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By Debra L. Glasser, M.D.

### Primary Care Internal Medicine in Crisis: A Personal Reflection

Primary care internal medicine, a field I have dedicated four decades to, is at a critical crossroads. The decline of internists practicing primary care represents not just a personal loss but a societal one as well. The era from the 1970s to approximately 2020 saw a vibrant ecosystem of primary care physicians comprising family practitioners, pediatricians, and internists. Each group brought a unique set of skills and expertise to the table, catering to the diverse healthcare needs of patients across different age groups.

### The Rise and Fall of Primary Care Internal Medicine: A Journey of Passion and Dedication

My journey into primary care internal medicine was fueled by a deep-seated passion for science and a desire to make a difference in people’s lives. The formative years of my medical education coincided with a period of significant social change, with initiatives aimed at training more primary care physicians gaining momentum across the country. I was fortunate to be part of a generation of medical students who embraced the ethos of serving as frontline caregivers in communities that needed them the most.

### The Untold Story of Internists: Navigating Complex Healthcare Landscapes

As I transitioned into my role as an internist, the challenges and rewards of providing comprehensive care to patients became evident. The dynamics of healthcare delivery were evolving rapidly, with new demands and expectations placing additional burdens on primary care physicians. The camaraderie among colleagues, the continuity of care, and the sense of purpose that defined my early years in practice were gradually eroded by systemic pressures and administrative tasks.

### The Demise of Primary Care Internal Medicine: A Looming Crisis

Recent trends indicate a worrying decline in the number of medical graduates choosing primary care internal medicine as their specialty. The allure of hospital medicine and lucrative subspecialties has overshadowed the intrinsic value of primary care, leading to a growing gap in the physician workforce. The erosion of professional satisfaction, coupled with mounting financial burdens and administrative hurdles, has dimmed the prospects for revitalizing primary care internal medicine.

### Charting a Path Forward: Reimagining the Future of Primary Care

Despite the challenges facing primary care internal medicine, there are glimmers of hope on the horizon. Efforts to revive the field must encompass a multifaceted approach, including policy reforms, investment in residency programs, and incentives to attract future practitioners. Addressing the root causes of physician burnout, streamlining administrative processes, and fostering a culture of collaboration are essential steps towards restoring the vitality of primary care internal medicine.

### Empowering Patients: Navigating the Healthcare Landscape

In the meantime, patients can play a pivotal role in shaping the future of primary care. By actively engaging with their primary care providers, understanding their healthcare needs, and advocating for quality care, patients can drive positive change in the healthcare system. Seeking out urgent care options, maintaining open dialogue with specialists, and prioritizing preventive care are key strategies for ensuring comprehensive and coordinated healthcare services.

As we strive to breathe new life into primary care internal medicine, let us stand united in our commitment to building a healthier, more resilient healthcare ecosystem for all.

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*Debra L. Glasser, M.D., is a retired internal medicine physician in Olympia. Have a question for her? Write to drdebra@theJOLTnews.com.*

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