California has made a significant commitment to strengthening primary care. In 2024, the state’s Office of Health Care Affordability established a benchmark to increase primary care spending to 15% of total healthcare expenditures by 2034, recognizing what decades of research has consistently shown: Robust primary care leads to better health outcomes, lower healthcare costs and healthier communities.

A recent issue brief from the California Health Care Foundation, titled “Payer Strategies for Primary Care Investment in California,” outlines how health plans, purchasers and providers can work together to reach that goal. Its recommendations focus on increasing physician payments, supporting team-based care, investing in practice infrastructure, improving data capabilities and creating greater accountability for results.

Those are important steps.

But they also raise an equally important question: Will increased investment be enough if there still aren’t enough primary care physicians to meet growing patient demand?

Investment is Necessary

The report acknowledges that strengthening primary care requires more than simply spending additional dollars. It calls for new payment models, stronger support for physician practices, better care coordination and investments in workforce and infrastructure.

These are practical recommendations that recognize the complexity of modern primary care. Physicians need the resources to deliver comprehensive, coordinated care while managing increasingly complex patient populations. Better payment models can reduce administrative burdens, encourage preventive care and help medical practices build multidisciplinary teams.

California’s investment benchmark represents an important policy commitment to making primary care a stronger foundation for the healthcare system.

But Investment Alone Doesn’t Create Physicians

Paying primary care physicians more appropriately can make the specialty a more attractive career choice over time. What it cannot do is quickly increase the number of physicians available to care for patients.

Communities across the country continue to experience shortages of primary care physicians, particularly in rural and underserved areas. At the same time, demand for care continues to grow as the population ages, chronic disease becomes more prevalent and more Americans gain access to healthcare services — all while primary care physicians retire in large numbers.

Building the physician workforce through the traditional pipeline is essential, but it is also a long-term strategy. Medical school, residency and board certification require years before a physician begins practicing independently.

Patients who need care today cannot wait a decade for workforce shortages to be resolved.

An Existing Workforce is Often Missing From the Conversation

One of the most notable aspects of the report is its recognition that workforce investment is necessary. Yet much of the discussion around physician workforce expansion continues to focus on producing more new physicians.

There is another opportunity that deserves greater attention.

Thousands of licensed physicians already possess years of clinical experience, diagnostic expertise, patient communication skills and medical judgment. Many may be interested in transitioning into primary care.

Rather than starting from the beginning, these physicians can build on the knowledge and experience they already have while receiving the additional training needed to practice in a new field.

Retraining experienced physicians through programs like Physicians Retraining and Reentry is not a replacement for expanding medical education or residency programs; it is a complementary strategy that can help address workforce shortages more quickly while maximizing the value of the clinical expertise already present within the healthcare system.

Building the Future of Primary Care Requires Two Investments

California’s primary care investment benchmark represents an important step toward improving access to care and strengthening the healthcare system. But financial investment and workforce investment are inseparable.

Continuing to educate the next generation of physicians while also creating pathways for experienced, licensed physicians to retrain as primary care physicians is a logical approach.

Primary care’s future depends on both.