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Impact of reductions in primary care funding on the composition of the physician workforce

A well-established primary care sector has allowed England’s National Health Service (NHS) to make efficient use of resources through the gatekeeping role that general practitioners have in controlling access to specialist services. Because of the poor economic situation in the United Kingdom, there is now considerable pressure on the NHS to use its resources more efficiently. These financial challenges are putting enormous pressure on general practices at a time when the NHS is also going through other major structural changes. Consequently, general practitioners in England increasingly find themselves having to make difficult decisions about the future of their practices.

In an article published in the Journal of Ambulatory Care Management, I discuss the impact of these financial challenges on the career intentions of physicians. In recent years, primary care has been an attractive career choice for young physicians because of the flexible, diverse nature of the work and the relatively high-income levels that established general practitioners can receive. However, unlike specialist physicians, who typically receive a fixed salary, general practitioners’ income is very dependent on their practice budget, workload, and expenses. With workload increasing and income levels decreasing, many younger physicians—who might previously have chosen a career in primary care—may now choose instead to train in a different specialty. Older physicians may choose to retire rather than work in this much more difficult environment. What impact austerity will have on the primary care workforce is therefore of great concern.

You can read another version of this article at the BMJ's Doc2Doc Blog.

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