TY  - JOUR
T1  - THe chasm between intention and achievement in primary care
AU  - Baron RJ
Y1  - 2009/05/13
N1  - 10.1001/jama.2009.558
JO  - JAMA
SP  - 1922
EP  - 1924
VL  - 301
IS  - 18
N2  - 
Reuben put it well: “Primary care is on death row.”1 A total of 21% of general internists are leaving that practice sometime in the first 10 years after completing training,2 and only 6.7% of all 2007 US medical school graduates are choosing family medicine or ambulatory internal medicine.3 The net loss is worrisome because robust primary care seems to be an important component of high-performing health systems.4 Enhancing primary care through such models as the patient-centered medical home has been proposed as an important if incomplete part of US health system redesign.5 Explanations offered in both professional6 and popular7 media for the disappearance of primary care physicians have focused on salary or income differentials between primary care physicians and their specialty colleagues, differentials that in some markets have reached a factor of 3. While higher primary care incomes would be helpful, at least as large a problem affecting primary care is the lack of capacity to perform successfully the work of a generalist.

SN  - 0098-7484
M3  - doi: 10.1001/jama.2009.558
UR  - http://dx.doi.org/10.1001/jama.2009.558
ER  -