It’s well known that fewer medical students are opting to become family physicians.
This is having a deleterious effect on training programs, where slots are going unfilled. It costs approximately $100,000 to train a single doctor, and hospitals are operating family practice residencies at a loss.
Two programs in Arizona are eliminating such primary care training positions, citing cost and declining student interest.
As “doctors are more likely to launch their careers near where they complete their medical training,” this further depletes the region of much-needed new primary care blood.
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- Should general internal medicine merge with family practice?
- Are family physicians better suited to practice primary care?
- The specialization of family medicine
- Should family physicians continue to provide obstetric and maternity care?
- How emotional stress affects physician training
- Can family doctors do safe first trimester abortions?
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As a candidate for one of those residency’s spots and a life-long Arizonan, I can agree that this is a tremendous blow to primary care in Arizona. These moves show a serious lack of foresight.
I think this connects with your earlier posts about whether the physician salary inequities lead to lack of student interest in primary care. The bigger issue is the lack of value placed on primary care and how that plays out in the reimbursement system. Hospital systems can’t make primary care “pay”, so they look for ways to divest themselves of these training programs. So we reap the final harvest of the system as it is currently constructed: nobody to do all the important basic cost saving services and who is trained to be alert to find the occasional zebra. In urban and suburban areas maybe this will all get taken care of by people self referring to various specialists (I can think of numerous patients in my practice that you will really enjoy seeing, specialist friends!)
But the real losers are the low income folks that get good care from residency programs and the inner city and more rural areas that can’t support a specialist practice and need well trained family docs to come to their communities. What do those people do when the pipeline dries up?
Its hard to imagine sustainable health care reform that doesn’t address this whole mess right up front.
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