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U.S. medical student entry into Primary Care (Family Medicine) has fallen by roughly one‑third since its 1997 peak, from 2,340 medical school seniors to 1,512 in 2026.1

And despite record participation in the National Residency Matching Program (NRMP), Family Medicine filled only 83.6% of its positions in 2026, leaving 899 positions unfilled.2

An unnerving gap in the pipeline of incoming practitioners.

I know how concerned I am about this as a patient, but I wanted to know more about the physician perspective. I reached out to Dr. Jennifer A. Kabak, Family Medicine Physician, and asked her some questions about her field of work.

Dr. Jennifer A. Kabak is a Board-certified Family Medicine physician who sees patients in Prima CARE’s Somerset-Swansea Medical and Ambulatory Care Centers in Massachusetts.

Dr. Kabak earned her Doctorate in Osteopathic Medicine at the New York Institute of Technology College of Osteopathic Medicine (NYITCOM). She completed her residency training in Family Medicine at Kent Hospital in Warwick, Rhode Island, where she also served as Chief Resident. Dr. Kabak has experience practicing Family Medicine in many diverse settings, from community health centers to offices where medical students and residents rotate to student health services. Prior to relocating to New England, she was on staff at New York University’s Student Health Service.

Dr. Kabak is a member of the American Osteopathic Association, the American College of Osteopathic Family Physicians, and both the Massachusetts and Rhode Island Society of Osteopathic Physicians and Surgeons.

Dr. Kabak provides comprehensive primary care to patients ranging in age from teens to the elderly, with a particular interest in preventive medicine and women’s health. As an affiliate of the Brown University Health Network, her patients are admitted to Saint Anne’s Hospital in Fall River, Massachusetts.

I’m grateful to Dr. Kabak for her honest takes and the insight into her day-to-day work, as well as for recording her answers in the audio version of this issue!

Debra: Dr. Kabak, when did you first realize you wanted to become a doctor?

Dr. Jennifer Kabak: I had transferred to New York University to start my junior year of college. I was studying journalism and had taken a job to help offset the cost of tuition. I was working for an Ophthalmologist on the Upper East Side and really enjoyed the work. Patients would ask my opinion after hearing from the physician, and I did not feel competent to weigh in on their treatment plan. It got me curious, and I wanted to do and learn more. In my personal life, at the time, I was dating a medical student and learning a lot about the medical field. Those two experiences started to get me thinking about not just writing about health care but possibly practicing it.

Debra: At what point did you decide to pursue Family Medicine/Primary Care, and why?

Dr. Kabak: As previously mentioned, I worked for an Ophthalmologist for years and thought I may be following him into that field. But during my third year of medical school, I was exposed to clinical rotations. I had a great Family Medicine clerkship. I believe my previous experience as a journalist led me to practice Family Medicine.

The same level of curiosity that makes a good reporter also makes a good Family Medicine physician.

I enjoy the story.

And there is always a story.

When I interact with a patient, especially for the first time, I make sure to gather all the data and store it in the medical chart. And the next time that patient comes in, depending on the reason, I make sure to utilize that information to continue the connection.

Debra: Do you feel like medical school and your residency prepared you well to practice Primary Care in the real world? Why or why not?

Dr. Kabak: At the time of my training, I do believe that both medical school and residency prepared me to start practicing in the real world. I had great support with my fellow classmates as we all pushed each other to the finish line of graduation. And I was very lucky to land in a residency program with an amazing group of clinicians, who are some of my dearest friends today. I was allowed to reach for the stars and go after any and all experiences to make my time in residency a well-rounded journey.

Debra: Should I read anything into the phrase “At the time of my training?” Do you think the training is different now?

Dr. Kabak: I do think training is different now. I was last involved in teaching almost four years ago, and I can say, at that time, I noticed training was different. When I was a student and a resident, books still played a very prominent role in our education. I went to a tech school; we did have technology rolled into our education through the simulation lab and the ability to watch lectures online, but I also have a vivid memory of books bulging in the pockets of my white coat. I fondly recall surviving my pediatrics rotation with the bible of pediatrics, Harriet Lane,3 in my pocket.

Today, technology is overwhelming. Smartphones are now in pockets instead of books, and information is immediately at your fingertips. I think these changes are good and bad. When I was teaching in New Jersey, I had an experience where the resident couldn’t answer my question about medication dosing despite sitting in front of his laptop. I think of this example and wonder if there is too much information out there and maybe, for some, it is difficult to identify the quality. My other thought is that maybe technology has made us a bit lazy. There is something to be said about looking up the answer because then, at least in my mind, you own that answer and will be able to recall it in the future.

Debra: I know an issue that is important to both of us is the amount of time, or lack thereof, that Primary Care physicians are scheduled to spend with each patient, largely due to the way insurance company reimbursements are structured. Can you provide some insight into what that really looks like? How does it impact your patient care, and how does it impact your practice’s bottom line?

Dr. Kabak: My day is broken into 20-minute appointment times, with an hour blocked off for lunch from 12:00-1:00pm, which is really catch-up time (sometimes my day bleeds into this hour, whether I am running late or sticking in additional patients, or dealing with all the administrative items). I do try to give my staff at least 30 minutes to eat lunch, have a breather, and not keep up with my crazy schedule.

Speaking for myself, I can say I NEVER allow time to impact patient care. Sometimes I need less than the allotted time, sometimes I need more, and sometimes life happens and I need to pivot and deal with an emergency, so time goes out the window. If I am running behind, I always go into the patient with an apology and let them know (privacy respected) why I needed the extra time. And, most often, I never get any pushback because my patients know I am giving each person his/her/their time and listening and reacting.

