BUILDING MORE MEDICAL SCHOOLS WON’T SOLVE PATIENT ACCESS ISSUES

Sheri Porter

doi:10.1370/afm.1610

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Economics
J T

Published on: 07 February 2014
A student's perspective
Harris Enzo

Published on: 23 January 2014

Published on: (7 February 2014)
Page navigation anchor for Economics
Economics
J T, physician
The return on investment for becoming a primary care doctor continues to get worse and worse as medical school costs have more than doubled over the past decade while physician reimbursements to primary care doctors have nearly halved. Students during their 3rd year rotations see how family medicine doctors barely break-even in their practice while seeing an enormous patient load and often committing chart fraud just to...
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The return on investment for becoming a primary care doctor continues to get worse and worse as medical school costs have more than doubled over the past decade while physician reimbursements to primary care doctors have nearly halved. Students during their 3rd year rotations see how family medicine doctors barely break-even in their practice while seeing an enormous patient load and often committing chart fraud just to stay in business. People don't go into primary care because it is not a good return on investment nor a rewarding lifestyle. This is simple economics at work. The solution is when government removes itself from healthcare.
Competing interests: None declared
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Competing Interests: None declared.
Published on: (23 January 2014)
Page navigation anchor for A student's perspective
A student's perspective
Harris Enzo, Medical student
Coming from a student's perspective I want to share some thoughts from the "front line" to your article. Most students who are going to medical schools or even wanting to go to medical school do not really want to be a primary doctor as their dream. This has many causes and one of them originates from student's innate competitiveness. These kids are smart and dedicated individuals who are one of the few from their gener...
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Coming from a student's perspective I want to share some thoughts from the "front line" to your article. Most students who are going to medical schools or even wanting to go to medical school do not really want to be a primary doctor as their dream. This has many causes and one of them originates from student's innate competitiveness. These kids are smart and dedicated individuals who are one of the few from their generation still on their path to reach a stereotypical 1st grade elementary career day occupation, this includes firefighter, policeman, navy seal, New York fashion designer, professional golfer, Hollywood director, wall street stock broker, or even the President of the United States. Just from the standpoint of competition these students went through since the 3rd grade spelling bee, they want to obtain the highest they can in life because their ambition is still continuing unlike many others in their generation, this applies to residency application process during 4th year. This innate thinking of A is "average" and B is "bad" developed for 18 years of their life is what pushes these individuals to go through the 500 pages pathology book at a Saturday night and get up next day for an early morning round with attending during their 20s while their non-medical school friends are enjoying their life fishing somewhere in Colorado. The innate competitiveness is a paradoxical force in medical students, at one end it pushes them to strive forward, on the other they don't really know what they want in life besides being extremely competitive and try to climb as high as they could. Sometimes it gets to the point where competition is an addiction for these students to feel a sense of purpose in life.
Even kids who do want to become primary doctor on the first day of medical school, the challenge and hoops so to speak these student jumped through will make many of them re-think the life they want to live after this gruesome 4 years of medical school competing with other like-minded individuals. The level of competition though constant exams and clinical performance in front of attending physician can really bend student's minds. I guess this goes back to the thinking of competition, where if you put a dolphin in an aquarium tank full of sharks, the dolphin will think like the sharks after awhile. Although school does teach us about the entirety of medicine with the aspects of healing, ethics, and patient- oriented health management, it still comes down to obtain the correct diagnosis, treatments in a short amount of time. The way of physicians as a complete healthcare leader, who can tackle medical problems, connect with patients and manage staff takes years to develop after medical school. So to think about problems like primary care physician shortage is relevant but unreal to many medical students since they are surrounded by doctors everyday.
I agree, this country does need to take a different approach on tackling shortage of primary physicians among many other healthcare things. But this "old" system is based on the concepts of competition and ranking that only medical students can understand fully and handle with their competitive nature they have developed in their past 20 or so years of- competition within academic settings with the lack of actual societal exposure & experience.
Competing interests: ?? None
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Competing Interests: None declared.