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Grouping Primary Care Disciplines May Distort Policy

Pediatricians, internists often have very different economic viewpoints

MONDAY, Feb. 1 (HealthDay News) -- The practice of grouping pediatrics, internal medicine and family medicine under the classification of primary care may result in distorted data because the three groups may not share the same view of health economics or have the same economic preferences underlying their choice of career, according to an article published online Feb. 1 in Pediatrics.

Gary L. Freed, M.D., and Kelly M. Dunham, both from the University of Michigan in Ann Arbor, examined data on internal medicine and pediatrics trainees. They found that internal medicine residents who were U.S. medical graduates and had debt of $100,000 to $150,000 were less likely to choose an internal medicine subspecialty, and high levels of debt were associated with the choice of a hospitalist career.

However, the authors found that in some recent studies, pediatric residents in their last year of training cited financial considerations only 2 percent of the time in 2007 and 2008, and were most likely to choose the field because they were interested in a specific disease or patient group or because of the structured hours and lifestyle.

"Recent research has demonstrated that there are substantive differences among internal medicine trainees and pediatric trainees," the authors write. "As such, we must be cautious when using data from one primary care specialty to suggest structural and/or policy changes regarding the economic structure of training for the others."

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