ACP: Residency match results demonstrate need to address national primary care workforce goals

March 19, 2009

For each of the past two years, the number of U.S. medical students choosing internal medicine residencies has decreased by approximately 1 percent from the previous year.

According to the 2009 National Resident Matching Program report, 2,632 U.S. seniors at medical schools enrolled in an internal medicine residency program -- down from 2,660 in 2008 and 2,680 in 2007.

"Although the year-to-year decrease is seemingly small, these numbers are particularly striking when compared with 3,884 U.S. medical school graduates who chose internal medicine residency programs in 1985," said Steven E. Weinberger, MD, FACP, senior vice president for medical education and publishing, American College of Physicians (ACP). "We are witnessing a generational shift from medical careers that specialize in preventive care, diagnostic evaluation, and long-term treatment of complex and chronic diseases, to specialties and subspecialties that provide specific procedures or a very limited focus of care."

The 2009 match numbers include students who will ultimately specialize in general internal medicine and provide primary care, as well as those who will enter a subspecialty of internal medicine, such as cardiology or oncology. Currently, approximately 20 to 25 percent of internal medicine residents eventually choose to specialize in general internal medicine, compared with 54 percent in 1998.

"This transition is happening at a time when America's aging population is increasing, and the demand for general internists and other primary care physicians will continue to grow at a much faster rate than the primary care physician supply," said Dr. Weinberger.

The Institute of Medicine recently announced that the U.S. needs 16,000 more primary care physicians just to meet the needs of currently underserved areas. The shortage will grow to 40,000 or more physicians, assuming current rates of health insurance coverage, according to two recent studies.

"Because it takes a minimum of seven years to train a primary care physician -- medical school and residency combined -- we need to expand the internal medicine workforce and reform our health care system so that young physicians are encouraged to choose primary care medicine as a career," said Dr. Weinberger. "ACP has long been concerned about the rising cost of medical education and resulting financial burden on medical students and residents, particularly for those choosing careers in internal medicine, who will find it difficult to repay these debts."

ACP has consistently called for reform of Medicare payment policies so primary care physicians can receive reimbursement that is commensurate with the value of their contributions.

"Reducing existing payment disparities would make internal medicine more attractive and increase the number of physicians entering and continuing to practice in primary care specialties," said Dr. Weinberger. "President Obama himself said at the White House Health Care Summit, 'we have to produce more primary care physicians.'"

In February, ACP called on President Obama to issue an Executive Order to assure that all federal agencies are working together to set primary care workforce goals and the policies necessary to achieve them. Expanding the primary care workforce goes hand-in-hand with access to affordable health insurance coverage -- a goal that ACP supports.

"Giving all Americans an insurance card will not guarantee that everyone will have access to care," said Dr. Weinberger. "There are not enough primary care physicians to care for them."

In November, ACP released a white paper documenting the value of primary care by reviewing 20 years of research. An annotated bibliography based on a literature review of more than 100 studies documents the evidence to support the critical importance of primary care in providing patients with better outcomes at lower cost, and the urgency of the need to prevent shortages of primary care physicians.
The American College of Physicians is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 126,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection and treatment of illness in adults.

American College of Physicians

Related Primary Care Articles from Brightsurf:

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Continuity of English primary care has worsened with GP expansions
A new study published by the British Journal of General Practice has found that patients' abilities to see their preferred GP has fallen greater in English practices that have expanded, compared with those that stayed about the same size.

Primary care office-based vs telemedicine care visits during COVID-19 pandemic
This observational study quantified national changes in the volume, type and content of primary care delivered during the COVID-19 pandemic, especially with regard to office-based visits compared with telemedicine encounters.

Expenditures for primary care may affect how primary care is delivered
This study looks at trends in out-of-pocket and total visit expenditures for visits to primary care physicians.

Primary care clinicians drove increasing use of Medicare's chronic care management codes
To address the problem of care fragmentation for Medicare recipients with multiple chronic conditions, Medicare introduced Chronic Care Management (CCM) in 2015 to reimburse clinicians for care management and coordination.

Primary care at a crossroads: Experts call for change
Primary care providers have experienced a rise in responsibilities with little or no increase in the time they have to get it all done, or reduction in the number of patients assigned to them.

Primary care physicians during the COVID-19 epidemic
Scientists from the University of Geneva has analysed clinical data from more than 1,500 ambulatory patients tested for COVID-19.

The five phases of pandemic care for primary care
The authors present a roadmap for necessary primary care practice transformations to care for patients and communities during the COVID-19 pandemic.

Women almost twice as likely to choose primary care as men
Analysis of osteopathic medical school survey data reveals women are 1.75 times more likely to choose primary care than men, according to a study in The Journal of the American Osteopathic Association.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

Read More: Primary Care News and Primary Care Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to