KevinMD wrote a really interesting editorial for USAToday about the growing shortage of primary care physicians.

How did we let primary care slip so far? The key is how doctors are paid. Known as “fee for service,” most physicians are paid whenever they perform a medical service. The more a physician does, regardless of quality or outcome, the better he’s reimbursed. Moreover, the amount a physician receives is heavily skewed toward medical or surgical procedures. A specialist who performs a procedure in a 30-minute visit can be paid three times more than a primary care physician using that same 30 minutes to discuss a patient’s hypertension, diabetes or heart disease. Combine this fact with annual government threats to indiscriminately cut reimbursements despite rising office and malpractice costs, physicians are faced with no choice but to increase quantity to maintain financial viability.

There are responses/recaps posted at the WSJ health blog and Medical Rants.

(I realize this is not technically a post about medical malpractice, though Kevin does mention that medmal costs ars one of the many expenses that force doctors to try to maximize their revenue and thus specialize. In any case, I thought it was too interesting not to blog about.)