Nothing that hasn’t been discussed here recently:

In 2005, for example, Medicare paid a typical primary care provider practicing in Chicago, Ill, $89.64 for a typical, half-hour office visit for a patient with a moderately complex condition (CPT code 99214). That same year in the same city, Medicare paid $226.63 to a gastroenterologist taking the same amount of time to perform a colonoscopy in an outpatient department and $422.90 to do it in a private office . . .

. . . The resulting income gap between specialists and primary care providers has serious consequences. Primary care providers may resort to shorter patient visits, with adverse affects on the satisfaction and well-being of their patients. Medical students carrying heavy student-loan burdens shun primary care careers, increasing the pressures on already overburdened primary care practitioners. And health care costs continue their relentless rise.