Federally qualified health care facilities continue to struggle to staff themselves with enough primary care physicians and other clinical professionals — and patients are paying the price.

Understaffed facilities are linked to many medical nightmares, from higher health care costs to (in rare cases) fatal medical errors. The problem hits rural and low-income areas the hardest.

One pediatric nurse quit her job when her “short-staffed” facility repeatedly compromised her ability to provide proper care.

One area plagued by a doctor shortage is Health Center Partners of Southern California. The health network of 17 organizations and 126 sites is about 50 primary care doctors short — yet the patient population continues to grow.

CEO Henry Tuttle said the challenge of recruiting primary care physicians has always been there and “it’s getting worse.”

“When care reimbursement equations call for higher rates for specialty services, it also tends to drain what was originally available in the primary care pool. Physicians who come through training … select a specialty rather than to stay in primary care,” Tuttle told Modern Healthcare.

The Kaiser Family Foundation (KFF), a leader in health policy analysis and health journalism, issued a report last year about the difficulty of recruiting enough medical professionals.

“Over 58 million Americans reside in geographic areas or belong to population groups that are considered primary care shortage areas,” the organization said. “The proportion of Americans living in HPSAs varies widely by state, from 1.4 percent (Nebraska) to 57.3 percent (Mississippi), but in almost half the states, it is at least 20 percent, including six states (including D.C.) where it exceeds 30 percent.”

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KFF expects the demand for primary care to rise over the next five years, “due largely to population growth and aging, and to a smaller extent, expanded health insurance.”

“The Health Resources and Services Administration (HRSA), the federal agency focused on improving access to care and strengthening the health care workforce, projects a shortage of 20,400 primary care physicians in 2020. Other experts, too, have projected a large shortfall in the coming years,” the foundation said.

Another patient didn’t get the diagnostic test that was needed.

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In some cases, the consequences of understaffed medical facilities are dire.

More than 250,000 Americans die from medical mishaps each year, according to a recently published Johns Hopkins study. That would rank medical errors as the third leading cause of death on the Centers for Disease Control and Prevention’s official list — just behind heart disease and cancer.

Dr. Marty Makary, professor of surgery at Johns Hopkins University School of Medicine and author of the study, said some mishaps stem from “poorly coordinated care and patient handoffs” — something health care professionals have experienced when the patient-to-doctor ratio is off-balance.

Beth Ann Schwamberger of Pittsburgh, Pennsylvania, told Health Line she quit her job as a pediatric nurse when her “short-staffed” facility repeatedly compromised her ability to provide proper care.

“Most nights on the job, I felt unable to provide my patients the high-quality care they deserved because of being short-staffed and having access to under-trained residents as our primary point of contact,” Schwamberger said.

She also admitted that during a night shift, one patient didn’t get the diagnostic test that was needed. Another patient was not placed in intensive care due to a lack of space, Health Line reported.