Primary care specialties are facing an uphill battle for survival, said John Goodson, M.D., a primary care advocate.

Goodson, an associate professor of medicine at Harvard Medical School and primary care internist at Massachusetts General Hospital, delivered the UMKC School of Medicine’s annual William H. Goodson, Jr., M.D., Lectureship on Oct. 28. John Goodson is the son of William Goodson, who practiced internal medicine in the Kansas City area for more than 45 years.

“I’m really dedicated to the care of my patients,” Goodson said. “That’s what keeps me going in life. The balance of my life is patient care and I will do all that I can to save primary care. That’s why I have become an advocate.”

In 2015, John Goodson established the Cognitive Care Alliance to encourage improved compensation for generalist physicians and to help ensure a highly talented primary care work force for the nation’s future. The alliance has since grown to a force of nearly 109,000 physicians covering the spectrum of primary care specialties, Goodson said.

Goodson said three issues are key to maintaining a strong primary care workforce: training medical students who enter primary care specialties; practice reform, including such things as infrastructure, support, team building and health information technology; and, ultimately, attaining parity of compensation for primary care physicians.

“The healthcare economy is not a free economy by any stretch of the imagination,” Goodson said. “We spend $3 trillion on health care. It’s a huge jobs program and there are many problems. Our job is to ensure that our work is appropriately compensated within this gigantic environment.”

While the complexity of the primary care specialties has increased, he noted that interest in primary care has decreased throughout the years. Goodson said he isn’t sure anyone has the perfect answer, but that the problem is understandable when one compares the compensation for primary care physicians to other specialists who earn much higher salaries.

He called for changes in the way service codes used for billing and reimbursement are defined and valued. Goodson said the playing field is tilted with too few primary care specialists included on the panel of health care professionals that determine those service codes and their values.

“We need to defend the cognitive capabilities of our professions,” Goodson said.

This was the 30^th year of the annual lectureship. A group of family, patients, colleagues and friends established the William H. Goodson, Jr., M.D., Lectureship in 1987 to honor his many contributions to the field of medicine in the community. Each year, noted speakers offer scholarly perspectives and information related to internal medicine to current and future practitioners.