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I read with interest the story “Primary Care Emergency” by Erick Bengel, the Editorial Board opinion, “Family doctor shortage has changed the health care system,” and the subsequent Guest Column by Sue Kretschmann, “Times’ editorial did disservice to nurse practitioners.”

I’m grateful for the attention this critical issue is getting, and there is more that should be said.

There is indeed a crisis in access to primary care in Southern Oregon. Mr. Bengel’s story compellingly and accurately describes the state of affairs. We simply don’t have enough primary care providers to take care of all us, and people suffer as a result.

It’s important to note that there is also a severe shortage of certain specialties — neurology, psychiatry and endocrinology, to name some of the most pressing.

The Rogue Valley has for decades benefitted from excellent medical care. Nurse practitioners and physician assistants, collectively known as Advanced Practice Providers (APPs), are deeply woven into the fabric of that care.

Ms. Kretschmann is right in correcting the misleading and unstudied assertion in the editorial that somehow APPs require supervision or constant consultation with physicians. Skill in providing good care comes in part from training and in part from practice.

A seasoned APP can be an outstanding primary care provider. I must also mention that suggesting that these providers give substandard care is wrong and serves to make a difficult situation worse. Patients need to be able to trust their providers, not have doubts cast on them.

We’re in this provider shortage mess for many reasons both local and national.

Federal funding for training doctors had flatlined from 1997 until the pandemic. The population is growing and aging. Medical graduates have tended toward choosing specialties rather than primary care.

COVID and other factors have pushed already high physician burnout rates through the roof with the predictable result of retirements and departures.

And locally we haven’t successfully adapted to the situation.

I know firsthand how hard all the primary care organizations in the valley have tried to recruit providers. There are too few candidates and fewer still who choose a smaller market like ours.

There are, however, solutions available to us. A key strategy in growing a provider base in any region is to develop medical residencies. Successful programs have been in existence in Klamath Falls and Roseburg since 1994 and 2020, respectively.

A family medicine residency in the Rogue Valley would attract doctors; data show that graduating residents commonly choose to stay put when entering practice.

Such a medical residency would require hospital sponsorship and financial investment. As yet neither of our local hospital systems has chosen to make it a sufficient priority to bring a residency into being.

At La Clinica, we will be kicking off our Advanced Practice Residency this fall with four APP residents spending a year learning with us and our many community partners. New grads need time and mentorship to mature into practice. This program will give solid structure to that time.

Our residency graduates will be excellent and confident providers. It won’t solve the crisis, but it’s a start.

There are other tangible ideas that go beyond the scope of this note. We begin by educating ourselves and speaking from legitimate information. We’ll get there by collaborating and attacking the problem together.