Health reform and primary care: physician training exposes tensions in field

The current debate over proposals to change the structures and funding of graduate medical education (GME) is focusing on academic medical centers and the degree to which the GME status quo may inhibit the diffusion of primary care physicians to needy areas. That debate may heat up soon given the recommendation of the Council on Graduate Medical Education that the U.S. educate 50 percent of physicians as primary care generalists. Meanwhile, Buffalo, NY, may provide the nation with a model for regional hospital collaboration in this area. There, seven area hospitals are pooling a portion of their GME funds to redistribute educational resources to primary care training. The CEOs of those seven institutions are pictured on this issue's cover.