Story URL: http://news.medill.northwestern.edu/washington/special.aspx?id=127843
Story Retrieval Date: 5/25/2013 12:37:31 AM CST
WASHINGTON – When Kat Burgett graduates from medical school in May, she’ll have racked up more than $150,000 in debt.
But Burgett, a 25-year-old student at Detroit’s Wayne State University, didn’t get into medicine for the money. And in that respect, she’s very different from her classmates.
“There’s a running joke in med school about following the ROAD to success – radiology, orthopedic surgery, anesthesia and dermatology, and those programs are so competitive. They’re known for great lifestyles, and they pay the big bucks,” Burgett said.
Burgett is studying internal medicine and plans to become a primary care physician. She joins only about 2 percent of U.S. medical students who choose a general internal medicine career, as more and more young doctors turn to higher-paying jobs.
Where’s the love for primary care doctors?
“There’ll always be someone to put a metal clip on a brain bleed but not the person who keeps them from having a stroke in the first place,” Burgett said.
President Barack Obama has said he’ll tackle health care reform this year, and the expected shortage of primary care doctors isn’t a small part of the problems he’ll be facing.
“We’re not producing enough primary care physicians, because the costs of medical education are so high that people feel they’ve got to specialize,” Obama said at a March forum on health care.
It takes a hefty salary to even put a dent in the kind of debt medical students incur. Since primary care doctors are at the lower end of the pay scale, the lure of the specialty is especially attractive.
“Primary care physicians make much less money than a number of specialist positions do, and many medical students are graduating from school with both debt from college and debt from medical school, and it’s big numbers. You hear everything from $200,000 to $250,000 as average amounts of debt,” said Valerie Arkoosh, the president-elect of the National Physicians Alliance.
Can helping young doctors now help America in the long run?
Arkoosh suggests loan abatement or loan repayment programs for students who exhibit interest in pursuing careers as primary care doctors. Some schools offer low-interest loans for primary care students or even loan forgiveness, an option at Harvard University’s medical school.
But is it enough to change the minds of young would-be doctors? To further complicate matters, physicians are also paid on a per-service basis, which forces the few primary care doctors out there to fit in as many patients as possible.
“They’re moving patients through the office as quickly as they can and seeing as many people as they can, and that’s the only way to make enough to keep the doors open,” Burgett said.
That’s not even touching the topic of rural communities, where they aren’t worried about a shortage coming up – they’re facing it right now. That 2 percent of students isn’t going to be enough to go around.
“We need health care reform that actually invests in health care,” Arkoosh said. “Right now, we need a system that makes sure that the best and the brightest young people become doctors and nurses and that they do that all across this country where we have tremendous disparities in terms of where people are practicing.”
More doctors, less disease. Makes sense, right?
Even more important, she says, is focusing on prevention. Getting more primary care doctors into the workforce could reduce the amount of illness and, conceivably, the high costs of health care.
“There will always be students beating down the door to get into medical school. But, we’ve all seen the writing on the wall – we know there’s going to be a shortage,” Burgett said. “We need to redistribute the incentives to bring in primary care, and there should be less incentives for something like dermatology.”
The current salary range for internal medicine physicians is $154,000 to $238,000 and family medicine had an average salary of $185,740, according to two different studies of physicians’ salaries. That compares with a range of $ 195,000 to $452,000 for dermatology, for example. Radiologists and orthopedic surgeons had an average salary of more than $400,000.
Statistics and graphic information from Association of American Medical Colleges.