Poor retention, not just recruitment, contributes to primary care shortage

To resolve shortages, the primary care field not only needs to attract more recruits, but also do a better job retaining them, indicates a new survey published in Journal of General Internal Medicine.

The study, conducted by the American College of Physicians (ACP) and the American Board of Internal Medicine (ABIM) to better understand mid-career attrition in internal medicine, found that 9 percent of all internists originally certified between 1990 and 1995 are no longer working in general internal medicine today, with general internists (17 percent) significantly more likely to leave than internal medicine subspecialists (4 percent).

The study also found that significantly fewer general internists (70 percent) than internal medicine subspecialists (77 percent) were satisfied with their career. Further, more general internists and internal medicine subspecialists who left internal medicine are satisfied with their career (87 percent) than those still working in internal medicine (74 percent).

Existing research suggests that general internists may be more likely to leave internal medicine due to a widening income gap between PCPs and many specialists, increasing demands, growing expectations and accountability for providing high-quality care, and payment based on the ability to perform in a challenging environment, according to a press release. Researchers also speculated that, in addition to dissatisfaction, the nature of general internists' work provided them with more opportunities outside of internal medicine and in to some non-medical fields.

For physicians who choose to persevere amid the myriad changes occurring in the country's healthcare system, embracing the business side of medicine will become imperative to survival, notes an editorial in the Washington Post. Joyce E.A. Russell, a Ralph H. Tyser distinguished teaching fellow at University of Maryland's Robert H. Smith School of Business, writes that post-reform, physicians will have to worry about negotiating, marketing and effectively communicating more than ever before, and recommends formal business education to help physicians hone these skills.

To learn more:
- read this article in The Medical News
- check out this press release
- read this JGIM abstract
- read this Washington Post commentary