Comments on: What do primary care physicians and cardiac surgeons have in common? http://www.kevinmd.com/blog/2009/08/what-do-primary-care-physicians-and-cardiac-surgeons-have-in-common.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: nanarcrhttp://www.kevinmd.com/blog/2009/08/what-do-primary-care-physicians-and-cardiac-surgeons-have-in-common.html#comment-109373 nanarcr Thu, 13 Aug 2009 22:58:34 +0000 http://www.kevinmd.com/blog/?p=39500#comment-109373 Primary care shortage could easily be solved: 1) Dramatically increase number of medical school slots 2) Make all NEW medical school slots available to US citizens/Permanent US residents as top priority 3) Contract for FREE med school education in exchange for matching # of years in primary care (no buyouts, no loopholes)As far as CTS, I was physician recruiter for 12 years, had many wonderful cardiac surgeons experiencing oversupply due to cardiologists performing procedures previously performed only by cardiothoracic surgeons. The overlap of noninvasive/electrophysiologist cardiac specialties into interventional/invasive, and all those stepping into CTS domain has blurred the line between medicine and surgery (from a patient perspective, I'm not sure for the good...) Valves and transplants will always keep CTS a necessity, but as long as folks are happy with cardiologists shoving stuff into their chests without even CTS backup available onsite or nearby, demand for this surgical specialty will decline.As for me, if I ever need a pacemaker or ICD, I'll travel to a board certified CardioThoracic Surgeon. I only have one heart, and one life. Primary care shortage could easily be solved:
1) Dramatically increase number of medical school slots
2) Make all NEW medical school slots available to US citizens/Permanent US residents as top priority
3) Contract for FREE med school education in exchange for matching # of years in primary care (no buyouts, no loopholes)

As far as CTS, I was physician recruiter for 12 years, had many wonderful cardiac surgeons experiencing oversupply due to cardiologists performing procedures previously performed only by cardiothoracic surgeons. The overlap of noninvasive/electrophysiologist cardiac specialties into interventional/invasive, and all those stepping into CTS domain has blurred the line between medicine and surgery (from a patient perspective, I’m not sure for the good…)
Valves and transplants will always keep CTS a necessity, but as long as folks are happy with cardiologists shoving stuff into their chests without even CTS backup available onsite or nearby, demand for this surgical specialty will decline.

As for me, if I ever need a pacemaker or ICD, I’ll travel to a board certified CardioThoracic Surgeon. I only have one heart, and one life.

]]> By: Michael Kirsch, M.D.http://www.kevinmd.com/blog/2009/08/what-do-primary-care-physicians-and-cardiac-surgeons-have-in-common.html#comment-109354 Michael Kirsch, M.D. Thu, 13 Aug 2009 17:41:52 +0000 http://www.kevinmd.com/blog/?p=39500#comment-109354 Ernie, I hope that I am wrong also, but I am concerned. Professions will always attract those who passionately pursue them. For example, many folks work in the government or for non-profit organizations for reasons that transcend their modest salaries. So, it will be with medicine. However, a medical education costs a fortune, a set salary afterwards will not draw our best and brightest to medical school. Beyond salary, there may be many other profound changes in the profession that may make it a less attractive career option. I didn't go into medicine for the money either. But, I think the long years of training we all did entitle us to be well compensated. Ernie, I hope that I am wrong also, but I am concerned. Professions will always attract those who passionately pursue them. For example, many folks work in the government or for non-profit organizations for reasons that transcend their modest salaries. So, it will be with medicine. However, a medical education costs a fortune, a set salary afterwards will not draw our best and brightest to medical school. Beyond salary, there may be many other profound changes in the profession that may make it a less attractive career option. I didn’t go into medicine for the money either. But, I think the long years of training we all did entitle us to be well compensated.

]]> By: ErnieGhttp://www.kevinmd.com/blog/2009/08/what-do-primary-care-physicians-and-cardiac-surgeons-have-in-common.html#comment-109352 ErnieG Thu, 13 Aug 2009 17:32:43 +0000 http://www.kevinmd.com/blog/?p=39500#comment-109352 Dr. Kirsch-- I think you are right, but hope you are wrong. I'm a young physician, and often wonder who the physicians of the future will be when it is economically undesirable to be an internist and the only thing we have is procedural specialists. They'll soon be squeezed, and then it will no longer be desirable to pursue a medical education, or at least will be desirable only to those absolutely dedicated to the profession. I'm not saying doctors went in it for the money, but it does not help that high expectations for care are unmatched by compensation. The sadness is not physicians aren't really at the table to define medical care and how it should be. Dr. Kirsch– I think you are right, but hope you are wrong. I’m a young physician, and often wonder who the physicians of the future will be when it is economically undesirable to be an internist and the only thing we have is procedural specialists. They’ll soon be squeezed, and then it will no longer be desirable to pursue a medical education, or at least will be desirable only to those absolutely dedicated to the profession. I’m not saying doctors went in it for the money, but it does not help that high expectations for care are unmatched by compensation. The sadness is not physicians aren’t really at the table to define medical care and how it should be.

]]> By: Rob Laihttp://www.kevinmd.com/blog/2009/08/what-do-primary-care-physicians-and-cardiac-surgeons-have-in-common.html#comment-109341 Rob Lai Thu, 13 Aug 2009 15:26:03 +0000 http://www.kevinmd.com/blog/?p=39500#comment-109341 You might find this video from The Doctor's Channel to be relevant. It discusses how factors such as increasing medical school debt and insufficient reimbursements for family, pediatric, and internal medicine physicians make primary care an undesirable field in the eyes of aspiring doctors. http://www.thedoctorschannel.com/video/2289.html You might find this video from The Doctor’s Channel to be relevant. It discusses how factors such as increasing medical school debt and insufficient reimbursements for family, pediatric, and internal medicine physicians make primary care an undesirable field in the eyes of aspiring doctors.
http://www.thedoctorschannel.com/video/2289.html

]]> By: Michael Kirsch, M.D.http://www.kevinmd.com/blog/2009/08/what-do-primary-care-physicians-and-cardiac-surgeons-have-in-common.html#comment-109337 Michael Kirsch, M.D. Thu, 13 Aug 2009 14:39:47 +0000 http://www.kevinmd.com/blog/?p=39500#comment-109337 The health care reform debate will also influence the number of students who will choose medicine as a career. I have read nothing about any 'reform' of the stratospheric costs of medical school education. Why would a pre-med incur enormous debt to become a physician, to then go on to work as a salaried employee for some entity? While passion for the medical profession will still hopefully draw some, marketplace forces that will make many students choose other careers. The health care reform debate will also influence the number of students who will choose medicine as a career. I have read nothing about any ‘reform’ of the stratospheric costs of medical school education. Why would a pre-med incur enormous debt to become a physician, to then go on to work as a salaried employee for some entity? While passion for the medical profession will still hopefully draw some, marketplace forces that will make many students choose other careers.

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