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May 2, 2011

Sustaining Excellence in Pediatric Care

Author Affiliations

Author Affiliations: Department of Pediatrics, Harvard Medical School, and Division of Respiratory Diseases, Department of Medicine, Children's Hospital Boston, Boston, Massachusetts.

Arch Pediatr Adolesc Med. 2011;165(5):388-391. doi:10.1001/archpediatrics.2011.36

Concern about the shortage of primary care physicians in the United States has increased with the signing into law of the Affordable Health Care for America Act in March 2010.1 Susan Dentzer, editor-in-chief of Health Affairs, wrote in the May 2010 issue that “the nation's system of primary care is horribly broken, the victim of underinvestment, misaligned incentives, and malign neglect.”2 Indeed, less than one-third of physicians now work in primary care,3 which has led to disruptions in access to health care and the quality of care given. In 2007, the Massachusetts Medical Society4 reported that patients were waiting longer to see physicians and that teaching and community hospitals were finding it necessary to adjust the level of services provided because of physician supply problems, even though the physician to patient ratio in Massachusetts was and remains the highest in the country.5 Despite the growing need, fewer and fewer medical school graduates express interest in pursuing a career in primary care medicine.6