Opinion: Eulogy for a medical home

Our primary care system is increasingly fragile, and too many people are having a hard time even getting appointments. Last week the crisis I have been warning the community about, supporting members through, and urging legislators and policymakers to help fix, reached my neighborhood and my family. Our family physician’s office is closing in March.

As the executive director of the Oregon Academy of Family Physicians, I advocate for strong, accessible primary care for every Oregonian. I know everyone deserves access to this kind of care because my family has benefited from it for 21 years at Family Medical Group Northeast. I deeply understand what a difference it can make for the health and wellbeing of a family. 

We were drawn to Family Medical Group because it is just blocks from our house, and we stayed because the care was exceptional. Though I never had a family physician before, it simply made sense that we would all see the same doctor. Family medicine meant I could bring my children to the same physician who advised me through breastfeeding challenges and the back pain that came from hauling those same kids around.

The clinic was among the first to earn Oregon’s Patient Centered Primary Care Home model recognition. They took pride in advancing to Five-Star status and maintained it until 2025. For patients, a medical home means same-day and Saturday appointment availability. When our strep-throat-prone kid went to bed with the sniffles and woke up with a fever, we knew she could be seen, tested, and if needed, get the prescription that would help her feel better quickly.

Medical homes focus on prevention. The Family Medical Group nursing team kept our kids on-schedule for their immunizations, seamlessly coordinating vaccines during well-child visits. For the adults, they made sure we stayed on track with preventive care and screenings, all while supporting us through the challenges of raising kids and entering midlife.

The clinic team delivered the comprehensive primary care advocates describe as the gold standard: a true first point of contact, continuity of care, and coordination with specialists when we needed them.

When Optum, a subsidiary of UnitedHealth Group, bought Family Medical Group in 2021, the clinic was thriving. Just five years later, after 40 years of serving the neighborhood, it is closing its doors. So what happened? 

As a patient, I can say that things felt different after the acquisition. The toys and books that once welcomed children in the waiting room disappeared in a renovation that made the space look efficient and modern but no longer warm. The long-time receptionist, who displayed photos of her dog, departed and new staff didn’t display any personal touches. Perhaps the shift reflected the growing pressures taxing primary care everywhere: complicated quality measures; a surge in patient portal messages, and an ever-expanding burden of prior authorizations and appeals. Stagnant payment levels make it very hard to stay afloat in primary care.

Despite knowing all this, I thought Optum’s size might offer insulation against those pressures. The conglomerate’s vertical integration is designed to maximize efficiency, savings and profits in every part of the system. However, some analyses show that whatever savings they may get through expanding market share don’t translate to reduced costs overall.

As the Willamette Week’s reporting noted, Family Medical Group was a full practice with eight or nine clinicians as recently as January 2025. Now, just two remain, and they too, will be leaving in March. With wait times for new-patient appointments long and growing longer, no doubt many patients are scrambling to find new doctors; one lucky neighbor just told me her first appointment at a new clinic will be in May 2027.

Closures like this reflect systemic failures that demand strategic attention. We need a groundswell of pressure on policymakers to confront and fix these underlying problems, and we cannot wait. Right now in Salem, former Governor Kitzhaber’s House Concurrent Resolution 202 is under consideration as a way of framing the work ahead. It envisions accessible and affordable health care for every Oregonian by 2033. So much needs to happen between now and then, and primary care family physicians are ready to roll up their sleeves. Oregon’s legislators must vote for HCR 202. 

Betsy Boyd-Flynn has over 20 years of experience serving physician organizations and, since joining the Oregon Academy of Family Physicians in 2018, has helped to lead initiatives strengthening family medicine training, public health collaboration, and primary care advancement.