Even the NY Times is writing about the need for more primary care doctors. Even more unbelievable and exciting is that the government is on board with this as well. Most people agree that if you give millions of patients health insurance, they are going to use it and are going to need to have doctors to see them. This didn't work out so well in Massachussetts. Primary care docs are in shortage already and this is even before any reform happens. Like it or not, the big reason for the shortage is pay. There is an unfair disparity of what family docs get compensated for compared to what some specialists get compensated for. That disparity is going to lead to a internal fight between physicians and that is going to be ugly. Before I go on, I want to define that term "disparity" for many of my readers. I agree that a neurosurgeon, who has a seven-year residency program, deserves to get paid more than I do as a family doc. In fact, I am not saying we should be all paid the same, by any means. But for a dermatologist to get paid three to four times what a primary doc gets is ridiculous. The article brings up the term "budget neutral" and the specialists not wanting to be part of that. Trust me, this internal strife is going to make the arguments amongst us physicians look like the arguments you see on the show Real Housewives of New York City. I am so embarassed to admit I actually have seen that show.