USA Today had an article recently on the shortage of surgeons across the country, writing the shortage is particularly hurtful to the 54 million rural Americans.
The article goes on to say what many already know: more medical students are choosing specialty care and “‘fewer and fewer are going into family medicine and primary care,’ says James King, president of the American Academy of Family Physicians. And ‘many are not willing to go’ to rural areas.”
The problem, they say, was rooted in 1980s and 1990s when medical schools capped enrollment.
To address the problem U.S. medical schools admitted nearly 18,000 students last year and the ultimate aim is to increase enrollment by 30% over 2002 numbers by the year 2015.
Whether or not we need more doctors is a matter of debate, but that’s not my argument here. There’s a reason medical students aren’t choosing career paths like primary care and general surgery and it’s easy to understand.
I was talking with a medical student who will shortly begin his intern status. We were talking about primary care; he indicated his $200,000 debt (!) and the fact that he will be in his early 30s before he makes his first real paycheck prevent him from even thinking about about general medicine as a career. So I asked, if a primary care physicians made $100,000 more than they currently make, would you at least consider it?
That’s wrong. Primary care physicians are an important element of our current system, future reform may hinge on their abilities. It’s one thing to say that we will have a shortage of physicians with the solution being to train more and an entirely different matter to convince/persuade them to train for needed primary care roles.
Paying them more is a start.
Addressing the lack of physicians in rural areas will take more creativity. Training more physicians and “hoping” they will choose underserved areas to serve is a bit naive. Maybe we could start with tuition forgiveness programs for serving in rural/underserved areas?