There is only one way to produce more primary care doctors. Money. You may want to throw prestige as another factor but that isn't tangible. The harsh reality is that the medical students of tomorrow need to know that they will be making a very good living. I am not saying that family doctors or internists are poor but to carry a $200,000 school loan burden while also being out of the workplace for 10 years for training while your friends having been making a living, you feel you are worth it. Money. Not big money like a neurosurgeon, either. Just more money. The Washington Post just put out an article Primary-Care Doctor Shortage May Undermine Reform Efforts. Duh. Please see Placebo Television #17. I love the example that the article put out about the disparity of procedure driven compensation and primary care. They compare a half-hour visit for $89.64 to your family doctor to the $422.90 paid for the colonoscopy done in the same time by a gastroenterologist. The specialists point out, in the article, that the colonoscopy "requires more equipment, specialized skills and higher malpractice premiums". Please. I know guys who run 30 scopes a day. The first one covered all the equipment and malpractice. As far as skill, the gastroenterologists have blocked FPs from doing colonoscopies even when they are trained to do it and because of lack of skill but because it is their turf. This is about money, plain and simple. Let's call it what it is and bump up the Medicare payment for cognitive services and lower the payment for all procedures just a smidgen. That will move the young ones in the primary care direction.
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