Leaders in medicine are trying to figure out how to make primary care attractive to students and residents once again
“AAMC has formed a group to consider broad issues around improving chronic care, including how a change in emphasis could be one way to attract more students into primary care. This group started its work last fall and is expected to produce a proposal sometime this year, Dr. Whitcomb said.

Trainees and students often don’t recognize the gratification of building relationships over many years, said Steven Weinberger, M.D., senior vice president for medical knowledge and education at the ACP. He said he hopes that by redesigning student and resident training, medical school faculty can demonstrate to students that primary care offers the potential for long-lasting relationships with patients.”

That’s all well and good, but perhaps primary care needs to appeal more to the bottom-line. It has been shown that a better lifestyle is a priority in today’s medical students, which is evident by more and more taking the R.O.A.D. to happiness. In comparison, primary care offers the pressure of seeing more patients in the setting of declining reimbursements. It doesn’t take a genius to figure out why interest in primary care is declining: doing more work for less pay isn’t the best way to sell the profession.

Health Care Renewal and DB’s Medical Rants also comment. It seems that many of the academic physicians in charge of analyzing the problem are out of touch with both the real world and the wants of medical students today:

Understanding student decision making is not rocket science. Kevin does primary care – and he understands what our leaders apparently do not understand.

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  • Anonymous

    Who can blame them? Graduates today finish with more debt and higher practice costs than at any time in the history of U.S. medicine, while facing a resource-constraining reimbursement system that has been racheting down physicians’ incomes for many years now. Let the researchers puzzle over this: why would anyone want to go into a field where every indication is that the annoying stressors become ever more burdensome while the costs of operating a practice rise relentlessly and reimbursement is nearly flat. Add to that the well-publicized efforts some who have already been in practice are making to get out of insurance-based practice and into other types of activity; concierge practice, and whatnot. If I had $200,000 in school loans and was also trying to play catchup in life to buy a house, save for retirement and do all those things that everyone else outside of medicine needs to do, I would certainly want to give great thought as to whether my field of choice was going to be compensated properly, without being sweatshopped.

    Here’s an idea: instead of wasting time head scratching, why don’t the researchers at the ACP address the real problem, getting the U.S. Government to pay properly for the services it is buying and to force insurers and other third-party payors to do the same, on behalf of those who have bought their policies. All the talk in the world won’t help; there has to be the belief that fair pay will be given for fair work, and enough pay to make the costs of getting qualified–all the costs, real, deferred and opportunity–worthwhile.


  • Anonymous


    A-freaking-men. I couldn’t have said it better. Funny how you never see that sort of straight talk in any of these “analyses” of the reasons behind the decline in the number of primary care physicians.

  • baran

    Hi I am baran
    I am medical student
    I see your blog

  • dlp

    Finished FP Residency in 1992. The worst decision I ever made in my life was Family Practice!! For the last 16 years or so I have have watched it continually decline in every single way. My income hasn’t kept up with inflation, while the other specialties are reimbursed more than double for way less than half the work. Huge decline in prestige….we are Primary Care Providers now….lumped in with nurses and PA’s and “advanced nurse practictioners” . I can’t believe that anyone would make Family Practice a career choice. Complete and total waste of my young adult years in training and waiting like a fool for FP to make a resurgence. FP is dead. It is no wheresville. I harbor so much anger towards the AAFP and all those who killed Family Practice. I cant even set up a no insurance practice without having to opt-out of medicare which would then make me unemployable. We as Primary Care Providers are held hostage by the Federal Government and insurance companies. Wasted my young life becoming a Family Practioner totally blinded by what others said about how noble it was. Any career choice would have been better for me. Most people with four year degrees have done way better than Primary Care Providers…what a demeaning term given to us now. I hate it.

  • WilliamManginoMD




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