Promoting Primary Care: Where to Start?

Abstract

To the Editor. —I enjoyed reading Stimmel's article, The Crisis in Primary Care and the Role of Medical Schools.1 In America, relative income defines the perceived value of a profession. If society determines that primary care is valuable and wishes physicians to pursue our specialty, then there are only two ways to improve perceived value. Primary care physicians can be paid more, or all other physicians can be paid much less. Changing the relative income of primary care physicians does not address access issues, however. There is a longstanding alternative that is politically feasible, economically sensible, and likely to increase the prestige of primary care. A primary care physician working in concert with three to five physician assistants as a primary care team can provide quality care for less cost and support higher primary care incomes. We are modifying our family practice curriculum to teach medical students to work