Editorial

Primary Care Challenges and the Educational Pipeline in the 21st Century

Authors: Arturo Loaiza-Bonilla, MD, Mark Edward Butt, MSEd

Abstract

Primary care is considered an essential element of a highly developed health delivery system. Accumulated evidence derived from population studies consistently shows that a highly functioning primary care system, when used at its optimum capacity, provides affordable health care, improved quality of life and accessibility, and decreased disease burden and mortality.1,2

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q2005;83:457–502.
 
2. Starfield B. The future of primary care: refocusing the system. N Engl J Med 2008; 2091;359:2087, 2091.
 
3. Chronic Disease Prevention and Health Promotion. CDC. Available at: http://www.cdc.gov/chronicdisease/resources/publications/index.htm. Accessed September 10, 2010.
 
4. Thorpe KE, Ogden LL, Galactionova K. Chronic conditions account for rise in Medicare spending from 1987 to 2006. Health Aff (Millwood) 2010;29:718–724.
 
5. American Association of Medical Colleges “AAMC Releases New Physician Shortage Estimates Post-Reform” Available at: http://www.aamc.org/newsroom/presskits/mdShortage1.pdf Accessed September 30, 2010.
 
6. Record J, Beasley B, McDonald FS, et al. Major concerns about internal medicine: insights from program directors. South Med J 2011;104:89–94.
 
7. Kirch DG. How to fix the doctor shortage. Wall Street Journal, January 5, 2010.
 
8. Salsberg E, Rockey PH, Rivers KL, et al. US residency training before and after the 1997 balanced budget act. JAMA 2008;300:1174–1180.
 
9. Hauer KE, Durning SJ, Kernan WN, et al. Factors associated with medical students' career choices regarding internal medicine. JAMA 2008;300:1154–1164.
 
10. Brotherton SE, Etzel SI. Graduate medical education, 2008–2009. JAMA 2009;302:1357–1372.
 
11. Advance Data Tables: 2010 Main Residency Match. National Resident Matching Program. Available at: www.nrmp.org/data/advancedatatables2010.pdf. Accessed July 20, 2010.
 
12. Baron RJ. What's keeping us so busy in primary care? A snapshot from one practice. N View Full Text | PubMed | CrossRef
 
13. Newton DA, Grayson MS, Thompson LF. The variable influence of lifestyle and income on medical students' career specialty choices: data from two U.S. medical schools, 1998–2004. Acad Med 2005;80:809–814.
 
14. Bland CJ, Meurer LN, Maldonado G. Determinants of primary care specialty choice: a non-statistical meta-analysis of the literature. Acad Med 1995;70:620–641.
 
15. Weeks WB, Wallace AE. The more things change: revisiting a comparison of educational costs and incomes of physicians and other professionals. Acad Med 2002;77:312–319.
 
16. American Academy of Family Physicians. “Statement on Medical Student Debt” Available at: http://www.aafp.org/online/en/home/policy/federal/issues/workforce/debt/statements.html. Accessed August 17, 2010.
 
17. Kahn MJ, Markert RJ, Lopez FA, et al. Is medical student choice of a primary care residency influenced by debt? MedGenMed 2006;8:18.
 
18. Schwartz MD, Linzer M, Babbott D, et al. Medical student interest in internal medicine. Initial report of the Society of General Internal Medicine Interest Group Survey on factors influencing career choice in internal medicine. Ann Intern Med 1991;114:6–15.
 
19. Rosenblatt RA, Andrilla CH. The impact of U.S. medical students' debt on their choice of primary care careers: an analysis of data from the 2002 medical school graduation questionnaire. Acad Med 2005;80:815–819.
 
20. Ebell MH. Future salary and US residency fill rate revisited. JAMA 2008;300:1131–1132.
 
21.Coster H. The best and worst-paying jobs in America. Forbes, May 25, 2010.
 
22. Robeznieks A. MGMA report shows increase in physician placement, pay. Available at: http://www.modernhealthcare.com, June 3, 2010. Accessed August 20, 2010.
 
23. Meyers DS, Clancy CM. Primary care: too important to fail. Ann Intern Med 2009;150:272–273.
 
24. American Medical Association. Report 8 of the report of the council on medical education (a-10) “Enhancing primary care as a medical career choice.” June 2010. Available at: www.ama-assn.org/ama1/pub/upload/mm/377/cme-rep8–a10.pdf. Accessed September 2, 2010.
 
25. Rittenhouse DR, Shortell SM. The patient-centered medical home—will it stand the test of health reform? JAMA 2009;301:2038–2040.
 
26. Carney PA, Eiff MP, Saultz JW, et al. Aspects of the patient-centered medical home currently in place: initial findings from preparing the personal physician for practice. Fam Med 2009;41:632–639.