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Primary care
September 15, 2008
Fewer medical students choosing primary care, and pay's one reason
Who’s going to take care of us when we’re old?
A survey of 1,177 fourth-year medical students just published in the Journal of the American Medical Association is sobering. It found that only 2 percent were interested in general internal medicine, the main specialty serving elderly adults, according to the online abstract. (You have to pay for the full article.)
The nation is experiencing shortages in primary care doctors, and I recently wrote an article about the shortage of providers in Texas and Travis County.
Why is this happening?
Many medical students graduate with huge debts, and when they look at their future earning power, primary care — also known as family medicine — is at the bottom, according to the JAMA study and other research. The gap has widened in the past 20 years, according to Mark Ebell, a professor and assistant to the provost at the University of Georgia.
“Family medicine had the lowest average salary — $185,740 — and the lowest percentage of filled residency positions among U.S. graduates, 42 percent, ” Ebell says in a news release posted on EurekAlert, an online news source for journalists. “Radiologists and orthopedic surgeons, who had an average salary of more than $400,000, had the highest percentage of filled residency positions among U.S. graduates (88.7 percent and 93.8 percent, respectively).”
In the past decade, the number of U.S. medical students entering family practice residencies has dropped by half, Ebell found.
That has affected more than just elderly folks. Studies show that infant death rates are ticking back up along with overall death rates from some chronic diseases. And for the first time since the flu pandemic of 1918, life expectancy is declining for a significant proportion of people in the United States.
Ebell concludes that a national push should be made to increase the number of primary care doctors. He suggests increasing insurance reimbursements to doctors and providing debt relief for medical school bills, which have quadrupled, from $35,000 to $140,000, in two decades.
“We rank behind many countries in the quality and efficiency of health care,” Ebell says, “and I think a lot of that is because we have neglected primary care.”
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