Primary care's eroding earnings: is congress concerned?
OBJECTIVE
Despite increasing data demonstrating the positive impact primary care has on quality of care and costs, our specialty faces uncertainty. Its popularity among medical students is declining, and the income gap is growing between primary care and other specialties. Congress has the power to intervene in this impending crisis. If we want to influence lawmakers' actions, we need to know how they are thinking about these issues.


METHODS
Using a set of questions covering several physician payment topics, we interviewed 14 congressional staff aides (5 aides on Medicare-oversight committees, 9 general staff aides) and one representative from each of 3 governmental agencies: the Medicare Payment Advisory Commission, Congressional Budget Office, and Government Accountability Office.


RESULTS
Interviewees revealed that issues in primary care are not high on the congressional agenda, and that Medicare's Sustainable Growth Rate (SGR) is the physician-payment issue on the minds of congressional staff members.


CONCLUSIONS
Attempts to solve primary care's reimbursement difficulties should be tied to SGR reform.
Laing
Brian Yoshio
BY
Department of Family and Community Medicine, University of California, San Francisco, CA 94110, USA. yoshi.laing@ucsf.edu
Bodenheimer
Thomas
T
Phillips
Robert L
RL
Bazemore
Andrew
A
Bazemore
Andrew
A
D004470:Economics, Medical; D017048:Health Care Costs; D006801:Humans; D006278:Medicare / Q000191:economics*; D011320:Primary Health Care / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics*; D013038:Specialization; D014481:United States