A healthy rant from the Daily Kos, which is accurate in saying that universal coverage will push primary care over a cliff:
Add a new national health insurance scheme or mandate””without addressing the dwindling supply of primary care docs””and things may quickly collapse. The pent-up demand for medical care among the uninsured and underinsured is huge. We have absolutely no reserve capacity to serve them.
Most of the essay is similar to what’s been discussed here, but the take on academic medicine caught my eye:
. . . the very culture of university hospitals and medical schools is profoundly hostile to primary care. The high priests of academic medicine are brilliant subspecialists, innovative surgeons and similar technically oriented superstars, hailed for their ability to bring research money and publicity to the medical center. Primary care by contrast is habitually denigrated and disrespected. The lip-curling sarcasm directed at the “LMD” (local medical doctor), the withering contempt for primary care in the trenches, has to be seen to be believed. Medical students “bake” for four years in this hot-house atmosphere. Small wonder so few choose primary care. Add in the vast disparity in income, and it’s a miracle anyone does.
Increasing the primary care numbers starts with respect for the work we do. Judging from what I read here, the hostility medical students have for generalist medicine starts at the very beginning.
If our colleagues don’t value primary care, how can we expect the public and politicians to?
