The Specialist-Generalist Income Gap: Can We Narrow It?

摘要

How do we characterize the current era in US health care? Perhaps "a time of increasing costs and decreasing health insurance". Equally accurate would be "the age of specialism". Hospitals have reorganized into specialty service lines; profitable specialist-owned surgicenters, endoscopy units, and imaging centers have multiplied; market-dominant single-specialty groups can negotiate high fees from commercial insurers. The gap between the income of many specialists and that of primary care physicians is wide and growing wider, leading a growing number of US medical school graduates to avoid primary care careers.