Thursday, July 05, 2007

Male Physicians Leaving Primary Care

According to the Center for Studying Health System Change, it seems men are leaving primary care for specialites like cardiology and dermatology, while women are heading towards primary care. Also, one in four primary care physicians are international medical graduates.
An exodus of male physicians from primary care is driving a marked shift in the U.S. physician workforce toward medical-specialty practice, according to a national study by the Center for Studying Health System Change (HSC). Two factors have helped mask the severity of the shift—a growing proportion of female physicians, who disproportionately choose primary care, and continued reliance on international medical graduates (IMGs), who now account for nearly a quarter of all U.S. primary care physicians. Since 1996-97, a 40 percent increase in the female primary care physician supply has helped to offset a 16 percent decline in the male primary care physician supply relative to the U.S. population. At the same time, primary care physicians’ incomes have lost ground to both inflation and medical and surgical specialists’ incomes. And women in primary care face a 22 percent income gap relative to men, even after accounting for differing characteristics. If real incomes for primary care physicians continue to decline, there is a risk that the migration of male physicians will intensify and that female physicians may begin avoiding primary care—trends that could aggravate a predicted shortage of primary care physicians.
Thanks to CMS, we can count on further shortages.



heartsaver said...

My name is Juan Rivera - Cardiology fellow at Johns Hopkins. I write a monthly column for Today in Cardiology and this month's column is on medical blogging. I operate a cardiovascular prevention blog for Hispanics, Corazon Hispano.

I just want to let you know that as part of the article I included a short list of recommended medical blogs. I included yours. Some people like to know when their blog is mentioned in an article, press release etc. I am letting you know since you are in the Cardiology field and TIC is obviously a Cardiology newspaper. You can read it by going to or just by waiting for the newspaper to come out.

- Juan Rivera

DrWes said...

Thanks for the mention. Nice job on your blog, Corazón Hispano. Added a link to it in my side-bar.

Medicienne said...

Dr Wes,
I am a prospective primary care IM resident.
I have always been interested in primary care medicine in India where I went to medical school. I moved here for family reasons and while building up my application for residency, most of my mentors advised me to give a thought to specialties other than this. Primary care seems to be 'looked down upon' over here and it is disappointing sometimes when people stereotype it as 'frustrating' and 'non-competitive'. Some even said this specialty is going to be wiped out as PAs and RNs take over.
What is the reason for such differences in the status of PCPs and specialists in the US?
Is there a future of this specialty?

DrWes said...


Some of the brightest and most talented physicians I know are primary care internists. I, personally, do not think primary care physicians are "looked down upon." After all, they are balancing a multitude of issues in the sickest patient populations. But the reality is that primary care internists do not have as many procedures that pay at higher reimbursement rates ("high RVU procedures"), and with declining Medicare reimbursements, this puts particular pressure on internists to make ends meet, especially when practice expenses consistently increase.

Follow your passion, not the media, and you'll do well, irrespective of your eventual specialty.