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    « Primary Care's Image Problem | Main | When the Patient Can't Afford the Care »

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    Ed Volpintesta MD

    February 20, 2010

    The New York Times
    Well Blog

    Dr. \Pauline Chen broached a serious subject in “Do You Have the ‘Right Stuff” to be a doctor” in the Jan. 15 issue of the New York Times.

    For almost a hundred years American medical schools have focused mainly on medical research. To be admitted to medical school, a student has to demonstrate a high aptitude for science. That is the reason why they turn out physicians who contribute greatly to the advance of medical science.

    But, as Dr. Chen pointed out, are students who might not have strong aptitudes for science, but who have personal qualities that would make them good practitioners being overlooked by the screening process? Should personal qualities like openness, conscientiousness, extraversion, and agreeableness also be taken into account as well?

    This question is not a new one. It was suggested that the answer lies with whether medical schools want to turn out great researchers or great practitioners. I don’t think however that this is an either/or situation. Since both kinds of doctors are needed why not decide what percentage of each will satisfy society’s needs; and adjust the medical school admission rate accordingly?

    However medical educators decide to handle this problem, the predominance of the sciences in medical school will make the transformation difficult.

    The shortage of primary care doctors is the most obvious example of how medical schools have created a lop-sided physician workforce. By over-concentrating on students’ scientific aptitudes, they have created a medical culture that rewards medical specialization to a much greater degree than primary care.

    The result is an unbalanced, over expensive, work force that under serves many of society’s basic medical needs. The lack of primary care providers is one of the central issues of the health care debate. I most likely will be solved, in part, by recruiting suitable trained nurses to provide some primary care services independently.

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