I just left primary care (internal medicine) to become a hospitalist. I can tell you primary care is no longer a sustainable lifestyle. I make about 1/4 of what my brother, an anesthesiologist, makes, and he is 10 years behind me in practice.
If Hilarycare becomes a reality, I plan to quit and open a quilt shop. Making any less than I already do, and being told what to do by the government would be an intolerable situation. Otherwise, I plan to hang in another 10 years or so until retirement (somewhat early)
We are not the only ones. Even in the hospitalist groups I see lot more foreign medical grads, and most of us are planning on retiring well before age 65
The hospitalist practice model is attractive to many internists. In our organization, they work 7 days on and 7 days off with 12 hour shifts and take no call. They are salaried employees. However, the turnover is incredible. Also, the patient satisfaction is less than optimum. Before my mother died, she was admitted to our largest hospital and asked me to discuss her care with her. While her care was technically fine, she didn't like the endless number of hospitalists and advanced practice nurses sent in to see her. She became particularly disturbed when a nurse practitioner she had never met before told her she needed to go to a nursing home. At that point, she asked me to find her an internist and I went to a competing organization in town to get her one.
What people here don't realize is that this in itself is horrible--there's nothing better than a seasoned doc with decades of experience.
Remember when Old Doc would cut back gradually on his practice well into his seventies, his patients getting old along with him, and was a resource for all the younger docs in town? Now docs squirrel away every cent to retire early and remove all that experience from the system .
And ask these docs if they like taking care of patients, they almost always say that they love the practice of medicine. It's all the stuff that comes with it now that they can't stand.