Running in place: The uncertain future of primary care internal medicine

[摘要] The future of primary care internal medicine physicians is uncertain. Accordingto a 2018 survey of internal medicine residents conducted by the American College ofPhysicians, only 11% were considering primary care as a career path.1 In 1998, that numberwas 54%.Possible reasons are many:• Lower pay compared with subspecialists ina pay system that rewards procedural competency over mental effort• Work schedules less fl exible than in otherspecialties (eg, hospital medicine practitioners may have 1 week on and 1 week off)• Perceived lack of respect• Increasing regulatory and record-keepingburdens• Tyranny of 15- to 20-minute appointments(irrespective of patient complexity)• Scope-of-practice concerns as other providers seek primary care equivalency status (eg, pharmacists, walk-in clinics, advanced practice providers, telemedicineproviders).

[学科分类] 卫生学