Editorial: Tables turn for primary care

The primary care physician is a rare sighting. Sexy television shows are about emergency room… The primary care physician is a rare sighting. Sexy television shows are about emergency room work and surgeries, not regular checkups and preventative care. It isn’t just the glamour that urges medical students to gravitate toward highly specialized fields. These specialties are also tagged with a high salary, and the primary care doctor is among the least paid.

A student makes sacrifices to reach the physician’s level. Between long education, high graduating debt and excessively long work hours, a physician comes a long way by the time the letters MD or DO can be found behind his name. Therefore it is of no surprise or concern that one following the path would seek complementary reward — the salary.

The primary care field, encompassing family medicine, pediatrics and internal medicine, is not the first place to turn. Indeed, family medicine, with the lowest average salary also had the lowest percent of filled residency spots in 2008  — 42 percent according to ScienceDaily.com, a popular science news website.

But the wave of health care reform that passed last week forever changed the prospects for the field. Under the Patient Protection and Affordable Care Act, primary care physicians will receive increased Medicare payments. All other fields face a 21 percent cut in Medicare payments from a separate bill. Additionally, the act applies a Medicare payroll tax for single people making more than $200,000 or couples making more than $250,000 — the kinds of numbers that generally don’t apply to primary care now.

Primary care is becoming more lucrative and will become more popular. It has to. And this is a change students should pay attention to.

According to the American Academy of Family Physicians, primary care is really the “base of the health care workforce pyramid.” Currently, the physician profile is only 31 percent primary care and 69 percent other specialties. This number has to increase for the health of the nation to improve; primary care directly affects the status of the United States in terms of infant mortality and overall death rates, according to ScienceDaily.com.

Incentives to achieve this are sprouting. Texas Tech University’s Health Sciences Center School of Medicine recently announced a three-year degree in family medicine, a primary care field. The curriculum is shorter than the traditional four years of medical school and gives students a new reason to enter primary care. The quality of education stays the same, because the fourth year of medical school traditionally serves to prepare students for specialty fields.

Additionally, the Liaison Committee on Medical Education, the national organization that vets many medical schools, has accredited Texas Tech University’s new program, speaking to its quality. For perspective, this committee also accredits the University of Pittsburgh School of Medicine and Harvard Medical School.

Going to medical school for three years will cut tuition costs for people who want to become primary care physicians. Texas Tech will also give a $13,000 scholarship to students to cover tuition and fees for their first year. Another medical school also has a similar three-year program: Lake Erie College of Osteopathic Medicine, in Erie, Pa., offers a program to graduate primary care physicians.

Entering this field is becoming more and more incentivised. The country is responding to primary care physician shortage on many levels and the 31-69 ratio will increase.

Surgery and emergency medicine will always have that fringe of appeal to the public. The time sensitive manner of the work makes it enticing. Although these specialties will not leave the television screen anytime soon, primary care will comprise a greater portion of physicians. Medical students should gear up for competition in a field that was yesterday’s underdog.