The ACP Advocate Blog
by Bob Doherty
Tuesday, May 19, 2009
Where have all the medical students gone?
I write this blog from a briefing for medical students and internal medicine residents attending ACP's Leadership Day on Capitol Hill. They are learning what they can do, with their colleagues in internal medicine practice, to get Congress to support ACP's priorities:
Ensure that all Americans will have access to affordable health insurance coverage and access to a general internist or other primary care physician.
As I look around the room, I am encouraged that so many energetic and optimistic young people - more than 100 in all - took time out of their studies and residency programs to learn about health policy. No one can make a better case for health care reform than the next generation of physicians.
Yet, if asked a few years hence, "Where have all the medical students gone?" it won't be general internal medicine, family medicine, or pediatrics. That is, unless something big happens to make primary care more appealing.
Right now, about one out of three doctors in the U.S. are in primary care specialties, compared to the 50/50 mix found in other countries with higher performing health care systems. This would be bad enough, but unless next year's graduating class (and the ones that follow) are given a reason to look more favorably on primary care, fewer than one in five physicians will be in primary care. We know this because only 17% of U.S medical school graduates in 2008 expressed a desire to go into primary care, an all time low. We also know from studies that without more primary care physicians, the American people will experience higher cost of care and lower quality.
I don't write this to put a damper on the eagerness of the medical students in this room. The fact that so few of them are thinking about going into primary care isn't a statement about them, but a statement about us, as a nation. If we really believe that patients should have a personal physician who is trained in comprehensive and longitudinal care, then we would show this to our medical students. We would pay primary care doctors better, reduce the paperwork and hassles (see yesterday's blog) associated with primary care, pay off their debt, and expose them to the joys of primary care in their training.
Tomorrow, I will be writing about a major new piece of legislation to be unveiled by Rep. Allyson Schwartz (D-PA) that will offer a comprehensive plan to realign federal health policy to produce more primary care physicians.
If this bill were enacted into law, as ACP hopes it will, we may soon be able to report that medical students are going into general internal medicine, family medicine and pediatrics. And the country will be better off as a result.
Today's question: Do you think that medical students' lack of interest in primary care is something that can be remedied by the federal government?
About the Author
Bob Doherty is Senior Vice President, American College of Physicians Government Affairs and Public Policy; Author of the ACP Advocate Blog
Email Bob Doherty: TheACPAdvocateblog@acponline.org.Follow @BobDohertyACP
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