Murmurs: It’s Hard to Find a Doc in Portland

IT’S HARD TO FIND A DOC IN PORTLAND: “Secret shoppers” pretending to be on Medicare insurance plans tried to set up primary care appointments in four cities: New York, Los Angeles, Chicago and Portland. Overall, they found that 77% of the clinics in the four cities accepted new Medicare patients. But there was an outlier: Portland. Just 35% of the clinics contacted in the city accepted new Medicare patients. Meanwhile, among clinics that did accept new patients, median wait times in Portland were higher than normal—61 days, compared with just eight days in New York City. The study published this week in Health Affairs Scholar by several academic researchers, including from Oregon Health & Science University, underscores that, for certain groups of people at least, it is markedly more difficult to get primary care in Portland than in other major cities. The reasons are not completely clear, but, notably, it’s not for a lack of docs. Researchers say Portland has a similar number of primary care clinicians per capita as other cities in the study. One big difference, they note, is market consolidation. A notably high 60% of primary care clinics in Oregon are affiliated with large health systems—which, one theory suggests, might feel less incentive to respond to market demands. “If I were a leader at the state level, at the local level, I would be really interested in trying to understand why Portland is such an outlier,” says Dr. Jane Zhu, an OHSU researcher on the project.

PPS PLANS TO CLOSE SEVERAL SCHOOLS BY FALL 2027: Portland Public Schools could close five to 10 of its 74 elementary, K–8, middle, and alternative schools by the start of the 2027–28 academic year, Superintendent Dr. Kimberlee Armstrong said at a March 10 press conference. In an early timeline presented to the Portland School Board, the district plans to engage families through spring, summer and fall before Armstrong makes her recommendations on a list by late fall 2026. The School Board will need to approve or modify that recommendation by the end of the year, and the district will iron out transition processes through the first half of 2027. The consolidations come as PPS has seen its enrollment decline 12%, from 48,708 in the 2018-19 school year to 42,622 in the current academic year. Projections indicate enrollment could fall another 12% by the 2035–36 academic year. Declining enrollment is a key factor in PPS’s string of budget deficits, and will likely play a role in informing which schools are chosen for closure. (Case in point: District officials did not consider schools with enrollments under 300 for seismic improvements with May 2025 bond funds.) PPS will consider many other factors in the process, including where multifamily housing might be most available in the future and school facility concerns, Armstrong said. Many national education researchers have said school closures often don’t save districts much money unless staffing is also condensed during the process. “It’s not millions of dollars that are saved from closing a school,” Armstrong said, nodding to that reality. Instead, closing schools presents “the opportunity to optimize school communities and make sure our schools are well resourced, and that we’re able to provide things for all of our schools in a way that responds to the needs of the students.”

COUNCIL RETREAT TURNS INTO WISHCASTING: During a seven-hour “priorities-setting” discussion on Saturday led by a Texas consulting firm, Portland city councilors spoke mostly about hopes and dreams, despite facing a difficult budget year in which they will likely be forced to cut millions from current programs and services. Little, if any, discussion addressed the difficult question of what councilors would seek to cut when faced with a general fund budget shortfall that’s estimated to exceed $100 million. When asked to list “success measures” for each of the six overlapping top priorities set early on in the retreat (public safety, housing-homelessness, the economy, core services/delivery systems, sustainable infrastructure, and quality of life/transportation), councilors instead gave answers of varying scales and specificity. Take public safety, for instance. Councilors tossed around such success measures as improving 911 and police response times, solving crimes, disaster preparedness and the ability to rebuild after a natural disaster, sending the right responder to the right call type, increasing public trust, and doing no harm. Speaking on background to WW, councilors shared differing thoughts about the retreat. Some said the discussion was too superficial and unrealistic given the city’s actual budget constraints. Others said it felt productive, even if only because it forced councilors who disagree to sit down and talk to one another. And some said the facilitators knew too little about the depth of divisions on the council to actually push it toward hard conversations. The city could not immediately provide a cost estimate for the retreat, saying it’s awaiting the final bill from the contractor.

PPS SCRAMBLES TO PATCH MIDYEAR DEFICIT: Portland Public Schools announced in late February an unexpected $10 million gap in its budget for the current academic year, which it later upped to $14 million. In finding ways to patch it, Superintendent Dr. Kimberlee Armstrong announced a first phase of changes to PPS central office staff in a districtwide email on Monday. Armstrong herself will take six furlough days and senior-level staff, directors and managers will take five furlough days, resulting in about $1.2 million in savings. But the district will need buy-in from six labor unions for multiday furloughs to make ends meet, and confidence in the administration appears to be dwindling within its largest union. PPS has offered the Portland Association of Teachers a choice between four furlough days or hundreds of layoffs, the union said in a March 9 statement. The teachers union, which is also currently engaged in contract negotiations, indicated they will conduct an independent analysis of PPS’s finances. “Our trust in PPS’s ability to navigate their financial realities has been broken, and our good faith feels taken advantage of,” the statement reads. Michelle Morrison, the district’s chief financial officer, added Tuesday morning that she expects the midyear deficit will have consequences for the $50 million budget shortfall the district faces next year. “We do expect that number to grow,” Morrison said. “We haven’t identified anything beyond that $50 million yet…but that is the floor at this point.”