April 2, 2008

21st-Century Primary CareNew Physician Roles Need New Payment Models

Author Affiliations

Author Affiliations: Greenhouse Internists PC, Philadelphia, Pennsylvania (Dr Baron); and American Board of Internal Medicine, Philadelphia (Dr Cassel).

JAMA. 2008;299(13):1595-1597. doi:10.1001/jama.299.13.1595

Primary care medicine is in search of redefinition. Prevalent payment modes have undermined traditional models and reduced workforce interest while some functions of primary care are emerging in new incarnations. Payers find physicians “too expensive” for basic primary care services, and young physicians find their earnings expectations greater than primary care careers can offer. Understanding these market forces could lead to better understanding of required physician expertise within the larger framework of primary care. A more explicit definition of that expertise could lead to more appropriate market valuation of physician services.

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