Then lawsuit mania hit, and they didn't get to have the fun of delivering babies anymore. "Urgent care" clinics opened up. The intimacy of FPs and their patients deteriorated through the defensiveness of the doctors who no longer trust their patients.
Primary care physicians are supplanted by the rise in PAs and NPs. A PA with lots of experience is actually more desirable to a hospital or outpatient clinic than an MD fresh out of school.
Also, talented diagnosticians in primary care devote hours of time to analysis and protocols only to watch the real $$ go to the specialist or surgeon who does the next stage of the patient care. Procedures are highly compensated--excellent diagnoses are not. Resentment of this is natural--human nature. Brains verses brawn sort of thing.
The shortage of specialists is more acute than FPs. The most pressing is the lack of trauma surgeons. ERs across the country are welcoming the downgrading of their Trauma levels.
Litigiouness and the knee-jerk resentment by the public (the attitude that somehow a doc comes by his MD through privilege rather than hard work) is going to create a doc shortage for boomers because the boomer docs are longing for retirement and are preparing well for it.
I work for trauma services in a Level 2 center that has been searching for another trauma surgeon for over a year. These people don't grow on trees. Neither do neurosurgeons. We don't want to be downgraded, but a hospital must meet certain staffing requirements to qualify as a trauma center and many centers nationwide are on life support.
Exactly right. When I was in med school in the early ‘90s there was a huge push to encourage primary care and discourage subspecialty training.