Trainees and students often don't recognize the gratification of building relationships over many years, said Steven Weinberger, M.D., senior vice president for medical knowledge and education at the ACP. He said he hopes that by redesigning student and resident training, medical school faculty can demonstrate to students that primary care offers the potential for long-lasting relationships with patients."
As Kevin notes, the ACP is ignoring the bottom line. Students don't -- they know which fields promise long, stressful hours with dwindling reimbursement.
I'm at a school that historically sent a huge fraction of its class into primary care, but this year should produce record-breaking numbers of radiologists, orthopods, and emergency medicine specialists. I don't think this would've changed if we'd been tracking the same patients across many years.
Truthfully, across the medical blogs I survey, I can't recall many posts extolling the virtue of these long-term relationships. I think "continuity-of-care" can be tremendously rewarding in pediatrics, in OB-GYN, and a few other fields. But during my medicine rotation, most outpatients visits could be described as "managing the decline" -- brief encounters with diabetics, heart patients, and COPD'ers where prescriptions were renewed and lab values were relayed. The grinding nature of these diseases means the patients get sicker and sicker, and time crunch puts a premium on friendly chit-chat or answering questions.
A friend in residency at an esteemed hospital reported that, when the internal medicine program made outpatient continuity-of-care a priority, the number of residents going into primary care actually shrank. Instead, they chose to subspecialize in cardiology, GI, or any number of fields with more desirable lifestyles.