It’s not your imagination. It really is taking longer to see the doctor these days.

A physician shortage that began pre-COVID-19 has only gotten worse post-pandemic, said Dr. Zubin Pachori, co-founder and managing partner of Premier Inpatient Partners and vice president of Collier County Medical Society, who calls it “a silent epidemic that’s not talked about enough.” 

Before the pandemic, “there was already a trend of physicians retiring as more and more of the baby boomer generation throughout the country go out of the workplace,” Pachori says. But when COVID-19 hit in 2020 and put a strain on hospitals, “it was one of those events that pushed people—whether it was physician burnout, stress of the event itself, whatever political things they agreed with or didn’t agree with—to leave the career earlier than they expected.”

Four years later, hospitals are still hard-pressed for physicians, due to issues such as financing, lack of affordable housing and a growing aging population with medical needs.

“We’re one of the few professions where we don’t set our own prices. It’s generally set by Medicare, and we’ve seen a 26% decrease in reimbursement since 2001,” Pachori says. “The job has only gotten harder since then.”

Florida Medicaid coverage ranks 46th in the nation, paying 58 cents to every dollar Medicare would cover, and 49 cents for primary care, according to the January Florida TaxWatch Report, “Addressing Florida’s Escalating Physician Shortage: Strategies and Solutions.”

Cost of living also can make it difficult to recruit talent. Collier County’s median listing home price in December 2023 was $839,000, according to Realtor.com. Lee County’s was $469,000. Both are trending upward year-over-year.

“Housing prices are so steep and have risen so sharply that it’s priced out a lot of people who would have come down here and gotten a starter home,” Pachori says. “Physician reimbursement has not kept up.”

The greatest needs

“We’re going to need 18,000 physicians across the state by 2035,” Pachori says, citing a Florida Medical Association study. “I think it’s probably an understatement.”

Pachori estimated one-third of the shortage would be for primary care physicians and practitioners, while two-thirds would be for specialists that run the gamut from emergency room doctors to cardiologists, surgeons and psychiatrists.

Physicians in cognitive specialties, such as nephrology, neurology, psychiatry, rheumatology and endocrinology are especially needed, said April Donahue, executive director of Collier County Medical Society.

What’s being done

Medical experts and associations have taken concerns to the state Legislature.

“We’re advocating for some things that may have a decent chance this year at the state level,” Donahue says. “For example, getting the medical loan repayment program expanded so that physicians who volunteer or work in rural areas can receive assistance with repaying their loans. If housing is really high and [students] have $250,000 in student loans, they may not be able to work in Naples as easily as some others.”

There’s also a call to expand the number of residencies in Florida, as 65% of Florida medical residents stay in the state to practice medicine, the Association of American Medical Colleges reported.

Meanwhile, physicians are getting extra help to combat burnout.

“Local hospitals and medical societies have done a lot of advocacy for having retreats where physicians can see national leaders who can talk about physician burnout and having private, one-on-one sessions with therapists,” Pachori says.

The public also can make a difference by advocating for doctors, Pachori adds: “If people want to talk to their legislators, it would be effective coming from patients, as well.”