As a medical student in his last year, I can attest that my classmates and I would like nothing less than a crystal ball. Always a daunting time in a future physician’s career path, the direction we point ourselves as we launch out of medical school this year seems as arbitrary as ever.
As we examine the rolling seas of medicine and try to determine our individual paths, there seem to be more clouds than blue skies, and certainly more shadows than light. This may or may not be a feeling many prospective physicians feel, but for the class of 2010 it comes as a tough pill to swallow. In a profession at the heart of a national policy debate and with a storied history to examine, it’s extremely disconcerting to be faced with so many question marks.
There is a certain idealism that comes from limited experience — an allowance that dreams need not be modified to persist. We all harbor these dreams and try hard not to let them be altered by a changing reality. However, from our superiors we receive mixed messages, and from the public we receive mostly blank stares. Our compatriots behind us in school look to us for advice, and many of us find ourselves mumbling incoherently. The traces of idealism that remain after several years of medical school don’t seem to fit with the puzzle of moving pieces in front of us. There are just too many variables.
One of the entities most shrouded in mystery seems to be primary care. As we look at the future of primary care, it seems disingenuous to examine its recent past, especially in light of the changes in policy that are on the horizon. Many of us feel that primary care is in some ways the answer to both our own inability to decide on a medical specialty and to our patients who so desperately yearn for care that is not fractioned and divided but holistic and caring. However, our mentors tell us to proceed with caution, and we don’t have the answers yet as to how primary care can help us to evolve.
Of course, there are answers to these problems as well, including getting out of the current insurance model and providing quality care that is affordable to patients. But to do this, we need both mentors and colleagues to help guide us; it’s not a road we can navigate by ourselves. In this vein, I’d call on physicians who are building their own health system and client base to interact with medical students and residents both virtually and physically, and show them that there are other options that exist for the administration of primary care.
My friends at DocTalker are spearheading one such movement, and I encourage others like them to reach out to medical students and residents alike. We certainly could use the advice. We are absolutely open to hearing about alternatives to the status quo. In fact, we almost yearn for it.
My cohort of physicians in training may not argue if they were described as the lost generation. We are straddling what most would agree is a broken health system and what is sure to be some sort of reform, with effectiveness still pending. We are some of the first to train in such a digital age, with Facebook, Twitter, and yes, Wikipedia, now literally at our fingertips most of each day.
Scientific knowledge is growing exponentially. It’s an exciting, and extremely daunting time. The most beneficial trait at this point would have to be adaptability, but it’s difficult to decide exactly which way we should try to bend. While we tackle the prospect of forging a new era in medical practice, it’s imperative that we work closely with mentors and those that have come before us that are trying to do the same.
Only good things will come of this relationship, particularly for primary care.
Until next week, I remain yours in primary care,
Dan Hart, Medical Student and Intern