The State of Primary Care/DR. BODENHEIMER REPLIES

With American medical-school graduates showing a decline in interest in primary care residencies and practices, IMGs are increasingly the "safety net," satisfying the staffing needs of practices and community health centers throughout the country.1 In the 1990s, with an oversupply of physi...

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Bibliographic Details
Published inThe New England journal of medicine Vol. 355; no. 24; p. 2595
Main Authors Chretien, Jane H, Das, Rohit R, Moorthi, Ranjani N, Kathleen Lent Becker
Format Journal Article
LanguageEnglish
Published Boston Massachusetts Medical Society 14.12.2006
Subjects
Brain drain
College students
Family physicians
Health care policy
Health facilities
Health maintenance organizations
HMOs
Hospitals
Internal medicine
Nurse practitioners
Nursing
Pay for performance
Payment systems
Physician assistants
Preventive medicine
Primary care
States
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Summary:With American medical-school graduates showing a decline in interest in primary care residencies and practices, IMGs are increasingly the "safety net," satisfying the staffing needs of practices and community health centers throughout the country.1 In the 1990s, with an oversupply of physicians a looming fear, some observers advocated a severe restriction in the training of IMGs. The IMG migration has been described as a "brain drain," but given the constraints of rigid and suffocating domestic academic atmospheres and poor remuneration in their own countries, IMGs have tended not to return home.1 This situation appears to be changing, as shown by the trend of outsourcing images for reading by U.S.trained IMG radiologists in their native countries.4 As IMGs, we believe that any examination of the future of primary care must involve a more detailed discussion of the role of IMGs and their contributions. Until recently, I believed that nurse practitioners would become the primary care clinicians of the future, and having worked with excellent nurse practitioners and physician assistants, I have great confidence in these advanced practice clinicians.
ISSN:0028-4793
1533-4406