Survey finds general internists leave practice sooner than subspecialists

May 07, 2010

A survey conducted by the American College of Physicians (ACP) and the American Board of Internal Medicine (ABIM) found that 9 percent of all internists originally certified between 1990 and 1995, including a significantly larger proportion of general internists (17 percent) than internal medicine subspecialists (4 percent), are no longer working in general internal medicine or one of its subspecialties about a decade after their original certification by ABIM.

"Where Have All the General Internists Gone?" published by the also found that, although most are satisfied with their career choice, a significantly lower proportion of general internists (70 percent) than internal medicine subspecialists (77 percent) were satisfied with their career. A greater proportion of general internists and internal medicine subspecialists who left internal medicine are satisfied with their career (87 percent) than those still working in internal medicine (74 percent).

"General internists are major providers of primary care to adults in the United States, which faces a shortage of primary care physicians," said lead author Wayne Bylsma, PhD, Vice President and Chief of Staff, ACP. "The research results underscore the importance of increasing the attractiveness of careers in general internal medicine and of retaining those who enter the field."

Two factors contributing to the primary care physician shortage include decreasing numbers of medical students pursuing careers in general internal medicine and general internists leaving their practices for other careers in and out of medicine. ACP and ABIM undertook the survey to better understand mid-career attrition in internal medicine. The study authors analyzed responses from a national random sample of 2,058 physicians originally certified by ABIM in general internal medicine or an internal medicine subspecialty from 1990 to 1995.

Existing research reviewed by the authors suggests that general internists may be particularly discontent and more likely to leave internal medicine due to a widening income gap between primary care physicians and many specialists, increasing demands, growing expectations and accountability for providing high quality care, and payment based on the ability to perform in a challenging environment.

Although research finds that dissatisfied doctors are particularly likely to leave medicine, the authors were not able to find conclusive evidence that the general internists they studied left internal medicine in greater proportion than subspecialists for this reason.

"A more likely explanation," said co-author Rebecca Lipner, Vice President of Psychometrics and Research Analysis, ABIM, "is that the 'general' nature of general internal medicine may give internists more options for careers outside of internal medicine and in to some non-medical fields."

Increasing support for primary care training programs, increasing Medicaid and Medicare reimbursements to primary care physicians, and expanding pilot testing and implementation of patient-centered medical homes are ways to increase and maintain the number general internists and other , according to ACP.

"A sizeable minority of internists -- 40 percent -- who have left medicine are open to returning," said Bylsma. "Changes in the practice environment might entice them back to primary care."

Explore further: What are the chances that your dad isn't your dad?

More information: http://www.springerlink.com/content/aw0x629757277624/

Provided by American College of Physicians

not rated yet
add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Obese British man in court fight for surgery

Jul 11, 2011

A British man weighing 22 stone (139 kilograms, 306 pounds) launched a court appeal Monday against a decision to refuse him state-funded obesity surgery because he is not fat enough.

2008 crisis spurred rise in suicides in Europe

Jul 08, 2011

The financial crisis that began to hit Europe in mid-2008 reversed a steady, years-long fall in suicides among people of working age, according to a letter published on Friday by The Lancet.

New food labels dished up to keep Europe healthy

Jul 06, 2011

A groundbreaking deal on compulsory new food labels Wednesday is set to give Europeans clear information on the nutritional and energy content of products, as well as country of origin.

Overweight men have poorer sperm count

Jul 04, 2011

Overweight or obese men, like their female counterparts, have a lower chance of becoming a parent, according to a comparison of sperm quality presented at a European fertility meeting Monday.

User comments : 0

More news stories

Down's chromosome cause genome-wide disruption

The extra copy of Chromosome 21 that causes Down's syndrome throws a spanner into the workings of all the other chromosomes as well, said a study published Wednesday that surprised its authors.

Simplicity is key to co-operative robots

A way of making hundreds—or even thousands—of tiny robots cluster to carry out tasks without using any memory or processing power has been developed by engineers at the University of Sheffield, UK.

Progress in the fight against quantum dissipation

(Phys.org) —Scientists at Yale have confirmed a 50-year-old, previously untested theoretical prediction in physics and improved the energy storage time of a quantum switch by several orders of magnitude. ...