According to the Journal of the American Medical Association, only 2 percent of medical students are entering primary care internal medicine.

A fourth year medical student gives some reasons why in a Baltimore Sun op-ed:

Like many medical students, I proudly wear Obama T-shirts and yearn to reform medicine. While watching the president speak, I envision myself working in primary care, on the vanguard of health care reform.

Then, a little later, reality hits.

That reality involves staggering medical school debt, where numbers show that 40 percent of students graduate with debt in excess of $140,000.

And it’s not all about the money. Combined with the fact that the burnout rate is higher in primary care, along with the onerous paperwork and bureaucracy requirements, it’s no wonder why students are avoiding primary care.

A paltry increase in pay isn’t going to stem the medical student tide towards specialty practice.

And to those who suggest that mid-level providers can help with the shortage of primary care doctors, think again. They are not immune to the same economic incentives, and indeed, we’re seeing physician assistants and nurse practitioners gravitate specialists’ offices as well.