My guess is that they're referring to Continuing Medical Education seminars, though I'm not sure.
I can say that this situation is going to get worse unless some drastic changes are made. I'm a med student working with a doc in Internal Medicine. The very first day we showed up at our preceptorship, he told me and my classmate to avoid primary care like the plague. He's a great doctor, very personable, and the kind of guy you'd want to see. He knows his stuff, and he's good for a laugh when it's needed and sympathy, as well. Always participating in medical pharmaceutical trials and keeping on top of things.
That said, his schedule is running him ragged. He sees 4 times the number of patients that a lot of doctors see in a day (who earn 2-3x more than he makes). I don't see the point, frankly. Specialize and move on. An extra 2 years of residency/fellowship are definitely worth it.
On top of this you're going to have a lot more women physicians arriving on the scene. Women who are traditionally a lot less willing to work long hours. Guess what that's going to do for the doctor shortage?
Well thank goodness this is what happens when you have socialists running the medical system. Now in America we have it great, insurance companies are driven by market forces to keep both the suppliers and consumers. I mean the doctors can just refuse to work with any company that doesn't pay his desired wage.
I guess the days of house calls and things done on a human level are really over. Sigh . . .
They are no longer part time psychologists with a bedside manner.
BUMP
Yes, that's right, three years after med school.
I have 11 years of practice as a primary care Internist, and 12 as a Gastroenterologist. My life is definitely easier, and better paid, than it was as a primary care doc. Of course, I earned that by staying on in training extra years beyond what primary care folks do, and by the fact that my work involves higher-risk procedures, using much more expensive tools, with higher malpractice cost. And my knowledge of my field is deeper and more current compared to a primary care doc, who must cover a larger area of medical knowledge and so cannot go as deeply into any one area.
Having been both types of doc, I can tell you that it's not that specialists are overpaid, it's that PCPs are grossly underpaid. But if you want to rectify the underpayment of PCPs by underpaying specialists (a truly socialist idea) then be prepared to wait six weeks for your heart disease or colon cancer to be treated, because who wants to do all the extra training only to be paid as if they hadn't?
Socialism can only level down, not up, making shortages, not plenty.
I might add that it's simplistic to reduce the matter to money alone. The hassle factor of primary care practice has to be experienced to be believed. And that hassle factor has nothing to do with the nature of a PCP's work. It is imposed by--you guessed it-- government. The commercial ensurers, as the article states, follow Medicare's lead because they can get away with it.
If I could drop Medicare and all commercial insurance, and escape the incredibly intrusive and useless paprwork and regulatory burden imposed by them, I could go to a cash-only basis, cut my fees in half, and still increase my income. I am absolutely convinced that if Medicare never happened, we'd still have excellent quality of medical care in this country,it would be cheaper, and primary care would retain its place of honor in the field of medicine. As it is today, excellence in primary care is punished.
I wonder how he proposes to coerce docs to accept hourly pay? Probably by using government. If it was more efficient to pay docs hourly, one would think they could charge it themselves (as some do, cash only psychiatrists), or the HMOs etc.. would do it.