Primary Care Docs Concerned About How to Care for 32 Million Newly Insured

John Commins, for HealthLeaders Media , March 25, 2010

It's not clear if reform will have a big enough impact on primary care to make it a more popular field with graduating medical students, many of whom graduate deeply indebted.

Farheen Qurashi, legislative director for the American Medical Student Association, and a medical student at the University of Missouri – Kansas City, calls the reforms "a good step but it is a first step."

"To incentivize primary care and to really shift the physician shortage and the way we deliver healthcare is going to take many years and many more investments in primary care, shifting healthcare delivery, and creating more and larger medical school classes," Qurashi says. "Really, it will require a change in our medical culture and this bill is just opening the door. We aren't done yet."

Qurashi says medical students are well schooled in the salary disparities between primary care and subspecialties like radiology and ophthalmology.

"Primary care physicians not only have lower reimbursements than other specialties, but also have a more difficult time balancing family and work and have a higher work load because of the shortage the country faces," Qurashi says. "A lot of those things go into the decisions that students make, and those are the kinds of medical culture things we need to look at changing before we can change the skewed primary care/subspecialty field distribution."

Heim says that even if there were a sudden tremendous interest in primary care from medical students, it'd still be too little, too late.

"I don't think we are going to be able to say that every single person who has insurance will have a primary care physician. We've gotten too far behind the curve," Heim says. "What I am saying is it is not 32 million people walking in the door today and it is not a catastrophe today. I am confident that we have time to begin to do a lot of the stuff that we have already been working on, and growing our workforce, and changing how we deliver care."

John Commins is a senior editor with HealthLeaders Media.

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