Subsidizing graduate medical education programs that favor primary care physicians is ineffective in growing ranks of PCPs, according to an analysis published by the Brookings Institution, a centrist think tank based in Washington, D.C.
As healthcare reform calls for more primary care physicians, the nation's current workforce skews too heavily toward specialists. Medicare funding for GME programs that favor primary care has not injected the needed ranks of PCPs into the workforce, according to the analysis. Instead, GME incentives are outweighed by incentives baked into the Medicare fee schedule — relative value units — that have created a significant pay gap between PCPs and specialists.
Addressing this issue is not easy — paying PCPs more would increase Medicare spending, while lowering specialist payments would be difficult to implement. The authors recommend Medicare rely less on the physician fee schedule to compensate PCPs or make budget-neutral adjustments to it. They also note that loan forgiveness programs for residents who choose primary care is a promising option.
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