Why primary-care is doomed, in a nutshell

“Medical schools across the nation are producing fewer primary care doctors. Today’s medical students instead are choosing niche surgical specialties, according to annual surveys by the Association of American Medical Colleges.

Most of those students are motivated by lifestyle goals, said Dr. Gilhooley, the medical director in Wilkes-Barre.

Family doctors usually work 10 to 12 hour days, often skipping lunch and not knowing when they will go home. They are submerged in paperwork required by HMOs, because primary care physicians are the gatekeepers for managed care.

Specialty care, in contrast, offers predictable hours that appeal to the younger generation of doctors, said Mr. Howells, the Mercy Hospital administrator.

‘The dynamics are changing,’ Mr. Howells said. ‘They (young doctors) want to go their kids’ little league games, they want to go to the PTA meetings.’

Compared to other fields of medicine, primary care also pays the least, according to annual surveys of doctors by Medical Economics magazine.

‘We make a good living, but when people are making three, four, five, even eight times more and putting in less hours, that is disturbing,’ said Richard English, M.D., director of the residency program for Wyoming Valley Health Care System. ‘They (young doctors) don’t want to do it.'”

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