The U.S. has doctors, but they’re not distributed where the needs are greatest. We are in short supply of primary care physicians, especially in rural communities. In this episode, Dr. Yurkiewicz speaks with policy analyst Lawson Mansell about the incentives — largely from the government — that influence what doctors choose to practice and where. These incentives systematically steer doctors away from the medicine patients need most.
They dissect several sources: payment that rewards episodic care over long-term relationships, outdated residency funding that favors hospitals over clinics, and underutilizing internationally trained physicians already living in the U.S. They also discuss hopeful initiatives, such as a bipartisan bill that would let Medicaid support a model known as direct primary care.
How can policymakers rewrite incentives to reflect workforce needs? How can we help more doctors choose to practice where they’re needed most?
0:06 Opening Monologue: Where Doctors Go Is a Policy Choice
1:52 Why Are Primary Doctors Paid Less Than Specialists?
19:20 Lobbying from the AMA and Unintended Consequences
24:18 The Pipeline In: Residency Funding Is Outdated
39:39 Wasting International Physicians’ Time
45:26 Bipartisan Support for Direct Primary Care
51:04 How Do We Get Doctors Where They’re Needed Most?
