May 2009 Contents

Would you be more likely to get a massage, manicure, facial, or other nonmedical body treatment at a “medical spa” that advertised physician ownership than you would to get one at a nonmedically affiliated spa, if the price were the same at both?
Yes.
No.

There is great disparity between the average pay earned by subspecialty surgeons (e.g., cardiac surgeons, neurosurgeons, orthopaedic surgeons) per hour of surgery and that earned by primary care physicians per hour of patient care that includes taking histories, making diagnoses, suggesting treatment plans, and educating and counseling patients. Which of the following best describes why you think this disparity exists?
The difference in the expertise needed for the task.
The difference in the length of training.
Greater appreciation of society for specialists.
The difference the service makes in the life of the patient being cared for.
All of the above.
None of the above.

The fact that many rural and inner city regions are medically underserved has been described as a “market failure,” implying that some outside help for pure market forces is needed. Which of the following interventions do you think would improve the distribution of needed primary care medical services? Check all that you think apply.
Restructure the National Health Service Corps so that loan repayment terms are fairer and service terms, more flexible.
Establish a national Heal America program based on the Teach America model that would pay physicians to practice in underserved areas for 2 years after they complete their training.
Increase Medicare payment for many primary care services, offset by reduction in Medicare payments for some specialist services.
Increase federal funding for medical schools that consistently produce a greater-than-average percentage of graduates who enter primary care residencies and work in underserved areas.
Increase salaries of all resident physicians so that overwhelming debt is not the driving factor in their choice of practice location.
Provide federal or state government subsidies for physicians who locate their practices in underserved regions.
Use more nonphysician health care professionals such as physician assistants and practitioners.
None of the above.