I Probably Won't Be Your Family Doctor

July 19, 2009|By Pooja Aggarwal

Like many medical students, I proudly wear Obama T-shirts and yearn to reform medicine. While watching the president speak, I envision myself working in primary care, on the vanguard of health care reform.

Then, a little later, reality hits.

With the number of senior citizens rapidly growing, by 2020 we will likely lack 200,000 physicians. So why do only 2 percent of medical students choose family medicine?

Medical students undervalue family medicine residencies in comparison to programs such as dermatology. Some highly regarded academic institutions, including my own medical school, do not even have a family medicine training program.

The thought of serving the needy allows some students to dismiss the glam factor of becoming, say, a plastic surgeon. However, their medical school debts are not so easily discounted. In a study in the Journal of the American Medical Association, 40 percent of students accumulated loans greater than $130,000 by graduation. Many find a career in primary care out of the question when procedural fields with higher reimbursement rates give the option to earn more than twice the income and work fewer hours. Unfortunately, physicians cannot bill health prevention measures such as blood pressure screens the same way they could bill Botox injections.

Sixty percent of students view internal medicine fields as requiring more paperwork than other specialties. Red tape generated by insurance companies leads many primary care physicians to be dissatisfied with their jobs, and students find this frustration glaringly evident when making career choices.

The president's American Recovery and Reinvestment Act pours money into efforts to convert from a paper to an electronic medical record system. However, the benefits of this switch will not be appreciated for years to come, and the shortage of primary care physicians is happening right now.

Health care provides promises medical care to those that are uninsured, but who will take care of these thousands of patients when they get coverage? Reform plans do not place enough emphasis on training physicians to serve preventive care roles.

President Obama was right in his speech last month to the American Medical Association. I did not choose my future profession to be a bean-counter or paper-pusher, but I worry that I may become one.

Pooja Aggarwal is a fourth-year medical student at the Johns Hopkins School of Medicine. Her e-mail is paggarwal@gmail.com.

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