Primary care and medical school
Folks in Rhode Island’s health care world constantly talk about the value of primary care. The state is engaged in all sorts of initiatives to make the work more appealing and effective- from increasing the amount of money health insurers invest in primary care to developing “patient centered medical homes.”
The idea is, too many people have their health needs met in the most expensive location possible (the emergency room) when a primary care doctor could take care of you for less money. Plus, if primary care doctors pay close attention to their patient’s health, they can prevent them from developing more expensive problems.
So that’s why I was surprised when I spoke to my friend Anna Goldman, who’s just finishing up medical school in New York. She tells me her advisers discouraged her from pursuing internal medicine and looked down on anyone who chose it as a specialty.
“Why don’t you aim higher? You’re too smart for that.”
It’s a familiar reaction when medical students tell their teachers they are considering a career in primary care. On the first day of my third year of medical school, the palliative care physician I was assigned to work with wrinkled her nose when I told her I wanted to go into primary care. “You should think long and hard before you choose to do that,” she warned, “If you want a decent life, don’t do it.”
It’s not the first time I’ve heard that primary care is hard work. Plenty of doctors say they wouldn’t pursue the profession if they were just graduating from medical school. Getting paid per visit leaves them running from room to room, spending less than 15 minutes with each patient. The hours are long and the pay is nowhere close to what specialists make.
Add that with medical schools that discourage students from pursuing primary care, and it’s a wonder anyone chooses the profession.
Despite all that, Anna chose to sign up for residencies in internal medicine and family medicine. She finds out on Friday (Match Day) where she’ll end up.
Why do you think the values of policy makers are so out of joint with the training at some medical schools? What needs to happen for more students to see primary care as a career option?