I think most would agree that we have a looming “perfect storm” in medicine which will result in a huge shortage of primary care physicians. This oncoming perfect storm will be due to an influx of patients because of health care reform and the aging baby boomers combined with fewer physicians choosing primary care specialties. Peter B. Bach, the director of the Center for Health Policy and Outcomes at Memorial Sloan-Kettering Cancer Center and Robert Kocher, a special assistant to President Obama on health care and economic policy published an article in the New York Times, Why Medical School Should Be Free. Their argument is interesting; however, I wonder if the basic assumptions are true.
They say that debt is why doctors shun primary care. I wonder how they came to this conclusion. I chose Family Medicine because I loved the relationship with patients, the continuity, the variety of patients and problems, and the challenge of being on the front line of medicine. I never thought about the money. Because I was in the Air Force, I did not have much debt so you could argue that the paucity of debt is why money didn’t play a role in my decision. My husband on the other hand had over $150,000 in debt and chose Anesthesiology. His decision was based on lifestyle and ability to spend time with his family, not on money. I would argue that almost all physicians choose their specialty based on interest in their chosen specialty and desired lifestyle, not money and debt. I don’t think that free medical school and stipends would impact these choices significantly. This proposed plan would be a drastic change in our medical education system and to assume this will solve the primary care shortage seems like a stretch to me.