I recently described the loathsome “relative value unit” (RVU) and its role in the decline in prestige and pay in primary care.  The RVU is maintained and updated by a small panel of 31 physicians called the Specialty Society Relative Value Scale Update Committee (RUC).  Twenty-seven of the 31 physicians are specialists, which is not at all representative of the physician workforce, given that primary care doctors comprise over one third of ...

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Prestige in medicine often follows research. Physician-scientists who do basic science research have often been considered among the giants of medicine. As the field of medicine advanced, the gap between what we knew from basic science and how we practiced grew. This created a need for more translational researchers: physicians who could bring what they knew from the laboratory bench to the bedside through large clinical trials. Now, the next great gap ...

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Much of the news we hear about primary care is disheartening at best, frightening at worst. Most of us have heard that there is a shortage of primary doctors, and with over seven million new patients enrolled (and counting) through Obamacare health exchanges, that shortage is going to get much worse. On the horizon, while medical schools are increasing their enrollment, there continues to be a dearth of students willing to apply ...

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When I came to medical school, I was certain I wanted to do primary care.  Despite the forces that steer many of us off the path – how many times have we heard, “but you’re too smart to do primary care!”? – after three years of medical school, I was still committed to primary care. But I struggled with which type of program would be best for me. I applied to both ...

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