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    Wednesday, August 30, 2006

    More than Just Learning How to Use Dyazide: The challenges of primary care:

    'I just came here so that one person would tell me that I wasn't crazy to go into internal medicine,' she said. She had come to medical school because she wanted to take care of patients, she said, but she was discouraged by negative remarks about primary care medicine made by faculty members and fellow students. Then she asked me whether I liked being a primary care doctor.

    I hesitated before I answered - after all, I thought, it was true that morale had declined among primary care practitioners during the past few years. I told her, honestly, what I considered to be the problems as well as the rewards of this career path, and said I thought that primary care was a really good job. Later, I wished that I had told her what I really think: that taking care of patients as their primary care doctor is the best job in medicine.

    For all its troubles and woes, I think its the best job in medicine, too. I would shout it from the mountain tops. (I don't have a mountain top, so I'll shout it from this blog.) I love the variety that you see in primary care. I love the continuity. I can't imagine spending all day doing the same thing over and over again - one cardiac cath after another, one pelvic exam after another, intubation after intubation, x-ray after x-ray. We may not get paid as much as the specialists, but it's a much more satisfying field.

    Unfortunately, medical students rarely realize it:

    The proportion of U.S. medical school graduates entering the three primary care specialties (internal medicine, family medicine, and pediatrics) dropped from 50 percent in 1998 to 38 percent in 2006 — that is, a loss from primary care of more than 1500 students this year, as compared with 1998

    As has been pointed out on this blog before, that means there's going to be a very real and painful demographic crunch as the boomers age:

    Although the line of students signing up for a career in primary care medicine is getting shorter, the line of patients in need of primary care doctors is getting longer every day.

    posted by Sydney on 8/30/2006 08:55:00 PM 0 comments


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