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November 13, 1991

The Supply of Primary Care Physicians

Author Affiliations

Orange County Health Care Agency Santa Ana, Calif

Orange County Health Care Agency Santa Ana, Calif

JAMA. 1991;266(18):2561. doi:10.1001/jama.1991.03470180061030

To the Editor.  —The analysis provided by Politzer et al1 of the inadequate supply of primary care physicians glossed over the fundamental issue of the large income disparities among the medical specialties and made no significant recommendations regarding the resolution of this problem. Financial incentives to medical school graduates to select primary care careers, resident bonuses, and loan and interest forgiveness are insufficient strategies. As long as surgeons, radiologists, ophthalmologists, and other specialists continue to make, on average, double the annual income of primary care practitioners, those specialties will draw young physicians at the expense of the latter.2Average-income figures also do not convey another reality: the minority of physicians within these specialties who view their careers in medicine largely as a commercial enterprise and who garner incomes that are three, four, or five times the national mean. These poor role models offer medical students a distorted image