when insurance changes, the whole thing is a nightmare,” she said.
“They can see what my cholesterol levels were, but they can’t see that I tried this medication and it didn’t work so well, so that’s why I’m on the other one,” said Ramirez, who lives in Simpsonville, South Carolina.
“If the new doctor doesn’t know that and it’s not written up somewhere, they’ll say, let’s switch to this other medication,” she said. “And it’s up to me to remember, we tried that once before and it didn’t work.”
Regular access to a family doctor can play a central role in a person’s ongoing health, experts say.
Not having a family doctor, not being able to get timely appointments, or being forced to frequently switch doctors all increase the risk that a person will become sicker over time, research has shown.
For example, seniors 65 and older who regularly see a primary care doc have a 16% lower risk of death within the next 15 years, according to an August 2026 study published in the Journal of General Internal Medicine.
Median survival time was at least two years longer among those with a primary care doc (15 or more years) compared to those without one (13 years), that study found.
That’s because having an engaged relationship with a family doctor can help prevent illnesses, better manage chronic disease like diabetes or high blood pressure, and catch small health problems that can become worse without treatment, said Dr. Joe Betancourt, president of The Commonwealth Fund, a health policy think tank.
“There’s no doubt we have a primary care crisis, and primary care matters,” Betancourt said. “It provides the most value for health.”
America’s lack of regard for primary care contributes to both the poor health of many citizens as well as the high cost of healthcare in the U.S., he said.
“We have the lowest life expectancy, highest infant and maternal mortality, highest burden of chronic disease, and when we look at what distinguishes those countries from us, it is primary care,” Betancourt said. “The other peer nations spend 15% of their healthcare dollar on primary care where we spend around 4 to 5%.
“We spend the most as a nation and have the least to show for it,” he said. “This is a critical issue and we are in crisis.”
Frontline Medicine
Family medicine provides comprehensive care that patients simply can’t get if they depend on urgent care or emergency rooms to treat immediate health problems, said Dr. Jennifer Brull, board chair of the American Academy of Family Physicians. She’s a family physician in Fort Collins, Colorado.
“When I see a patient, I am not just thinking about their physical, I am thinking about, did you get your pneumonia shot when you turned 50?” Brull said. "Because now it’s due at 50, but that changed just a year ago. It used to be 65. Maybe we could get you that today, which two years from now keeps you from getting pneumonia and being in the hospital.”
Research has consistently shown that access to family doctors and primary care in the United States extends lives and curbs illness:
Folks who live in counties with fewer than one primary care doc for every 3,500 people have an average life expectancy nearly a year (311 days) shorter than people in counties with more doctors, according to a 2021 analysis in the Annals of Internal Medicine.
Every 10 additional primary care doctors per 100,000 people increases average life expectancy by more than 51 days, according to a 2019 study in JAMA Internal Medicine.
For every additional primary care physician working in a county, about 16 hospitalizations are prevented and 14 years of life are saved per 100,000 people, says a 2022 study in the journal Postgraduate Medicine.
If people can’t get in to see their doctor, they tend to “delay care, often getting sicker and sicker until they are so sick they have to go to the emergency room, which is one of the most expensive care settings,” said Sophia Tripoli, senior director of health policy at Families USA, a health consumer advocacy organization.
“We see folks getting really sick, and their sicknesses complicate and compound,” Tripoli said. “When they do show up for care, they need much more intensive intervention to deal with the health conditions they have.”
The Four Jobs
Family doctors serve four main roles when it comes to keeping patients healthy and living longer, said Betancourt, who in addition to his role at The Commonwealth Fund is an associate professor of medicine at Harvard Medical School in Boston and provides primary care to a large Spanish-speaking and minority patient panel.
First, they manage prevention, he said. They nag you about your vaccinations. They hound you about your high blood pressure and cholesterol. And this keeps you out of the hospital.
For example, about half of people with high blood pressure don’t know they have it, he added.
“The single biggest killer of Americans is cardiometabolic disease,” Betancourt said. “If you don’t have a primary care doctor who’s checking your blood pressure and your cholesterol and your blood sugar, we are failing the public.”
Nearly all adults (96%) with a usual source of primary care have received preventive services for chronic disease, compared to 68% of those without regular primary care, according to a 2026 analysis by the Milbank Memorial Fund, a health policy think tank.
The same is even more true for children, that analysis found. Those with a family doctor or a pediatrician were more likely to receive preventive services for vision testing (74% versus 21%); accident or injury prevention (44% versus 22%); secondhand smoke exposure (37% versus 21%); and obesity prevention (96% versus 81%).
Second, primary care doctors are the first people to see what Betancourt calls “low acuity problems” — little niggling health issues that could be warning signs.
“The primary care doctor will routinely get called for patients who have burning in their urine, whose asthma is a little bit worse, who is feeling light-headed because of their blood pressure,” Betancourt said. “Some of these low acuity situations, if not dealt with, can lead to poor health outcomes.