Now, how does it impact my practice’s bottom line? That is a question for my boss! As a sole practitioner, I am very cognizant that I need to see patients to bring money into the practice. But I NEVER sacrifice patient care to make that happen. If it means I don’t get to eat lunch at “lunch time” or I don’t get a minute to use the bathroom until the end of the day, or I have to run and finish notes at a later time in the day, I do that.

In a perfect world, I see patients in a timely manner in a set schedule, and at the end of the day I shut my computer and go to my second life of being a mom, wife, and daughter. But unfortunately, that is not realistic. And while that is not ideal, what would make it less traumatic would be if patients recognize that physicians have a life outside of medicine that we would love to be 100% present at. So, the yelling, screaming, and demanding that they project onto us is not appreciated. For the most part, we are all just trying to manage the “work-life balance.”

Debra: Patients, myself included, perceive that some doctors want to treat the symptoms of a problem but not find the root cause. I’m curious to hear your take on this.

Dr. Kabak: Sometimes, if it is truly something quick and easy and symptom-oriented, then treating the symptoms is not such a bad idea. If symptoms persist, then there needs to be a deeper dive, which would lead to trying to diagnose a cause.

Now, this is where it can get a bit sticky. Sometimes, trying to get to the root cause is not so easy, and I think it then depends on the physician…and the relationship between the doctor and the patient. As a Primary Care physician, I have a good relationship with my patients and know them pretty well.

I remember a patient calling me during COVID (when we were not in the office but doing a lot of telemedicine), and she had been seen by an outside Urgent Care a few times for a “sinus infection.” She was not getting better and finally decided to call my office. She had a history of sinus infections, but when I got on the phone with her, I stopped her and told her she did not have a sinus infection and whatever was going on, either she was going to hang up and call 9-1-1 or I was going to because she could not complete a sentence on the phone (due to shortness of breath). I like to pride myself that I know my patients fairly well, and this was not a symptom of her typical sinus infection.

Debra: During your career, you’ve experienced the transition from paper files to Electronic Health Records systems and, now, the advent of AI tools. How has that changed the way you interact with patients and document their care?

Dr. Kabak: The transition from paper to electronic health records, for me, has not been such a major change. I believe I am able to connect with my patients even with a computer in the room and I sometimes utilize it to show them pictures or look up some things they may be using. AI is still a bit too advanced for me, and while it is slowly leaking into my exam rooms, I am not using it so much that I feel I can speak intelligently about it at this time.

Debra: Why do you think the Primary Care workforce is shrinking and fewer medical students are choosing it as their specialty? What can be done to change that?

Dr. Kabak: Primary Care is hard. Primary Care is not well-respected. Primary Care is not well-paid for all the things we have on our to-do list. Primary Care is sometimes the “dumping ground” for everyone else in the medical field.

For example, a patient sees his/her/their Cardiologist, who recommends weight loss. The patient asks if any of those new medications would be helpful.

The cardiologist responds with a resounding “Yes!” but then tells them to call the Primary to send in the prescription, to see if it will be approved,

If it is not approved, it is now up to the Primary to fight for the approval. And if it is denied, it is the Primary Care physician who gets yelled at by the patient. Yes, you read that right…yelled at. We are told we must have filled something out wrong, sent it in wrong, made some error (though most likely the insurance just does not want to cover it due to cost).

So, I am not sure how to fix the shrinking workforce because it is multifactorial:

• One of the biggest things for me would be to focus on a way to minimize or erase my student loan debt. Because I currently do not work in the not-for-profit world, I am not eligible for student loan forgiveness. Certainly, my work as a Primary Care physician is no less, and I am still available and accessible for patients. So, eliminating barriers to loan forgiveness would definitely be a start.

• Respect and recognition of Primary Care and utilizing us as a prominent member of the team and not a dumping ground to get things done.

• Showcasing the beauty of the doctor-patient relationship.

• Ensuring that the Primary Care physician has the support to pull off all these demands by making sure we can afford to staff our offices and practices.

Just to name a few things…

Debra: I’m interested in having you elaborate on “showcasing the beauty of the doctor-patient relationship.” Any specific ways you would recommend doing this in order to draw more future practitioners to Primary Care?

Dr. Kabak: My immediate thought was “marketing.” Social Media. There is definitely some navigating to make sure there are no privacy violations or misinformation. I think about StoryCorps4 on NPR-maybe doing some of those. I think about using the social media platforms to showcase the many different opportunities someone can go into if they choose to specialize in Family Medicine. And utilize social media to show the good, bad, and ugly of Family Medicine and maybe the higher ups will notice and swoop in to help solve!

Debra: Is there anything else in the field of Primary Care that you think it’s important for chronic illness patients to know?

Dr. Kabak: Be KIND. Chronic illness is most often a team approach. Pick your team well, and make sure that all members of the team communicate.

After we finished our Q&A, Dr. Kabak reached out to me with an Opinion piece from The New York Times about AI in Primary Care and medical school training (gift subscription link), which is a perfect follow-up to our conversation.

Thank you again to Dr. Jennifer Kabak for sharing her experience! And if you know someone in medical school who hasn’t decided on their specialty yet, tell them how grateful patients are when they can find a good Primary Care doctor like her.

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Each issue of “What’s Her Problem?” includes questions for further discussion. Leave a comment below!

This week’s questions:

If you are a patient, has your experience with Primary Care changed at all over the last few years? If you are a doctor, does Dr. Kabak’s experience resonate with you? What suggestions do you have to counteract the shrinking workforce problem?

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