Medical schools don't produce enough primary care doctors, study says

[Ed Barrow]

Source: Baltimore Sun

As the U.S. grapples with a shortage of primary care physicians, many in health care fear that access will sharply decline as health reform adds millions more Americans to the ranks of the insured.

A new study highlights a trend that could make things worse: Many medical schools produce more researchers and specialists than front-line doctors, especially those willing to work in underserved areas and among minorities. Public medical schools such as the University of Maryland ranked higher than private medical schools such as John Hopkins University in meeting a "social mission."

"The purpose of the study is not to denigrate the research of great universities," said Dr. Fitzhugh Mullan, professor of health policy at George Washington University and lead author of the study. "But we need to ask how medical schools can help with the whole spectrum of national needs."

The George Washington study, published Tuesday in the Annals of Internal Medicine, generally found that medical schools in the Northeast performed poorly, as did schools with significant National Institutes of Health research funding. Historically black colleges and schools in small cities had higher overall rankings.



Read more: http://www.baltimoresun.com/health/bs-hs-primary-care-study-20100615,0,6289224.story

[Brickbat]

1. Students want to get into specialities, which pay more, and they want to avoid rural areas, which

have a HUGE need for primary care doctors and family doctors.

[JDPriestly]

9. It's not just about money.

In many practices, especially at HMOs, primary care physicians to spend the time with their patients that would make medicine a rewarding profession. And on top of that, a lot of the work that primary care physicians do is repetitive and not so challenging as the specialist work. Those are the real reasons why young doctors don't want to do primary care. They want the intellectual and skill challenges as well as the patient-contact that a specialty practice brings.

[Oregone]

2. What about the invisible hand?

Shouldn't compensation adjust to automatically create the perfect amount needed for everybody who can afford to see one?

[damntexdem]

4. The Invisible Hand is in need of occupational therapy.

But there aren't enough OTs, either.

;-)

[damntexdem]

3. New report, old story.

This has been true for decades. Some primary docs can be replaced with nurse practitioners and physician assistants -- but schools aren't producing enough of them, either.

[cbdo2007]

5. doctors can't afford their student loans on Primary Care Physician salaries.

Many here would be shocked if they knew their PCP salary.

[JDPriestly]

10. Very true. The student loans plus a family are too much on a

primary care physician's salary.

[glinda]

19. More money in plastic surgery.

[FSogol]

6. Close down your kid's Steam account, kick them off your cheeto stained couch, and

send them to medical school. Problem solved.

[swilton]

7. One of the components of our broken medical care system

is the skyrocketing costs of medical schools. If medical schools were affordable, we would have more physicians period - specialists and non-specialists.

The costs of medical school drive up the fees we pay the medical professionals. Although many would ridicule the salaries of doctors and medical professionals in Europe, because their education is essentially paid for, their out-of-pocket costs are much less and they can charge lower fees - a win-win scenario for patients and care-givers.

[JDPriestly]

11. Medical schools are expensive for good reason.

We don't want doctors to practice in our country who have not received top training.

[swilton]

14. Sorry, to disagree but the money charged by medical schhols

does not guarantee competence - it only guarantees greed. Or at least doctors are forced to charge higher prices and become captives of insurance and pharmaceutical interests.

There is equivalent competence in other countries but costs are controlled - this is why there is a growing exodus from this country to other countries for surgeries that are more affordable.

[JDPriestly]

21. I think all higher education should be free, but as long as it isn't,

we want the best faculties at medical schools. Problem is, most of the best doctors or scientists can earn huge amounts of money in places other than on faculties of medical schools. So we have to be sure that the teachers on our medical school faculties are decently paid in comparison to doctors' salaries outside academia.

[Dawson Leery]

8. Specialists make more money.

Especially on older people, who need much more care.

[BumRushDaShow]

12. We need a modern version of the "Barefoot Doctors". n/t

[FBI_Un_Sub]

13. Motivation into specialties to pay off loans

Declare the critical need areas as suc, and waive/forgive student loans for docs who go into them.

[Dappleganger]

18. Don't forget the most basic reason...

Greed.

[safeinOhio]

15. In general I'm against importing labor

but, in the case of doctors, we should open up our boarders to qualified foreigners that can pass the boards here. Even give them credit for residency until our system can catch up with the shortage. They could fill the GP shortage quickly.

[Dappleganger]

17. Actually, this has already happened.

There's been a huge influx of foreign PCP's over the past decade due to the upturn in American students specializing. Both our pediatrician and my PCP are foreign and took advantage of the existing system (and are doing quite well).

[Dappleganger]

16. Greed is good...

I think they learn that from their classes pretty much from day one. Those who intend to become PCP's are usually taunted until they change their mind since they want to make as much money as their classmates. They figure they've spent a 100 grand on school so far, what's a bit more to be able to make a huge salary very quickly?

[Hoyt]

20. This has been true for decades. Bout time someone gets serious about changing it.

Newly hatched docs can often pay off their loans by practicing in under-served areas. Not enough choose to do so, though.

There are other ways to improve access to primary care too -- if we ever get smart enough to realize we need a plan, incentives, less lobbyists protecting their turf, etc.