Robert Centor: “The pay rates for many subspecialties have negatively influenced an appropriate distribution of career choice . . . Talk to medical students and residents and you learn that many really do make decisions based on money.”
Related posts:
- Choosing a specialty: For love or money
- Physician recruiting: Money talks
- Teaching hospitals = higher quality care?
- Medical students avoiding primary care, is it more than money?
- Mediocre care to 1500 patients, or outstanding care to 500 patients?
- The measurement trap
- Investing in primary care
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I’m on faculty at two medical schools (one MD, one DO). My talks are to 3rd year students, after my lectures, I have started polling them on what factors they consider when choosing their future specialty and the #1 answer — LIFESTYLE. When I ask what that means, one student clarified, the maximum compensation for the minimum hours worked. Very blunt and honest.
Whereas, hanging on a cross for peanuts is SO much more admirable.
Duh!
Do you really think young students decide to be doctors because they have a life long dream of passing gas (anesthesia) or reading X-rays or treating skin or doing urology? No, they learn that these specialties are the R.O.A.D. (radiology, opthalmology, anesthesia, derm) To Happiness while they are in training. Pay and honor primary care and you will see a shift. Until that happens, young doctors will make choices that are fun and lucrative.
“Pay and honor primary care . . . “
But who is to be compelled to pay? Who is to be compelled to give honor and by whom?
Better to end centralized price fixing and let the market decide. If in the end, the public is not willing to pay primary care commensurate with the resources required for their training and motivation, then the public shall not have it.
It may be that this culture really wants and is only willing to pay for, and therefore deserves, disjointed uncoordinated and impersonal high tech care consisting of a string of procedures.
If so, then let it be.
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