Vermont’s stock of primary care physicians continues to shrink, according to the latest statewide survey from the Vermont Department of Health, a trend state health officials say threatens access to basic medical care for many residents.
Declining headcount and fewer full-time hours
The department’s 2024 survey found 529 individuals practicing as primary care providers in Vermont, down from 569 in 2022. The count is far lower than the first survey in 2004, which recorded 634 primary care doctors. The state converted that workforce to a full-time equivalent measure and determined Vermont has the equivalent of 402 full-time primary care clinicians.
In addition to fewer clinicians, primary care doctors are spending less time in patient-facing roles. The Department of Health defines full-time as 40 patient-facing hours per week for 48 weeks annually; under that metric only 39% of primary care physicians in Vermont met full-time status in 2024, compared with 42% in 2014.
“I don’t think this is shocking, really, to anyone. It’s not the first time we’ve seen this trend, and unfortunately, we haven’t done enough to make the trend change,”
Vermont Health Commissioner Dr. Rick Hildebrant said in an interview that the trajectory concerns him and that efforts to address the problem are not moving quickly enough.
Why the decline matters
Primary care physicians serve as the entry point to the health system for most patients, providing preventive care, chronic disease management and coordination with specialists. Health-sector leaders warn that reduced primary care capacity can lengthen wait times, curtail access for people seeking new providers and increase unnecessary use of emergency and specialty services.
Jessa Barnard, executive director of the Vermont Medical Society, noted that ongoing relationships with primary care clinicians are a key factor in preventing hospitalizations and reducing downstream healthcare costs.
Advocates often point to other states’ experiences to underline the return on investment in primary care. For example, Oregon has been cited for research suggesting that each dollar invested in primary care generated substantial savings in other parts of the system, particularly emergency and specialty care.
How the numbers have changed
| Year | Primary care physicians (headcount) | Full-time percentage |
|---|---|---|
| 2004 | 634 | — |
| 2014 | — | 42% |
| 2022 | 569 | — |
| 2024 | 529 | 39% |
Local impact and practical concerns
For patients, the combination of fewer clinicians and reduced hours can mean longer waits for routine appointments, difficulty establishing care with a new provider, and greater reliance on urgent care or emergency departments. Rural communities, where recruiting and retaining clinicians is often harder, may feel the strain most acutely.
Health Commissioner Hildebrant framed the situation as a policy and workforce challenge: the state needs both to bring new clinicians into Vermont and to encourage current providers to remain and provide adequate patient-facing time.
- Access: Longer appointment wait times and limited openings for new patients.
- Coordination: Less continuity of care makes managing chronic conditions and preventive screening more difficult.
- Costs: Potential rise in avoidable emergency and specialty care when primary care is not available.
What comes next
State leaders have repeatedly said recruiting and retaining primary care clinicians is a priority, but officials acknowledge progress has been slow. The Health Department’s recent numbers underline the scale of the challenge: reversing a two-decade decline will require targeted strategies on workforce development, incentives for practice in underserved areas, and measures to make primary care practice sustainable for physicians.
At a minimum, the new survey gives policymakers and healthcare organizations an updated baseline from which to measure the effectiveness of any interventions aimed at strengthening Vermont’s primary care capacity.
As the debate continues, patients and providers alike will be watching whether state and local responses follow the urgency signaled by the numbers and the concerns voiced by public health leaders.
