"There's a crisis in primary care, probably much worse than most people realize," says Dr. Steven Berk, Dean of the Texas Tech University School of Medicine (The New York Times, September 9, 2012). Interestingly enough, on the first day of medical school, almost half of U.S. students surveyed intend to go into primary care. Why is it then that fewer than 20 percent actually end up in a primary care field like family or general medicine? What changed their minds between year 1 and year 4 of medical school?
Finances certainly play a role. U.S. primary care physicians earn $140,000 to $150,000 a year, but specialist can double or triple that amount. Add medical school debt to the equation and primary care becomes less attractive.
But, it's not just about money. "There's a culture of discouragement that exists in most medical schools around primary care," says Dr. Andrew Morris-Singer of Primary Care Progress. "A lot of medical schools disparage primary care." Quoted in the same New York Times article is Dr. Marjorie A. Bowman, the Chair of the Department of Family Medicine and Community Health at the University of Pennsylvania: "It is absolutely clear that [practicing primary care] is a lower prestige thing to do; if you're looking for prestige, family medicine is not where you go." Dr. Bowman adds that medical school deans and leaders need to show more respect for family medicine.
By 2020, the U.S. will have a shortage of 45,000 primary care doctors; by 2025, the projected shortage is 65,000 (Association of American Medical Colleges). To address this shortfall, our medical schools must become part of the solution. Right now, they're part of the problem.