Why this medical student has second thoughts about primary care

I went to medical school to go into family medicine. During my interview when I said I wanted to do family medicine, the interviewer looked me up and down and said, “You know, you don’t have to say that just because you are at (insert name of primary care focused medical school).”

Now, less than two years into medical school, I’m watching with sadness as the “con” side of my pro/con primary care seesaw tips lower and lower. My intentions of writing this are not to bash, elevate, or debate any specific specialty, but to explain what the current state of primary care looks like as a second-year medical student and how that will affect my residency decision and therefore the future of health care.

There is a large disconnect between practicing physicians and medical students. My point of writing this is to bring up the some of the concerns that medical students perceive as rational reasons to stay away from primary care, even if they feel as though they would make great primary care physicians.

Through my eyes as an eager medical student, two recent legal changes shook my outlook on primary care:

1. Oregon NP Payment Parity Bill (HB 2902): “The first state in the nation to require insurance companies to follow ‘equal pay for equal work’ rules on insurance reimbursements for nurse practitioners, physician assistants and physicians in primary care and mental health.”

2. VA Grants Full Practice Authority to Advanced Practice Registered Nurses

When I read those articles, everything changed. Why would any medical student want to pursue primary care after eleven years of post-high school education, when they could do the same thing, for the same pay as a nurse practitioner or a physician assistant? I can’t help but ask myself, will I be overtrained to go into primary care? Will I take too many exams, work too many hours, and take on too much debt to go into primary care?

It is the erosion of physician territory, particularly in primary care, that makes me step back from my prior commitment to primary care and strongly reconsider options that pay better and are not encroached upon by other professions. Part of me feels like a traitor.

If you want to know how to get more students to go into primary care, I would start by addressing these fears. It is hard for medical students to decipher if the primary care boat has simply hit a wave and taken on a splash of water or if it is more like the Titanic heading towards an enormous iceberg. Some specialties appear to be watching from the shore pointing and laughing rather than assisting or calling for help. The boat I am on is heading towards what looks like thick smoke.

Put yourself in my shoes: Do I jump ship or take a deep breath and hold on?

The author is an anonymous medical student.

Image credit: Shutterstock.com

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