The future of primary care: the ACP responds

A few days ago, I wrote about how the our leaders in primary care were out of touch with what drives medical students’ career choices:

That’s all well and good, but perhaps primary care needs to appeal more to the bottom-line. It has been shown that a better lifestyle is a priority in today’s medical students, which is evident by more and more taking the R.O.A.D. to happiness. In comparison, primary care offers the pressure of seeing more patients in the setting of declining reimbursements. It doesn’t take a genius to figure out why interest in primary care is declining: doing more work for less pay isn’t the best way to sell the profession.

This brought out some frank talk:

Let the researchers puzzle over this: why would anyone want to go into a field where every indication is that the annoying stressors become ever more burdensome while the costs of operating a practice rise relentlessly and reimbursement is nearly flat . . . If I had $200,000 in school loans and was also trying to play catchup in life to buy a house, save for retirement and do all those things that everyone else outside of medicine needs to do, I would certainly want to give great thought as to whether my field of choice was going to be compensated properly, without being sweatshopped.

DB’s Medrants, Health Care Renewal and Blogborygmi all chimed in, suggesting that the ACP is out of touch with the realities facing medical students when choosing a career.

I wrote to Dr. Steven Weinberger, senior vice president for medical knowledge and education at the ACP, who was quoted in the original article, directing him to these opinions. He responds:

Dear Dr. Pho,

Thanks very much for your note and for directing me to your website. Indeed, a key to solving the problem is fixing the dysfunctional reimbursement system. The ACP (through its Washington office) is very much involved with trying to do just that. However, fixing the reimbursement system is not the easiest task in the world. Interestingly, a small step in the right direction is something like payment for e-mail communications between doctors and patients, for which there are some pilots, as was described recently in the New York Times.

Small steps indeed, but we still have a long ways to go. It is encouraging that the ACP is listening, and our continued vigilance in providing real-life feedback to our leaders will be essential in primary care’s future.