America is staring down a looming healthcare crisis: a shortage of primary care doctors that’s only getting worse. By 2036, the Association of American Medical Colleges predicts a deficit of up to 86,000 physicians, driven by an aging population and a wave of retiring doctors. Meanwhile, Gen Z—born between 1997 and 2012—could be the key to filling the gap. As the generation now entering medical school, they’re passionate about purpose-driven work and work-life balance. So why aren’t more of them choosing family medicine?
The Primary Care Problem
Primary care—think family doctors, internists, and pediatricians—is the backbone of healthcare, managing everything from routine checkups to chronic conditions. But it’s losing appeal. Only about 1 in 10 US medical students today picks primary care, a sharp drop from decades past. Instead, many gravitate toward high-paying, high-prestige specialties like dermatology or surgery. The result? Fewer doctors for the everyday care Americans rely on, especially as the population over 65 doubles by 2060.
What’s Turning Gen Z Away?
For Gen Z med students, the hurdles are clear. Primary care often means lower pay—around $250,000 a year versus $450,000 or more for specialists—paired with crushing student debt that can top $200,000. Add in long hours, administrative overload, and less control over schedules, and it’s no wonder many opt-out. “I want a life outside medicine,” one Gen Z student told me, echoing a generation that prizes flexibility over burnout.
Specialties, by contrast, offer better compensation and often narrower, more predictable workloads. Dermatology, for instance, boasts cushy hours and a median salary pushing $500,000. Gen Z’s practical streak—honed by growing up amid economic uncertainty—makes these fields hard to resist.
A Passion for Purpose Meets Reality
It’s not that Gen Z lacks idealism. Many start med school eager to make a difference, drawn to primary care’s focus on underserved communities. But the system wears them down. Endless paperwork, insurance battles, and pressure to see more patients in less time sap the joy of the job. “I wanted to help people, not fight bureaucracy,” a third-year student said, explaining her shift to radiology.
Can the Tide Turn?
Experts see hope. Gen Z’s push for balance could reshape medicine if the system adapts. Some propose loan forgiveness tied to primary care service—say, $50,000 per year in rural or low-income areas—to offset debt and lure students back. Others point to team-based care models, where nurse practitioners and physician assistants handle routine tasks, freeing doctors for meaningful patient time. Early signs suggest Gen Z likes this collaborative vibe—it aligns with their team-oriented mindset.
Residency programs are also pivoting. Places like the University of North Carolina are tweaking training to emphasize lifestyle perks and community impact, hoping to hook purpose-driven students. And Gen Z’s tech-savvy nature could be a boon: they’re eager to use AI and telemedicine to streamline work, potentially reviving interest in primary care.
A Generational Crossroads
Gen Z isn’t wrong to want it all—impact, income, and a life. But their choices could determine whether America’s doctor shortage becomes a full-blown disaster. If primary care can evolve—offering better pay, less grind, and more purpose—they might just sign on. Otherwise, the family doctor could become a relic, and we’ll all feel the loss.