Internists quitting; impact on primary care foreseen

An expected shortage of primary-care physicians caused by medical school graduates choosing other specialties may be aggravated by an exodus of general internists leaving the field, according to a report in the Journal of General Internal Medicine.

Although the federal government is seeking to boost the ranks of primary-care doctors to help care for the millions of newly insured patients entering the healthcare system under the recently passed healthcare reform law, a survey of physicians who passed an American Board of Internal Medicine certification exam in general internal medicine or related subspecialty between 1990 and 1995 indicated that 9% had left internal medicine in midcareer.

More significant, however, may be that 17% of general internists had done so, compared with only 4% of internal medicine subspecialists. Researchers said it was unclear if this was due to job dissatisfaction, and they concluded that it was more likely that physicians were using general internal medicine as “a convenient stepping stone to careers outside of internal medicine and to some nonmedical fields.”

In all, about 6% said they were working in another medical field, 2% reported they were temporarily not practicing but planning to return to the workforce, about 1% had retired, and less than 1% had left medicine.

The report included mailed survey responses received from 2,058 physicians out of 3,610 who were randomly selected from the 33,364 internists who passed an ABIM exam between 1990 and 1995. Survey data was collected between September 2006 and February 2007. The survey was funded by the ABIM and the American College of Physicians internal medicine specialty society, and the authors of the report are employed by the two organizations.