This blog has consistently sounded the death throes of primary care – and the ivory tower academics don’t seem to get it. John Black sounds of on the many issues leading to the death of the profession:

Primary care is dying, and those in the ivory towers need to start beating the drum. One cannot tell the true vitality of internal medicine by what one saw and heard in San Diego. For one thing, probably more than half of the members of the ACP are subspecialists, not general internists. We can continue to have a dynamic annual meeting of the ACP, even if no general internists ever came to it again. True, the ACP did author “The Impending Collapse of Primary Care” and came up with the Advanced Medical Home concept. However, only 11% to 15% of third-year internal medicine residents are going into general internal medicine, and the vast majority of internal medicine residents are becoming hospitalists, not outpatient physicians.

His solution?

Separate the evaluation and management (E/M) coding for general outpatient internal medicine and family medicine from other E/M coding, and double the reimbursements. This is basic supply and demand. No one will do the job, no matter how needed, if the pay is too low to cover overhead. And make a decent salary commensurate with one’s training and skills.

The bottom-line: make primary care more attractive to medical students. And whether you like it or not, the hard truth is that money speaks volumes.

Health Care Renewal with more doom and gloom.