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New Physician Roles Need New Payment Models

Richard J. Baron, MD; Christine K. Cassel, MD

JAMA. 2008;299(13):1595-1597.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Primary care medicine is in search of redefinition. Prevalent payment modes have undermined traditional models and reduced workforce interest while some functions of primary care are emerging in new incarnations. Payers find physicians "too expensive" for basic primary care services, and young physicians find their earnings expectations greater than primary care careers can offer. Understanding these market forces could lead to better understanding of required physician expertise within the larger framework of primary care. A more explicit definition of that expertise could lead to more appropriate market valuation of physician services.

Fee-for-service reimbursement has undermined good primary care.¹ At a time when advances in understanding systems of care point to new models in which physicians' roles might be redefined to contribute more value to patients and to the delivery system, financing models have not yet caught up. Many of the most important . . . [Full Text of this Article]

Author Affiliations: Greenhouse Internists PC, Philadelphia, Pennsylvania (Dr Baron); and American Board of Internal Medicine, Philadelphia (Dr Cassel).