Audit Scotland, which conducted a study on underpressure services, claims health chiefs have "failed to deliver".
They say a seven-year-old plan to tackle GP workload and improving patient care has not been fulfilled.
The watchdog's report reveals: The estimated number of wholetime equivalent GPs has fallen.
Pressure on GP practices has increased.
Proposals to support GP teams with more nurses, physiotherapists and other specialists have moved more slowly than planned.
Patients are finding it more difficult to access care.
The strongly-worded report states: "The Scottish Government has not set out how it intends to invest in general practice over the medium term. It is unlikely to hit its target of 800 more GPs by 2027.
"Spending on general practice has fallen in recent years. Between 2021-22 and 2023-24 it decreased by six per cent in real terms, putting more pressure on practices."
Last night campaigners and opposition MSPs demanded urgent action to rebuild GP services. A spokeswoman for the Rebuild General Practice campaign said: "The report helps shine a light on the crisis. The government needs to create a plan to retain the GP workforce, release fair funding as part of the wider NHS, and give GPs greater freedom and autonomy to do our jobs."
Scots Lib Dem leader Alex ColeHamilton said: "GPs feel burnt out, overwhelmed and under immense pressure. If the chance comes to leave, they're keen to take it. Scottish Liberal Democrats have repeatedly urged SNP ministers to address the crisis. Our efforts secured £14million more for general practice but this report makes clear a lot more needs to be done."
Audit Scotland chiefs said the effects of Covid lockdown were still being felt among GPs.
Stephen Boyle, Auditor General for Scotland, said: "The pandemic pushed back plans for general practice. But new delivery deadlines were missed and there's not been enough transparency on progress.
"The Scottish Government needs to clarify its plan and set out the actions, timescales and costs to deliver it." In 2017, the Scottish Government pledged an extra 800 GPs by 2027. To date only 135 have been added but with many GPs no longer working full-time the net effect is a loss of 67 whole-time equivalent GPs.
Boyle's report also states: "There is a lack of clarity about investment in the medium term. ...