Thursday, September 11, 2008

Only 2% of Medical Students Going Into General Medicine

With only 2% Medical Students planning careers in General Internal Medicine, we are in for a huge medical crisis. The USA will have 200,000 fewer doctors overall than it needs by 2020, yet the number of older Americans is expected to nearly double.

The reasons are clear and medical students are walking away from Primary Care specialties in droves.
  • High medical school debt (average >$150K)
  • Lowest income of all specialties
  • Highest hassles and horrible paper work of all specialties
  • High cost of running an office (supplies, phones, billing, space needed, employees needed)
  • Grueling crush of patients with no relief (no lunch, no break, no time for research or thinking about complex medical problems)
  • High level of responsibility for "everything"
  • Grueling call schedule
  • Lack of respect from other physicians. Often dumped upon... "Call your primary"
  • Requirements for best practice prevention and screening without systems to help manage it.
  • Inability to combat low reimbursement and claims denials.
There is already a shortage of primary care physicians across the Country and even in academic meccas like San Francisco and Boston, you will not be able to easily find a doctor to take you as a patient. The mature primary care physicians are dropping all insurance and doing "concierge" medicine. They are busy with fewer patients at higher reimbursement by dropping out of the low pay insurance game.

As Internists and Family Medicine doctors retire or wind down, there is no one to take their place.

Forget what you hear about Universal Care. If you can't find a doctor, it doesn't matter what your insurance is. With 2% of Medical Students choosing primary care, the Emergency Departments and high priced specialists will thrive and continuity of care will be a thing of the past.


Anonymous said...

It’s interesting to see that even a boring topic like medicine can capture such media space and have so many words devoted to it. To quote an instance we can mention chantix. Its one of those drugs that almost represents the whole concept of the quit smoking drugs, or rather publicity has made it that. Irrespective of the fact how chantix works or how effective it is it has managed to gain a fair amount of attention and make way to the people’s homes. Thanks to publicity or rather publicity agenda superstardom for a drug was an unthought of concept a few years back.

Cecilia said...

I'm a med student, and I hear you. I'm not planning on going into primary care, for many reasons, but the ones you mention are among them. I wish I were more of a hero, but I'm not. Something clearly needs to change...

Anonymous said...

I get asked constantly about who is accepting new patients and I cannot think of any doctor's name to refer. It is already a crisis. You can get an appointment with a dermatologist in one day for botox but try to get a new primary care doctor and you are just out of luck.

tracy said...

i have an amazing, kind, wonderful, excellent Internest, i can't imagine how i got so lucky as to find him...and i expect any day now for him to become a Hospitalist...just like the last wonderful Internest i would be awful, but i couldn' say i would blame him, for giving up the fight...

tracy said...

PS Congratulations on the award, Dr. Brayer, you most definately deserve it!! i love your blog-how do you find the time to do everything?? i sure am glad you do!
thanks sooo much,

Toni Brayer MD said...

Thank You, Tracy!

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