Primary Problems: Primary care docs must see twice as many patients as specialists to make the same amount of money or less (Result: Too many hours + too little pay = burnout)

Secondary Problems: Dealing with insurance companies that reimburse below costs and dictate what medications will be covered for patient treatments (result: doctors become administrators that must first deal with treatment restraints and second on treatment outcomes)

Tertiary Problems: Medical students learn to choose specialties over primary care because of the insurmountable problems associated with this type of practice (result: Severe shortage of primary care doctors mean patients can’t get into their practices for care, and end up increasing the cost of healthcare by going directly to Emergency Rooms or Specialists when a primary care doctor could have treated the patient at a fraction of the cost)

Rx: Some docs decide to retire, some work locum tenens, and some just continue to work for more and more hours with less and less pay. Not a solution but a byproduct of the last few decades of regulatory legislation, public corporation shareholder profitability expectations, and litigation.