How do the current disparities in physician payment rates, which are substantially lower for primary care physicians and general surgeons, contribute to the shortage of these physicians?
Our nation’s insidious policies deter medical students and residents from pursuing careers in primary care and general surgery. Studies indicate that income disparities have a significant negative impact on the choice of medical specialties. The incomes of most subspecialists are nearly three times that of a primary care physician. The instability of the physician payment system stemming from the flawed sustainable growth rate formula (SGR) results in the threat of annual cuts triggered by the SGR. This unpredictability forces primary care practices with limited revenues and narrow margins to make difficult decisions about whether to lay off staff, reduce their Medicare patient population, defer investments or opt for early retirement. General internists are already retiring earlier than other physician specialties at the same time that fewer medical students and residents are choosing primary care. Stabilizing the payment system to accurately reflect the cost and value of providing ca
