February 23rd, 2011 by KevinMD in Health Policy, Opinion
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There are plenty of reasons why medical students aren’t choosing primary care as careers. Lack of role models. Perception of professional dissatisfaction. High burnout rate among generalist doctors. Long, uncontrollable hours.
But what about salary? Until now, the wage disparity between primary care doctors and specialists has only been an assumed reason; the evidence was largely circumstantial. After all, the average medical school debt exceeds $160,000, so why not go into a specialty that pays several times more, with better hours?
Thanks to Robert Centor, there’s a study published in Medscape that shows how money affects career choice among medical students. Here’s what they found:
Sixty-six percent of students did not apply for a primary care residency. Of these, 30 percent would have applied for primary care if they had been given a median bonus of $27,500 before and after residency. Forty-one percent of students would have considered applying for primary care for a median military annual salary after residency of $175,000.
And in conclusion:
U.S. medical students, particularly those considering primary care but selecting controllable lifestyle specialties, are more likely to consider applying for a primary care specialty if provided a financial incentive.
Money matters. There should be no shame for new doctors to admit that. After all, they’re human too, and respond to financial incentives just like anyone else. And when most medical students graduate with mortgage-sized school loans, salary should be a factor when considering a career. Read more »
*This blog post was originally published at KevinMD.com*
October 20th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, News, Opinion
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The first-year medical students I precept were too young to see Tom Cruise’s alter ego Lieutenant Pete “Maverick” Mitchell grace the big screen in the 1986 blockbuster film “Top Gun.” Yet, the story has a relevant analogy to medicine.
According to the film, during the Vietnam war American pilots were relying too much on technology to bring enemy fighters down. They weren’t as skilled in taking out the opposition. They fired their technologically advanced missiles to try and get the job done. They didn’t think. It didn’t work. They forgot the art of dogfighting.
The military discovered that technology alone wasn’t going to get the job done. The best fighter pilots needed the skills, insight, and wisdom on when to use technology and when not to. As a result, the Navy Fighter Weapons School, known simply as Top Gun, was created to retrain the military pilots on this vital lost skill. The goal of the program was specifically to make the best of the best even better.
Like the military, the country is discovering that the healthcare system enabled with dazzling technology isn’t getting the job done either. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
September 8th, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
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“MEN WANTED FOR HAZARDOUS JOURNEY. SMALL WAGES,
BITTER COLD, LONG MONTHS OF COMPLETE DARKNESS,
CONSTANT DANGER, SAFE RETURN DOUBTFUL. HONOR AND
RECOGNITION IN CASE OF SUCCESS.”
With this want ad, circa 1914, Sir Ernest Shackleton recruited 28 souls with an unimaginable challenge: To cross the unexplored Antarctica on dogsled. The polar explorer knew exactly what human characteristics he needed to pull off such a feat and understood that straight talk would resonate with a few select men.
Shakleton and his crew boarded their ship, the “Endurance,” and sailed the world’s most dangerous oceans straight into harms way — still considered one of the world’s greatest survival stories. Amazingly, all men survived against unimaginable odds. Their story reminds us that we all stand on the waves and wakes of dreamers, doers, slaves, and fools, all who say, “We did it, took our chances, immigrated to the U.S., headed West, built a new business, risked it all.”
And, if you listen closely, you will hear their stories as an invitation that has been repeated throughout history: “What will you do? Whether your turn or your calling, what will you do?”
Today, I’m posting a similar want ad to medical colleagues. The journey may be far less physically dangerous, but considering prevailing attitudes, perhaps it’s as daring in imagination. Read more »
September 1st, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Opinion
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Everyone understands the need for a robust primary care workforce in making healthcare more affordable and accessible while keeping those in our care healthy. With the aging of America and healthcare reform, even more Americans will need primary care doctors at precisely the same time doctors are leaving the specialty in droves and medical students shun the career choice.
As a practicing primary care doctor, I’ve watched with great interest the solutions for the primary care crisis. And I’ve been utterly disappointed.
Patients so far don’t like the patient-centered medical home (PCMH) as noted in Dr. Pauline Chen’s New York Times column. The changes recommended won’t inspire the next generation of doctors to become internists and family doctors. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
