Primary Care's Image Problem

In this week's "Doctor and Patient" column, I write about the dwindling numbers of U.S. medical students who are choosing to go into primary care. Medical educators have pointed to enormous educational debts, lower income, and less controllable hours and lifestyle as the major reasons that students prefer other specialties over primary care. Even with the current legislative attempts to remedy some of these issues, medical educators continue worry about a worsening shortage of primary care physicians.

Why? Because primary care also suffers from a terrible image problem.

While the frisson of advancing treatments and approaches to patient care seem to envelope most other specialties, the image of primary care remains one of a vaguely anachronistic practice, a group of doctors who stand not on the forefront of creative change but who are continually left holding the biggest bag of administrative expectations and clinical care coordination and demands. 

But that image may be changing. 

To find out more, please read this week's column. And join the discussion at Tara Parker-Pope's "Well" blog or below.

Comments

[sosaysgreenweaver.blogspot.com]

Hello! I am a second-year medical student and very strongly considering a Primary Care career. I absolutely agree that there is an image problem to be addressed, but I think that you might underestimate the reimbursement issue.

Dermatology has a terrible image problem among medical students. It is thought of as boring, not on the forefront of anything and populated by the vain. We recently had our dermatology block and some of our faculty had a conversation about that image with a group of us, and there really are a lot of parallels to how people see primary care. That said, there is huge competition for derm residency spots. It is really unfortunate, but I think the difference is a many many years' history of reimbursement difference.

While it might be image more than reimbursement that medical students respond to, the two do seem to be connected. I think until there is some significant equalization, the prestige will fall short.

[Brian Blank]

Hi, Dr. Chen -

I know I'm a couple months late to the party, but I wanted to thank you for this article on primary care's image problem. I'm a post-baccalaureate pre-med student at Harvard right now with a big desire to go into internal medicine. In my past life I was a cable news reporter/producer, and as I get ready for medical school I'm writing a book on primary care and the sad lack of interest from so many current medical students. It's kind of depressing! So I'm compiling stories of "primary care champions", doctors who still love what they do. Maybe, in some small way, I can help change primary care's image problem.

Anyway, just wanted to introduce myself. If there's ever anything I can do for, please don't hesitate to ask.

-Brian Blank

[Pauline]

Thanks, Brian. And good luck on the book and your post-bac studies!