In medical schools, primary care continues to be among the least respected fields a student can choose.
No where is that more starkly illustrated than in Pauline Chen’s recent New York Times piece, where she tells a story of a bright medical student who had the audacity to choose primary care as a career:
Kerry wanted to become a primary care physician.
Some of my classmates were incredulous. In their minds, primary care was a backup, something to do if one failed to get into subspecialty training. “Kerry is too smart for primary care,” a friend said to me one evening. “She’ll spend her days seeing the same boring chronic problems, doing all that boring paperwork and just coordinating care with other doctors when she could be out there herself actually doing something.”
This lack of peer respect is one reason why only 2 percent of medical students choose primary care internal medicine as a career.
Regular blog readers will know that the generalist-specialist salary disparity, combined with the paperwork and high professional dissatisfaction rate, are major reasons why future doctors are avoiding primary care medicine.
But there remains an implicit bias among medical educators favoring procedure-based medicine, mostly due to the disproportionate amount of dollars specialists bring to an academic institution. Hospitals and medical schools give specialists unspoken, preferential treatment, and that sentiment trickles down to medical students.
There’s no doubt that influencing future doctors away from primary care starts from the earliest stage of medical training.
