Primary Care and the Affliction of Internal Medicine

Abstract

The number, nature, and distribution of generalist physicians will be a focus of considerable attention as we restructure our health care system. Inner cities and rural areas have too few of them, growing health maintenance organizations find it increasingly difficult to hire enough of them, and progressively fewer graduating medical students are selecting careers in primary care. In internal medicine in particular, the generalist is becoming an endangered species. For nearly two decades, training programs in internal medicine have been producing more subspecialists than generalists, and the disproportion persists^1,2. To create sufficient numbers of general internists, it is . . .