Where have all the doctors gone? Physician choices between specialty and primary care practice

Public concern about physician manpower is becoming increasingly focused on the distribution of physicians across specialties. Although an optimal mix of physicians has not been clearly defined, most interested parties agree that more primary care doctors are needed. We examine economic, psychological, and organizational incentives that tend to induce physicians to pursue careers in subspecialties rather than primary care. The existing incentive structure needs to be examined more closely and will almost certainly have to be redesigned if efforts to redeploy physician manpower are to be successful.