This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
The gap in median income between primary care physicians and specialists is well-publicized. Health care policy discourse that focused on this gap currently pits primary care physicians against all specialists. However, a number of specialists are also nonprocedural in that they derive the bulk of their income from evaluation and management. Nonprocedural specialties are experiencing the same economic disadvantages as primary care, with the resulting difficulty in attracting graduating US medical school seniors into the specialty. This predicts notable future workforce shortages unless there is a fundamental change in the financial incentives. There are strong financial incentives to focus on procedures rather than patient-centered care. To assure the availability of a balanced physician workforce, the availability of a full spectrum of expertise, and access of patients with chronic conditions to the appropriate physicians, health care financing must change the misaligned financial incentives and meaningfully close the income gap for both primary care and nonprocedural specialties.
Footnotes
Dr. Sigsbee, as President-Elect of the American Academy of Neurology, receives a stipend. The opinions are those of the author.
-
- CMS
- Centers for Medicare and Medicaid Services
- PPACA
- Patient Protection and Affordable Care Act
- RBRVS
- Resource-Based Relative Value Scale
- RUC
- Relative Value Scale Update Committee
- RVU
- relative value unit
-
Disclosure: The author reports no disclosures.
- Copyright © 2011 by AAN Enterprises, Inc.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
