Why It's So Hard to Get a Doctor's Appointment in Williamsburg

Too many patients, too few doctors, no easy fix

Feb 07, 2025

Doctors at TPMG manage between 1,500-3,000 patients each. (Williamsburg Watch Photo)

No, it’s not your imagination. Getting in to see a doctor has gotten difficult in our area.

And when you do get in, the experience is a far cry from the old Dr. Marcus Welby days.

When Verna Baer’s doctor found a carcinoma on her face last October, she was scheduled for surgery to remove it. But then the surgeon who was scheduled for the procedure resigned, and she had to wait until December for a replacement.

Then the dermatology office stopped taking her insurance and she had to find another dermatologist who is going to see her this month. Surgery is tentatively scheduled for April, six months after her diagnosis.

“This is the second doctor and the second dentist I have visited who have left…it’s very discouraging,” the White Oaks resident said.

In July of 2023, Sentara Family Medicine New Town sent this writer’s wife an email apologizing for long wait times, explaining a spate of resignations left “over 5,000 patients currently without a direct provider.” The situation has improved with new hires, but as of Wednesday, a receptionist said it could take a new patient several months to schedule a first visit with a doctor.

Crushing workloads, coupled with the ability to earn more money working for specialty practices, make family medicine less appealing to young doctors. And they leave patients with what one practitioner calls a “conveyor belt” experience when they do seek care.

But even specialist practices are facing a crunch. A recent report by the Association of American Medical Colleges projects the United States faces “a total projected shortage of between 13,500 and 86,000 physicians by 2036.” More than a third of active doctors will retire in the next decade, the AAMC said.

Adam Atherly, professor of health administration at Virginia Commonwealth University, listed the culprits in an interview:

1. Our population is getting older and “older people use more healthcare.”

2. The United States has more specialists relative to primary care doctors than any other country, and we pay them more.

3. The integrated healthcare mandated by the Affordable Care Act expanded the need for complex and costly electronic health record systems that are unaffordable for solo practices.

“Corporate practices are buying up all the independent practices,” Atherly said. “It is very difficult to remain as an independent practitioner.”

One industry expert said the large corporate groups, like Sentara and Riverside, benefit from snapping up private practices because they will then funnel referrals to more profitable specialists and advanced treatment within their systems. Non compete agreements mean some doctors who change their mind about working there may have to travel outside our area to keep working.

Insurance companies also have more leverage on what they pay doctors because 99% of Americans are under some form of managed care, added Louis F. Rossiter, a retired William & Mary research professor in health economics who is a former Secretary of Health and Human Resources for Virginia.

Medicare payments are not keeping up with inflation, Rossiter said, and now the federal government is holding back an additional 2% of what doctors would be paid.

That means practices limit the number of new Medicare patients they accept, he added, “because they’re not getting paid, and they really need to save room in the practice for commercial patients.”

“Every insurance company bases their rate off of Medicare,” said Dr. Katherine A. Roberts, an endocrinologist with a practice on Bulifants Boulevard. “I made less in 2024 than I made in 2003.”

Group practices are attacking the doctor shortage by implementing what they call a team approach: you are seen by a nursing practitioner or a physician assistant. They are known as advanced practice providers, and they take over most of the doctor’s routine tasks such as physical exams, prescribing medications and making referrals.

That frees doctors to supervise care and step in as necessary, “enabling them to spend less time on things that other people can do,” said Dr. Steven Pearman, Sentara’s vice president and chief medical officer for primary care.

It also means you may never see your primary care physician as long as you are relatively healthy.

The typical doctor at a Tidewater Physicians Multispecialty Group practice handles between 1,500 and 3,000 patients, said CEO David Warren.

TPMG is a for-profit group of more than 200 doctors in Hampton Roads. Doctors at TPMG are free to decide how they will run their medical practices while leveraging the group’s administrative and IT backbone, Warren said.

But that is still no panacea.

“We’re having trouble recruiting physicians,” he said. “The people who are coming from medical school…are coming into their first real job with (a student debt) of $300,000 or more.” They are going to look for higher paying jobs, and probably in cities with a bit more star power than Williamsburg’s small-town vibe.

“If you’re single, you’re not going to be looking at Williamsburg, you’re going to be looking at Richmond or Virginia Beach,” Warren said.

The workload isn’t just hard on doctors. One nurse practitioner who resigned last year from Sentara spoke of long hours that left her spending her Sundays returning emails from patients.

VCU Professor Atherly says patient satisfaction surveys across the world show “everybody hates their health care system.” But given the tension between supply and demand, “ultimately you have to do something to control costs.”

For those who can afford it, subscription-based medical concierge services are becoming an alternative to traditional practices.

In our next installment Tuesday we will tell you more.

Clarification — we have edited the 3d paragraph to clarify that the Batten School and VIMS are separate facilities on the same campus.

William & Mary Receives Largest Scholarship Gift in Its History

$50 Million for Coastal and Marine Sciences Undergraduate Degree

William & Mary announced its largest ever scholarship gift Wednesday -- $50 million to provide scholarships for undergraduate students at the Batten School of Coastal and Marine Sciences.

The $50 million gift, from William & Mary alumnus Dr. R. Todd Stravitz and his family’s Brunckhorst Foundation, will pay full tuition for students pursuing the school’s new bachelor’s degree in coastal and marine sciences.

R. Todd Stravitz (Alfred Herczeg, W&M photo)

Batten will launch Virginia’s first undergraduate degree in coastal and marine sciences in the fall of 2025. Students will take classes at the school’s facilities, which are co-located with the Virginia Institute of Marine Science in Gloucester Point.

Stravitz is a transplant hepatologist who focused on the liver, gallbladder and biliary tree at Virginia Commonwealth University. His grandfather, whose family is one of the owners of privately-held Boar’s Head Provisions Co., Inc., started the foundation in 1968. The foundation supports medical research and environmental protection.

“Our best hope for solving the environmental crises we face is educating young people to care for and improve our planet,” said Stravitz, a 1982 William and Mary graduate. “Programs like this are critical to our future.”

He joined Virginia Commonwealth University because of its reputation in liver research and treatment and focused on hepatology, a subspecialty that focuses on the liver and gall bladder.