Robert B. Copeland, MD, FRCP
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Robert B. Copeland, MD, Georgia Heart Clinic, 109 Medical Drive, La Grange, GA 30240; e-mail, email@example.com.
Copeland RB. Making It Possible for General Internal Medicine To Survive. Ann Intern Med. 2004;140:661-662. doi: 10.7326/0003-4819-140-8-200404200-00017
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Published: Ann Intern Med. 2004;140(8):661-662.
I have practiced for almost 4 decades as a small-town cardiologist who has also provided principal or primary care. In this issue, Larson and the Society of General Internal Medicine (SGIM) Task Force on the Domain of General Internal Medicine got it right (1). They outline a future mission that reaffirms the fundamental strength of internal medicine: breadth and depth. They recognize the potential for teams of clinicians to improve patient care. They highlight the importance of a reimbursement system that rewards high-quality care and good outcomes.
Our already overworked and under-reimbursed training programs and physician practices cannot meet the cost of these necessary changes without payment reform. From my perspective, payment reform includes paying for patient care transacted over the telephone and e-mail. It also means paying more for high-quality care. Without this fundamental change, internal medicine cannot survive, partly because internists cannot otherwise afford to redesign their practices to meet the challenges of contemporary practice. We must find effective ways to reward practices that invest in the large changes necessary to produce consistent high-quality care.
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Cardiology, Education and Training, Healthcare Delivery and Policy.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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