Study: Pay Pushed Drop in Primary Care Physicians
The percentage of medical students choosing careers in primary care or family medicine over specialties significantly has dropped in recent years, according to a study released Feb. 20 by researchers from UC-San Francisco, the San Francisco Business Times reports.
Thomas Bodenheimer, a UCSF professor and lead author of the study, said the situation is largely caused by a growing income gap between primary care physicians and specialists. He added, "Payment reform to narrow the income gap is essential if the United States is to maintain a good primary care base and a cost-effective health care system."
According to the study, medical specialists earn nearly twice as much as primary care physicians for working the same amount of hours.
Bodenheimer said several factors are causing the widening gap, including an increased volume of specialty services, such as diagnostic and other imaging procedures. He also blames the disparity on the failure of the "resource-based relative value scale," or RBRVS, a system founded in 1992 to decrease the gap in physician compensation.
Bodenheimer says the system failed partly because the process for reviewing and updating physician fees is strongly influenced by a committee of the American Medical Association that is composed mostly of specialists.
Bodenheimer says that short-term strategies for decreasing the gap include changing the composition of the AMA review committee and urging Medicare to take action. His long-term proposals include pay cuts for specialists and possibly shifting to a system of prepaid-per-patient charges rather than fee-for-service (Rauber, San Francisco Business Times, 2/23).