Growing need to redesign primary care
Results of the 2007 National Resident Matching Program (NRMP) show that the number of medical students choosing internal medicine residencies stayed about the same compared to 2006. The 2,680 American medical students entering categorical internal medicine training programs was similar to the 2,668 figure from last year.
The American College of Physicians (ACP) says these numbers further underscore the need to redesign internal medicine training and fundamentally change the way that primary care is organized, delivered, financed and valued.
ACP has cautioned that unless there is an increase in the number of medical students choosing internal medicine careers, there will not be enough internists to care for an aging population, which will result in lower-quality care, diminished access to care, higher costs, and decreased patient satisfaction. ACP-proposed reforms call for a patient-centered health care system that builds upon the relationship between patients and their primary and principal care physicians. This model of health care delivery has been proven to result in better quality, more efficient use of resources, reduced utilization, and higher patient satisfaction.
ACP also calls for a redesign of training in internal medicine to ensure that tomorrow's internists meet the challenges of both an expanding body of medical knowledge and a rapidly evolving system of health care delivery.
According to Steven E. Weinberger, MD, FACP, ACP senior vice president for medical knowledge and education, "If trends continue, there will not be enough general internists to take care of an aging population with growing incidences of chronic diseases. The health care system will become increasingly fragmented, over-specialized and inefficient - leading to poorer quality care at higher costs."
As the single largest group of physicians, internists represent the backbone of the health care system. They not only diagnose and treat diseases of adults but also coordinate health care and play a critical role in preventing disease and promoting health and well-being. Internists practice in a variety of settings, ranging from outpatient offices and clinics to inpatient acute care hospitals to long-term care facilities. Their expertise and scopes of practice extend from a broad base of internal medicine (encompassing all organ systems) to highly specialized clinical areas.
In addition to direct patient care, internists are also involved in many other types and combinations of activities, including teaching, research, administration, and health care policy.