Duke closes its family practice residency

General internal medicine is also a dead end. This is a serious problem and no one outside of medicine understands it. The lead-footed government has created incentives for young doctors to avoid these career choices like the plague. In twenty years if someone has a fever and “feels bad” they will have a problem deciding which specialist to go see, as there will be no more “general doctors”.

I think everyone can see clearly that it is a bad thing not to have quality primary care doctors, but why isn’t anything being done about it? Is my assumption incorrect? Will it be better to have a pure specialist system with more retinal specialists than internists?
b

I am a current medical student. (3rd year)
I can honestly say that the fields I won’t ever touch are family medicine or Ob/Gyn.
My fiance is also a medical student and if she goes into internal…. it better be a sub-s. No way am I going to school for this long to get pushed around by this crap

Using PAs and NPs require supervision. What normally happens is a doctor who is seeing 20 patients a day also has a NP see 15 patients a day. Do you think he/she re-examines the patient, develops a differential and then does a quick uptodate search to verify his treatment is still correct. Hell no. All he/she has time for is to say, “great, thanks” and run to the next room. that system actually is much harder for the doctor and exposes him/her to more liability, while only slightly increasing his/her revnue. The NP requires another MA to bring their patients back and that much more ancillary staff for billing, calls, insurance, etc.

Anyone who has ever been treated by a NP knows it is nothing like being seen by a doctor. You hope that the NP is confident in their diagnosis, but you can tell their not.

I know financially having “extenders” looks great on the financial side of things, but to the person on the exam table, it is a lose-lose propisition.

Next solution?
b

It will get worse before it will get better.