• Government
• Profession
• Business
• Opinion
• Health

• Health reform
• H1N1
• P4P
• EMRs
• Medicare
• Liability
• AMA House
• » More

• Book Excerpt
• Business Pitch
• Meetings
• » More

• Contract Language
• Ethics Forum
• In the Courts
• Practice Management
• Technically Speaking
• » More

• Issue dates
• Regions
• Health plans
• Sections
• News briefs
• Columns
• Editorials
• Letters
• Writers
• Other years

• Search tips
• E-mail alert
• Radio
• RSS
• Mobile
• Subscribe
• Institutions
• Staff directory
• Advertising
• Permissions
• Reprints
• News media
• Site guide
• Useful links
• About
• Premium
• Contact

Primary care matches down again; fourth year of decline worries some

Experts attribute the falling numbers in part to HMOs' easing restrictions on patient access to specialists and growing job opportunities in subspecialty areas.

By Jay Greene, amednews staff. April 9, 2001.

• PRINT|
• E-MAIL|
• RESPOND|
• REPRINTS|
• SHARE

Primary care residency matches are down for the fourth straight year, while subspecialties such as anesthesiology and pathology are scoring double-digit percentage increases.

Growing job opportunities for specialists, along with a belief that medical school debt can be retired more quickly with higher specialty income and a lack of financial incentives to practice primary care, appear to be driving the trend toward more subspecialty training.

One reason for the decline in primary care is that there appears to be more job opportunities in subspecialty areas, said Jordan Cohen, MD, president of the Assn. of American Medical Colleges. "Managed care also has eased restrictions on patients' seeing specialists, and that has made specialties more attractive," he said.

But the continued drop in primary care matches is causing alarm for those who believe the demand for generalist physicians will increase in the future.

"A growing and aging population suggests there is a greater need for more primary care doctors," said Herbert Waxman, MD, senior vice president for medical education, American College of Physicians--American Society of Internal Medicine. "A shrinking pool of primary care doctors with an increase in chronic disease is a bad combination for the future."

In 2001, the total number of primary care residency matches, including international medical graduates, decreased 3.8% to 9,701 from 10,067 in 2000, according to data released late last month by the National Residency Matching Program and the Assn. of American Medical Colleges. As a consequence, 52.8% of all students chose primary care in 2001 compared with 54.7% in 2000. [...]