The Wall Street Journal reports

primary-care doctors, including internists, family physicians, and pediatricians, are in short supply across the country. Their numbers dropped 6% relative to the general population from 2001 to 2005, according to the Center for Studying Health System Change in Washington. The proportion of third-year internal medicine residents choosing to practice primary care fell to 20% in 2005, from 54% in 1998.

A principal reason: too little money for too much work. Median income for primary-care doctors was $162,000 in 2004, the lowest of any physician type, according to a study by the Medical Group Management Association in Englewood, Colo. Specialists earned a median of $297,000, with cardiologists and radiologists exceeding $400,000.

This is the phenomenon that in Crisis of Abundance I dubbed “premium medicine.”

The focus of the story is on how the reduction in primary care doctors hurts the Massachusetts health plan. I think that is almost beside the point. My guess is that this is another instance in which American medical care is allocated at the margin in a cost-ineffective way. If insurance companies were not paying so much of the bill, people would not see so many specialists. Specialist income would decline, and more physicians would stay in primary care.

UPDATE: Michael Cannon comments.