Are We Legislating A Primary Care Crisis?

It was the same years ago in residency. There was both a categorical and primary care residency track. Each had their own distinctive curriculum and rotation schedule. The outpatient track did more time in the clinic, the categorical more on the hospital wards. We trained side by side. We attended many of the same lectures. And our fellowship choices matched identically. In fact, most of my colleagues from the primary care group are now cardiologists, gastroenterologists, and pulmonologists. Even then, those in training changed their opinion midstream when they realized what their professional lives would entail. It has become vogue to blame doctors and academic institutions for the falling number of generalists. We wag our fingers at the university behemoth who takes government moneys and then trains super specialized physicians. But, if you have been in education long enough, you know that the primary care push has been going on for decades. It just hasn't been that successful. Students and young physicians, time and again, change paths when faced with the day to day work of comprehensive primary care even though it is one of the most challenging and fulfilling jobs in medicine. Indeed, one might say we have come here by our own careful planning. We have legislated it that way. When you create a body that advises medicare on payment structure which is made largely of specialists and proceduralists and has no interest in protecting cognitive medicine, You have legislat...
Source: In My Humble Opinion - Category: Family Physicians Authors: Source Type: blogs