Micropractice Model Not the Answer to Primary Care Crisis

Medical Economics published my letter to the editor in their September 5th issue. The contents of the letter follows:

For primary care to attract more medical students, it will need to transform the delivery of care to improve the doctor-patient relationship, as well as professional satisfaction. While I applaud the efforts of the solo practitioners who follow the micropractice model ["The one-person show," June 20, 2008], this evolution won't save our specialties of internal medicine or family medicine.

Current graduates are flocking toward radiology, ophthalmology, anesthesiology, and dermatology because they offer a more predictable lifestyle with relatively good compensation.
Micropractice practitioners not only take a substantial pay cut, but also are wedded to their practice by being a sole proprietor.

Despite some erroneous assumptions, many patients find their primary care doctors in large group practices particularly satisfying and personal. These innovative groups practice the medical home touted by the AAFP and the ACP as the future for primary care.
With the use of electronic medical records, same-day access for appointments, the ability to communicate via e-mail, and improved revenue generation, patients and doctors are finding this model of delivery far superior to what has been practiced in the past.

Unless medical students and current practitioners see and join practices where primary care doctors have rewarding professional lives and are compensated well, the numbers of primary care doctors will dwindle rapidly, which will result in a complete collapse of the health-care system in the near future.