“Urinary tract infections can become a kidney infection. Uncontrolled blood pressure can become a heart attack or stroke,” he said. “The patient might be fine, but some are the beginning of a situation that could become way worse.”
Health Quarterbacking
Third, family doctors help manage chronic diseases on an ongoing basis.
“Primary care doctors play a very, very large role in managing chronic disease,” Betancourt said. “A large part of my work is managing my patients’ blood pressure, decreasing their cholesterol, addressing any cardiac risk they might have and managing their diabetes.
“With that comes myriad behavior change issues, like working with you to stop smoking or lose weight,” he continued. “It’s not just treating chronic disease from medications. It’s also lifestyle, behavior and the like.”
This attention from a primary care doctor does pay off, according to the Milbank report.
Having a usual source of primary care lowers by 11% the odds that a person with a chronic disease will land in an ER, and their risk of hospitalization by 20%, the report found.
And again, kids with a chronic disease get even more out of having a family doc or pediatrician — their odds of either needing an ER or hospitalization drop nearly 50% with regular care, the Milbank report found.
Fourth, family doctors can play a key role in coordinating care when a person is diagnosed with a severe, potentially life-threatening illness, Betancourt said.
“When we detect something that requires a specialist and greater attention, my job is to coordinate that care for you in a timely manner,” he said. “If it’s a large mass in the breast, I need you to get to a breast surgeon immediately. If it’s a large mass in the colon, we need to get you the right surgeon.
“The primary care doctor not only gets you that referral, but I will serve as a backstop to make sure you don’t fall through the cracks,” Betancourt said. “They really serve as the quarterback to make sure care is getting done and getting done well.”
Dr. Bayo Curry-Winchell, a family doctor in Reno, Nevada, cited a heartbreaking case — a patient who struggled with shortness of breath and a recurring cough for five months.
The patient had been seen at multiple urgent care clinics, but no one had referred her for a CT scan that would examine her lungs, Curry-Winchell said.
“I was able to get (a CT scan), and unfortunately, she had a mass in her chest,” she said. “That delay, when it comes to cancer, time is everything. A delay in care means a delay in getting treatment.”
Invisible Care
Unfortunately, this comprehensive service often goes overlooked when it comes to being compensated, Tripoli of Families USA said.
“It’s often under-reimbursed or not reimbursed at all,” she said. “The family physicians and primary care doctors just do that work anyways and build it in, and I would say it’s one of the areas where we’re seeing so much increased demand and pressure.”
For example, care coordination “is an incredibly important function of going to see a doctor, for a clinical practice to be able to effectively manage treatment,” Tripoli said.
“Yet it’s really not reimbursed or paid for in our healthcare system in an explicit way,” she said. “It creates a very challenging dynamic where it is a key function of being able to effectively manage health, and yet we undervalue it.”
Echoing Betancourt’s sentiments, Tripoli added: “We’re spending trillions of dollars every year on health care, and only 5% of that goes to primary care.”
The system currently is responding to the nation’s shortage of primary care doctors with fragmentation, Betancourt said. Nurse practitioners or doctor’s assistants now are responsible for some referrals to specialists, while urgent care centers treat minor injuries like a sprained ankle.
“I used to get upset about that,” Betancourt said. “Now I’m happy that the patient is seeing somebody. It’s a sprained ankle. It’s not that big of a deal.”
But that could wind up costing the patient, given that it’s the job of their primary care doctor to notice every little thing.
“You come in for that sprained ankle and I might find you have wildly high blood pressure and say, ‘We got to get you treated,’ ” Betancourt said. “We are probably going to get more fragmented in how we provide care. The one doctor/one patient model, it won’t be a one-size fits all. We’re seeing that already with urgent cares.”
The key will be whether a person’s family doctor is continually notified of visits to other types of providers, regardless whether they’ve dropped in at a pharmacy or an urgent care or a retail medicine clinic, he said.
“If we can still carry a thread where primary care doctors are still responsible for a patient and connected to them, but don’t have to do everything, that’s where I think we might get to a better place,” Betancourt said.
SOURCES: Lynn Ramirez, resident of Simpsonville, South Carolina; Dr. Joe Betancourt, president of The Commonwealth Fund; Dr. Jennifer Brull, board chair of the American Academy of Family Physicians; Sophia Tripoli, senior director of health policy at Families USA; Dr. Bayo Curry-Winchell, a family doctor in Reno, Nevada; Journal of General Internal Medicine, August 2026; Annals of Internal Medicine, March 2021; JAMA Internal Medicine, February 2019; Postgraduate Medicine, January 2022; Investing in Primary Care: The Missing Strategy in America’s Fight Against Chronic Disease, Milbank Memorial Fund, February 2026
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