It seems medical students and residents do (although in dramatically decreasing numbers) enter primary care in spite of these obstacles with no help from their teachers or their colleagues already in practice. Many only take the plunge if they are assured an adequate salary, a limit on hours worked, and limits on venues of practice (no hospital, no nursing home e.g.). We are entering an era of medicine of helter skelter with no long term vision. Choices made for convenience or following the path of least resistance is rule of the day. This opens up the law of unintended consequences.
This is not a big versus small argument. It is a throwing out the baby with the dishwater concern. Can’t we have both large and small? Will the professionals passively submit themselves to these barriers or will they step up to the plate and take back control of their education. Yes, their education. No one should be thrown into the working world without some tools or support so the sick or not so sick are attended to in a humane way.
Attitudes are set early in a doctor’s training and these attitudes are heavily affected by their mentors and the public’s view of the doctor-patient relationship. Should be we just let it play itself out or is there some heavy lifting needed to reverse this trend?
Dr. Don Green
I was under the impression our glorious leader had this all under control, insuring 30 million more Americans, at gunpoint if need be. I mean as a member of that largest of generations, the baby boomers I didn’t really expect government would take care of me in my elder years. That is what the 401Ks were for, the things which my generation didn’t start early enough.
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p>In this “post HIPPA” world however the doctor patient relationship has become a doctor client medical surveillance system relationship amongst other equally Satanic health related themes.
Doctors themselves and the uninspired public have let this situation smolder. Hopefully enough good citizens and those in the profession will wake up to the fact that the way they receive care is being hijacked. Fortunately there are still some young academic physicians as referenced in the article who are seeing the light. This is clearly a societal problem as doctors become more and more married to a schedule that pays ok and doesn’t give a fig about any attention to your day to day well being. The lights go out at 5pm.