3 Ways Healthcare Reform May Impact Medical Education

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Emphasis on primary care would be good and we can't deny there are a lot of things to consider to truly transform primary care. For one, some small to medium sized practices don't have enough infrastructure to enable essential advancements. They just can't fund personnel for this. A community, on the other hand, can. Then, a community-based health care extension can contribute in the progress of primary care. Things they can do:
1) Provide small practices with services of professionals.
2) Connect local primary care practices to existing community resources (e.g. social services, mental health services, and public health resources and programs).
3) Give essential technical assistance to primary care practices.
4) Work hand-in-hand with academic centers and primary care practice–based research networks to correspond practical clinical trials to respond to practice-informed research questions.

Roberta Clarendon of CA 3:53PM November 14, 2011

informative one

Jan Rob of 2:15AM September 29, 2011

All medical students pay the same tuition. If we want our med. students to commit to primary care, discount their tuition by at least half in return for working in primary care at least 5 years after residency. Otherwise, the only ones in primary care will be PAs and NPs with no one to oversee their practice.

do of MA 12:57AM May 13, 2011

Well said, Ob/gyn in Houston. Money wasnt an issue at all for me until I started receiving bills in the mail to cover my loans. Im $200,000 in debt and I dont want to/deserve to work like a dog to pay that off and have time to spend with my family.

Psychiatry Resident of TX 3:32PM May 11, 2011

If you notice, there is a new wave of membership primary clinics. You pay a fee, locally $1500 a year, to be a patient. They then proceed with your normal billing of insurance, copay, etc. The clinic will take only a number of patients. Locally this is 500 or 600. Do the math. This clinic sees the future. People with the funds are willing to keep their trusted doctor. Hopefully, we won't see a decline in the requirements to be a primary physician. What I do expect, and do not favor, is the use of nurse practitioners as a primary physician. Very valued, but not equally trained. The initial requirements of being a nurse are fabulously lax compared to a physician. Big government is going to have it's day to save money.

LC of MD 12:30AM May 09, 2011

I think sense of purpose is important and believe that most people do not go into medicine *for the money*. I myself didn't. However, some med students/young docs become more real about financial realities of being a doc--rising tuition/overwhelming student debt/declining compensation, etc. And--gasp!--many doctors-in-training realize that a) life is not all about practicing medicine, b) it's not unreasonable to want to spend some time with one's family, and c) seeing more patients in less time does not necessarily make one happier.
What a lot of people overlook is that some people choose to go into lifestyle fields not just for the money, but for the more reasonable work schedule and less-frenetic hour-to-hour pace of the work.
Think about it - we have an increasingly sicker population, while compensation and time available for seeing these patients is declining. Let's say you're pursuing medicine solely out of a sense of purpose--wouldn't your passion for medicine erode a bit if you had less and less actual face time with your patients, longer wait times in your clinic (and thereby more frustrated patients), and so on? This is the reality of many areas of medicine. Especially in the case of primary care.
Just like teachers need to be paid more and be given the space/smaller class sizes/resources to thrive really do the fantastic job they WANT to do, primary care docs need, yes, better compensation, but also more time to really do a great job in taking care of their patients.
Many in medicine would do their job for 100k a year if they knew they would have ample time/resources to see their patients and provide care for them in a thorough, compassionate, positive, and--dare I say--fun way. In other words, practicing medicine "in the way I intended to when I went into this field". Would I see 40 patients in a 1/2 day for 50 or even 100k more a year? No. Life is too short to be miserable and burnt out.
With health care reform, it's important to not just open the floodgates of coverage and see how the docs and other providers manage cracking under an overwhelming situation. That's a quick way to drive a lot of good people away from medicine. We can and should be more efficient, effective, and provide coverage to all, but we have to do it in the right way. Otherwise, a number of really good future (and current?) physicians may be looking to find and fulfill their sense of purpose somewhere else.

OB/Gyn resident in Houston of TX 6:16AM May 06, 2011

Own your statement Capella, radiologists and anesthesiologists overwhelmingly are in it for the money, they admit it and so can you.

Reg Broccoli of MN 3:26PM May 04, 2011

I do not agree that medicine career attracts individuals with higher sense of purpose. It varies by specialty! For pediatricians -- yes for sure. For specialties like anaesthesiology and radiology -- I dont know. -- Capella Campomayor, New York.

Capella Campomayor of NY 11:33PM May 03, 2011