It should come as no surprise that there is a shortage of family physicians in Georgia. This is yet another symptom of our failing health care system. As pointed out in the AJC, this problem is not unique for Georgia ("State low on family physicians," Page One, July 20). There is no policy at either the state or national level to guide the training, supply or distribution of health care providers. In addition, physicians who build relationships with patients and their families and provide medical care over time, though loved and appreciated by their patients, are not "valued" by our current health care system.

Research has shown that patients with a primary care physician have both lower costs and improved outcomes. Unfortunately, physicians are poorly compensated for the face-to-face care they provide and are not compensated at all for the outcomes they achieve. Physicians are paid for the things they "do" to patients. Managing patients with high blood pressure, diabetes and depression, encouraging healthy lifestyles and promoting appropriate preventive screening tests are not valued like procedures or diagnostic tests. As a result, average compensation for specialists is two to three times that of a family physician or internist. Compensation for family physicians has been declining for the past 10 years. Primary care physicians, while working harder, are being paid less.

So are we really surprised that after 11 years of training, a physician would choose not to go into family practice? Until we restructure the payment system so that primary care physicians are adequately compensated for the important care they provide, we as a state and a nation will continue to experience shortages of the physicians patients need the most.

> Dr. Harry J. Heiman is an Atlanta family physician.