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U.S. Efforts to Boost Number of Primary Care Doctors Have Failed
Date:1/10/2013

ents and primary care, obstetrics and gynecology physicians, as well as the number of all other physicians trained.

The U.S. government provides hospitals almost $13 billion annually to help support medical residencies -- training that follows graduation from medical school -- according to study background information. Other funding sources include Medicaid, which contributes almost $4 billion a year, and the U.S. Department of Veterans Affairs, which contributes $800 million annually, as of 2008.

Together, the cost of funding graduate medical education represents the largest public investment in health care workforce development, the researchers said.

An earlier study, published in the December 2012 issue of the Journal of the American Medical Association, showed fewer residents are choosing primary care in the United States. Of third-year residents, only 21.5 percent were planning on becoming internists. Experts estimate that the nation will be short 50,000 primary care physicians in the next decade.

Chen said hospitals are likely to recruit specialty residents because their presence benefits their facilities. "Having residents in the hospital frees up the attending doctors to do more procedures, which increases revenue for physicians and for the hospital," she said.

What is driving the interest in medical specialties?

Dr. Perry Pugno, vice president for education at the American Academy of Family Physicians, said he thinks the trend is based on perceived quality of life. "Student interest in lifestyle has pushed the pendulum away from primary care," he said. "You can make more money and not work as hard. The income is somewhat a proxy for prestige too."

Pugno said he thinks the primary care situation is even worse than the numbers suggest. Many of the residents in primary care and internal medicine will go on to pursue specialties, such as cardiology or general surgery, he explained.

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