Publications

The U.S. News & World Report (US News) annually ranks educational institutions on several criteria that affect many readers’ views of their institutional reputations. One critic of the US News rankings recently declared the medical school rankings a “beauty contest.” We agree and set out several years ago to persuade US News to shift the source of its data and diversify the foci of its medical school rankings to reflect a broader range of social mission metrics. We focused this effort on US News’ “Best Medical Schools: Primary Care” ranking because of the ongoing erosion of the primary care physician workforce and because, for some schools, it is a specific social mission.

In most of the U.S., primary care is in deep crisis. Family physicians are reporting high levels of stress and burnout, thanks to a reimbursement treadmill that requires many of them to see four patients every hour in order to make a living. Older physicians are retiring prematurely. Heavily indebted medical students are shying away from family medicine and pediatrics, which pay less than half the $500,000-plus salaries offered to surgeons, cardiologists, and other specialists. When surveyed, few newly minted doctors express interest in joining community-based practices, preferring the set salaries that come through employment with large institutions.