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Primary Care's Hidden Loss

To Pay Bills, Medical Students Pick Specialties, Not Family Practice

September 29, 2009|By Jill Rosen , jill.rosen@baltsun.com

In medical school, Goel learned doctors have mere minutes to spend with each patient - far too few for much of a loving touch. She's learned patients often can't afford the care they need. And she's learned that her dream of becoming the patient, warm, oh-so-personal doctor from her childhood memories is probably not feasible.

Yet she's determined to become an inner-city pediatrician.

"If more people saw this system from the inside, they would have a different idea," she says. "If we as a society realized how broken our system is, we might not fear changing it so much."

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Goel, who grew up comfortably in Timonium, readily admits that if she were "doing it for the money," she certainly wouldn't have chosen a primary care field. She'd be angling for dermatology, radiology, plastic surgery.

And she certainly wouldn't be hoping to stay in Baltimore, where she knows she'll be immersed in staph infections, sickle cell anemia and people who can't afford the care she thinks they deserve.

"Ten years from now, I'd love to be in Baltimore, delivering care to people that don't have it," she says.

Tim Feeney, a second-year student from Morris County, N.J., isn't counting on riches, either. And that's probably a good thing, considering he's going for a Ph.D. in biochemistry and an M.D., hoping to one day study viruses and treat challenging cases.

At 26, he's a bit older than some of his peers, having spent time as an EMT and a firefighter before starting school. As an undergraduate at the University of Maryland, College Park, he cut costs by living at the Prince George's County firehouse and volunteering for the department.

He's always wanted to help people. And now, in medical school, he's refining that wish. He's begun to see emergency rooms clogged with people with ailments that should have been treated much earlier, doctors needlessly testing people because they fear malpractice suits.

He's come to the conclusion that he might be able to help more people in research, seeing patients as well as searching for cures for HIV or herpes.

"It's definitely daunting," he says. "Reform will happen, but I'm not sure it will happen as soon as President Obama wants it to. People are scared, and I can understand why."

Goel, who calls herself "a bleeding heart liberal," thinks health care reform without a public insurance option won't substantially change what needs to be fixed.

And she's become increasingly frustrated watching the political wrangling, the spreading of false information, the mounting predictions that a bill of real reform won't pass anytime soon.

"If you want to have free market pricing on cars and houses, that's fine," she says. "But the detriment of not being able to purchase health care is not the same as not being able to afford a Lexus. The consequences are life and death."

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