Health outcomes in health provider shortage areas (HPSA) are often worse than those in non-health provider shortage areas. To understand this difference, I examine practice patterns amongst primary care providers in an HPSA and a non-HPSA, using Utica and Boston as case studies, respectively. While there has been a wealth of research on the differences between patients in these two designations, the research on providers has largely focused on motivations to work in HPSAs (Ferguson et. al, 2009, Liu, 2007, Schlack et. al, 2022, & Rereddy, Jordan, Moore, 2015). To fill the gap in provider patterns in HPSAs and non-HPSAs, this study explores how these two groups of providers interact with patients, insurance companies, and bureaucracy, as well as their experiences of burnout. Drawing on in-depth interviews (n=14), I find that providers across designations share many of the same issues concerning the healthcare system including fear of medical malpractice attitudes, heightened burnout, diminished career satisfaction, and frustrations with insurance bureaucracy. However, these groups notably differ in three key areas: patient transportation, changes in visit length, and cultural competency training. Additionally, while HPSA providers often alluded to the shortage of specialists, non-HPSA providers spoke to the beginnings of a primary care provider shortage that may not be felt as directly in Utica due to the prevalence of allied healthcare professionals. These findings highlight the need for further research into the reasoning behind the growing PCP shortage in Boston, as well as the need for policy remedies for shared concerns about the increasingly complicated field of primary health care.

Type of Work

Thesis - Limited Access

Department or Program



Hamilton College


Bachelor of Arts

Date of Graduation


Faculty Advisor

Matthew Grace

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.