Excerpted from AP: “Fewer US med students choosing primary care”, Sep 9, 2008
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Note:
One of my hot buttons is the way that politicos confuse “health insurance” with “health care”. It’s relatively easy to throw money at problems. It’s harder to fix fundamental problems. This article highlights a fundamental problem.
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The coordinated care provided by primary care doctors can keep costs down by preventing harmful drug interactions, unneeded medical procedures and fragmented specialty care, Goodman said.
Only 2 percent of graduating medical students say they plan to work in primary care internal medicine, raising worries about a looming shortage of the first-stop doctors.The results of a new survey being published Wednesday suggest more medical students, many of them saddled with debt, are opting for more lucrative specialties.
In a similar survey in 1990, the figure was 9 percent.
Paperwork, the demands of the chronically sick and the need to bring work home are among the factors pushing young doctors away from careers in primary care, the survey found.
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“I didn’t want to fight the insurance companies”
“Medicare’s fee schedule pays less for office visits than for simple procedures”
Primary care doctors … “speed to see enough patients to make a reasonable living,”
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It’s hard work taking care of the chronically ill, the elderly and people with complex diseases — “especially when you’re doing it with time pressures and inadequate resources.”
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The salary gap may be another reason.
Family medicine had the lowest average salary last year, $186,000, and the lowest share of residency slots filled by U.S. students, 42 percent.
Orthopedic surgery paid $436,000, and 94 percent of residency slots were filled by U.S students.
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Meanwhile, medical school is getting more expensive. The average graduate last year had $140,000 in student debt.
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A separate study in JAMA suggests graduates from international medical schools are filling the primary care gap.
About 2,600 fewer U.S. doctors were training in primary care specialties — including pediatrics, family medicine and internal medicine — in 2007 compared with 2002.
In the same span, the number of foreign graduates pursuing those careers rose by nearly 3,300.
“Primary care is holding steady but only because of international medical school graduates … and holding steady in numbers is probably not sufficient when the population is growing and aging.”
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And as American students lose interest, teaching hospitals will probably become less interested in offering primary care programs.
JAMA called on Congress to create a permanent regulatory commission to encourage training for needed specialties.
U.S. teaching hospitals now receive $10 billion a year from the government to train doctors.
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Full article:
http://news.yahoo.com/s/ap/20080909/ap_on_he_me/med_fewer_docs&printer=1;_ylt=AnGPB0GDsuNJ96p_SpCK0D5a24cA
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September 11, 2008 at 5:21 pm |
Good point. I think that this trend has also increased the number of nurse practioners and physician assistants in the US which has had an overall positive effect on our healthcare delivery. These nurse prac training programs are comprehensive and seeing a NP lowers overall healthcare costs.
I think an overall shortage of medical professionals is a larger concern given the number of 65+ Americans we will have by 2020. We do not have enough professionals trained in geriactric care. Thankfully, more seniors will be able to afford to pay for better care given their financial status.