“The article was written in the Clinton era, at a time when there was a sense the nation’s healthcare system might be reformed. But there was backlash to the plan,” Dr. Rosenthal says. “Today, we are again considering healthcare reform, except this time people are more willing to accept it because the high cost of healthcare is now affecting businesses and the economy.”
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Change in Outlook
President Obama’s stated goal of extending health insurance to more Americans makes increasing the ranks of primary-care physicians, general internists, and hospitalists even more urgent, experts say. In Massachusetts, a state that is experimenting with universal health coverage for all of its residents, a shortfall in the primary-care work force is evident, Dr. Weinberger says. It is troubling news, because research consistently shows that when a primary-care physician coordinates a patient’s care, the result is fewer visits to the ED and medical specialists, he says.
“What this means is, we need more internists in the outpatient side to care for these patients longitudinally,” Dr. Dressler says. “We need more hospitalists, as the burden of inpatient care is very likely to grow as well.”
Dr. Rosenthal says more students will be attracted to medicine in part because the recession is making solid, good-paying jobs that play a vital role in communities very attractive. If better support were available for students interested in primary care, he says, he would have reason to hope more students would choose generalist careers.
“There was this expectation among people in their 20s that, if they were bright and able, they would have a nice lifestyle without having to work too hard. But the recession is having an effect on this generation’s outlook,” Dr. Rosenthal says. “I think there is a changing landscape out there.” TH
Lisa Ryan is a freelance writer based in New Jersey.
References
- McDonald FS, West CP, Popkave C, Kolars JC. Educational debt and reported career plans among internal medicine residents. Ann Intern Med. 2008;149(6): 416-420.
- Rosenthal MP, Diamond JJ, Rabinowitz HK, et al. Influence of income, hours worked, and loan repayment on medical students’ decision to pursue a primary care career. JAMA. 1994;271(12):914-917.