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

Bodenheimer, Thomas; Matin, Mina; Laing, Brian Yoshio

doi:10.1007/s11606-008-0740-8

Cited by 6 publications

(4 citation statements)

References 6 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the eyes of students, a high income confers high prestige; even students who do not value income may find this added prestige a compelling influence on their career decisions. In the USA, the relative incomes of physicians in various specialties are shaped by national policy decisions . Addressing this gap in payment is essential for correcting the primary care shortage.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Specialty income and career decision making: a qualitative study of medical student perceptions

et al. 2019

View full text Add to dashboard Cite

Context Medical educators in the USA are interested in the ways medical students make career choices because shortages in key specialties, particularly primary care specialties, limit access to care. Although anticipated specialty income is a strong predictor of student interest, no studies have qualitatively explored the reasons why income is important to students. By better understanding students’ perspectives on income and specialty choice, educators can help students make choices that fit their goals and better educate students about the specialties in which the need for expansion is greatest. Methods In 2012, Year‐2 students at one USA medical school were invited to write an essay about how debt and anticipated income levels influence their career choices. A total of 132 essays (response rate: 67%) were qualitatively analysed using a hermeneutic phenomenology approach to conventional content analysis, in which themes emerge inductively from the data. Researchers employed peer debriefing, modified member checking, thick description, code–recode strategies, audit trails and reflexivity to ensure quality and rigour. Although this analysis initially focused on student perceptions of specialty income, prestige also emerged as an important related theme. Results Three major findings emerged. Income is of varying importance to different students. Students value income because it provides freedom and flexibility, and power and security. Students recognise that high income confers social prestige. Students also define specialty prestige in other ways, including match competitiveness, perceived expertise, opportunities for advancement through fellowships, and power and autonomy. Conclusions Medical students’ perspectives of specialty income, specialty choice and prestige are more complex than previously reported. Medical educators should frame conversations about specialty choices in ways that incorporate varied perspectives on income and prestige. Health policymakers should recognise that income and prestige influence medical students’ decisions in complex ways. These insights may inform strategies to counteract shortages in key specialties, including primary care specialties.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In the USA, the relative incomes of physicians in various specialties are shaped by national policy decisions. 45,46 Addressing this gap in payment is essential for correcting the primary care shortage. Our results also support previous data demonstrating that students view primary care physicians as having less workplace autonomy.…”

Section: Discussionmentioning

confidence: 99%

Specialty income and career decision making: a qualitative study of medical student perceptions

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Even in the National Health Service Corps, young physicians often have to use extended repayment plans to balance their finances ( 5 ). Family medicine practices also suffer from unbalanced Medicare reimbursement policies, which tend to overwhelmingly favor specialists ( 34 ). In our proposal, accelerated students pay for 3-years of in-state tuition and are only responsible for the fourth if they opt out of the program.…”

Section: Discussionmentioning

confidence: 99%

Bolstering the pipeline for primary care: a proposal from stakeholders in medical education

Shi

Lee

2016

Medical Education Online

View full text Add to dashboard Cite

The Association of American Medical Colleges reports an impending shortage of over 90,000 primary care physicians by the year 2025. An aging and increasingly insured population demands a larger provider workforce. Unfortunately, the supply of US-trained medical students entering primary care residencies is also dwindling, and without a redesign in this country's undergraduate and graduate medical education structure, there will be significant problems in the coming decades. As an institution producing fewer and fewer trainees in primary care for one of the poorest states in the United States, we propose this curriculum to tackle the issue of the national primary care physician shortage. The aim is to promote more recruitment of medical students into family medicine through an integrated 3-year medical school education and a direct entry into a local or state primary care residency without compromising clinical experience. Using the national primary care deficit figures, we calculated that each state medical school should reserve 20–30 primary care (family medicine) residency spots, allowing students to bypass the traditional match after successfully completing a series of rigorous externships, pre-internships, core clerkships, and board exams. Robust support, advising, and personal mentoring are also incorporated to ensure adequate preparation of students. The nation's health is at risk. With full implementation in allopathic medical schools in 50 states, we propose a long-term solution that will serve to provide more than 1,000–2,700 new primary care providers annually. Ultimately, we will produce happy, experienced, and empathetic doctors to advance our nation's primary care system.

show abstract

“…It is caused and sustained by Medicare reimbursement policy, which must be reformed to value primary care in a real way. 26,27 Until federal physician payment policies are changed, the high income of specialty careers will always be more attractive to medical students, even those with no debt.…”

Section: Fixing the Income Gap Is Essentialmentioning

confidence: 99%

The Impact of Debt on Young Family Physicians: Unanswered Questions with Critical Implications

Phillips

2016

The Journal of the American Board of Family Medicine

View full text Add to dashboard Cite

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

Cited by 6 publications

References 6 publications

Specialty income and career decision making: a qualitative study of medical student perceptions

Specialty income and career decision making: a qualitative study of medical student perceptions

Bolstering the pipeline for primary care: a proposal from stakeholders in medical education

The Impact of Debt on Young Family Physicians: Unanswered Questions with Critical Implications

Contact Info

Product

Resources

About