Author Affiliations: Division of General Internal Medicine, New York University School of Medicine, New York (Dr Schwartz); Uniformed Services University of the Health Sciences, Bethesda, Maryland (Dr Durning); Division of General Internal Medicine, Hennepin County Medical Center, Minneapolis, Minnesota (Dr Linzer); and Department of Medicine, University of California, San Francisco (Dr Hauer).
We appreciate the letter by Olson and Rosenbaum and share their encouragement regarding medical students' improved views of internal medicine careers in our study.1 We agree that narrowing the compensation gap between cognitive and procedural specialists is an important policy aim that might encourage more students to follow their values into generalist careers. However, it remains difficult to tease out the direct impact of income from the influence of work life, lifestyle, and prestige. We lack direct evidence that reducing the wealth gap would expand the primary care workforce. Nevertheless, as good internists, we are compelled to act despite the uncertainty and to carefully study its impact.
Schwartz MD, Durning S, Linzer M, Hauer KE. Medical Students’ Changing Views, Career Choice, and Primary Care Payment Reform—Reply. Arch Intern Med. 2011;171(19):1772-1773. doi:10.1001/archinternmed.2011.489