Patients in Peril: The Demise of Primary Care in America

Once, Americans could count on having a personal or primary care physician who would see patients for new or chronic problems, whether in the office or the hospital. The appeal of such a system is more than psychological, for both primary care and continuity of care with a physician over time are associated with improved patient care, greater patient satisfaction, and lower overall costs.

These days are ending as primary care in the United States is rapidly disappearing. Where once 80% of American doctors were in primary care, now perhaps only a quarter of new graduates enter the field. Existing primary care doctors are retiring prematurely while many of those remaining feel demoralized, dispirited, and defeated. Experts predict increasing shortages of primary care doctors. The collapse of primary care will increase overall costs, hurt hospitals and insurers, but most of all damage the care of patients.

Patients in Peril explains the roots of the problem, the travails of primary care in America, the role of medical schools, hospitals, insurers and government, and how this all affects patients. Patients in Peril also offers practical achievable reforms that would improve care, reduce costs, and potentially avert this disaster.