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