According to the California Health Care Foundation, over 11 million Californians live in an area that is experiencing a shortage of doctors. That’s one out of every three people in our state. Here on the Northern Central Coast, more than 335,000 people live in a federally designated Health Professional Shortage Area. At a time when patients need more care than ever, our health care system is failing to keep up with the overwhelming demand for even the most routine services.

Maybe you’ve experienced it yourself. Due to a devastating shortage of physicians nationwide, patients are having to wait longer for their appointments, drive longer distances to receive treatment, or seeing longer waits in emergency rooms, and sometimes forego care altogether.

Why is this happening? There are many reasons, from a wave of retirements during the pandemic to ongoing physician burnout. But one of the most important drivers of this trend is inadequate Medicare payments to physicians.

The rising costs of medical equipment, labor and operations are a nationwide problem for physicians who are struggling to keep their practices financially afloat while remaining steadfast in their desire to treat medically underserved populations covered by Medicare or Medicaid. Inflation and cost increases are happening throughout the country, but they are particularly pronounced in Central California.

Doctors are deeply concerned and, frankly, exhausted by these increasing costs. Yet, the federal government has slashed Medicare reimbursement to physicians for years — and 2025 is no different. Congress recently allowed another 2.8% cut to take effect, making it even harder for doctors’ offices to make ends meet. Medical practice costs have risen 60% while Medicare physician payment has declined by 33% since 2001.

Things are at a breaking point. We want to continue serving the people in our communities who need us most, but these cuts have real-world consequences, forcing physicians to make difficult decisions about whether we can continue accepting Medicare patients in our practices. This puts the health of some of our most vulnerable patients at greater risk.

Case in point: I recently saw a patient who had suffered a heart attack, seeing her back in the hospital two weeks later after she had a severe hypoglycemic episode. It quickly came to my attention that she did not have a primary care doctor to help her manage her medications, resulting in complications.

I helped her coordinate follow-up care, but it took two social workers more than 48 hours to find someone who could accept a patient with Medicare. This was not because no one in the medical community cared about this struggling patient, but because physician practices desperate to keep the lights on are facing financial instability exacerbated by Medicare policy. Increasing expenses and continued cuts to physician reimbursement mean that many medical practices cannot take on new Medicare patients.

Thankfully, Rep. Jimmy Panetta (D-19th District) just introduced the “Medicare Patient Access and Practice Stabilization Act” to address this worrying trend. His bipartisan bill would reverse the 2.8% cut to physician reimbursement that went into effect at the beginning of this year, and add a 2% update, extending a lifeline to countless California physicians and their patients. I thank Rep. Panetta for his leadership and concern for our communities.

After addressing this year’s cut, I urge federal lawmakers to then make meaningful progress toward a physician payment system that includes providing an inflation-based payment update to physicians through Medicare. Doing so would be critical to help physicians stay afloat and expand seniors’ access to care, particularly in communities that are already struggling with physician shortages.

I strongly urge California’s members of Congress to follow Rep. Panetta’s courageous lead to create a sustainable system — now and in the future — for physicians and patients alike.

Donaldo Hernandez, MD is a hospitalist in Santa Cruz and past president of the California Medical Association.