Low pay, high expenses, 4th-class status plague primary care

LETTER — Posted June 20, 2005

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Regarding "Subspecialties flourish as IM residents shun primary care" (Article, May 16): As a general internist, I can tell you why the numbers are decreasing for primary care.

First: Declining reimbursement. When physician assistants, nurse practitioners, CT scan technicians and nuclear medicine technicians make more money than those in primary care, there is something wrong with the system.

Second: We are treated like fourth-class citizens by the specialists, insurance companies and the patients we try to help.

Third: Increasing costs of doing business, particularly the increase in liability premiums. (It's great. We testify against each other, and for what -- money.)

Fourth: Endless paperwork, most of which is unreimbursable.

Fix all this and they will come.

Brent Layton, MD, Claypool, Ariz.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/06/20/edlt0620.htm.

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