Innovative Initiatives for Fostering a New Generation of Primary Care Doctors
August 19th, 2018This past week, the New York Times reported that NYU Medical School announced that they will be making tuition free for all their students. This is a bold step for a prestigious medical school and their realization that medical school debt has led to proliferation of doctors in specialized fields and a shortage of primary care physicians.
As a primary care physician, I understand the current dilemma all too well. Primary care (aka general medicine, internal medicine) does not pay nearly as well as other specialities. For many medical students who graduate with debts in excess of $200 thousand dollars (even more, if they took loans out for college), it may take years to repay this debt. Meanwhile, their peers in finance, law or accounting would have been debt free much earlier. This lost income in the early years can have devastating repercussions. I don’t blame medical students for wanting to choose specialties, where they could be making triple or quadruple the income of primary care providers. Insurance reimbursements simply pay more for procedure-oriented fields such as orthopedic surgery or gastroenterology. This will not likely change in the near future unless health care is reformed.
I think NYU has taken a revolutionary step that I hope will be copied by other institutions. Primary care is a much-needed specialty and needs more attention. For the aspiring medical students, I would like to say that primary care is one of the most gratifying fields of medicine. In my over 15 years of practice, I cherish being able to care for my patients and their families. Over the years, many of them know me as their personal doctor and not just the dermatologist they see every few years or their gastroenterologist they see every 10 years for their colonoscopies. This is also a field that keeps me on my toes and is always exciting and interesting. Rather than just learning one set of organs, you have to know a little of everything. Each day, I have to use my knowledge of dermatology, ENT (ear nose throat), gastroenterology, cardiology and even psychiatry! Sometimes, I find myself being more of a confident in my interactions with patients than a prescriber. I do hope those current and future NYU medical students will reflect on the amazing gift they have just been given and understand that the door is open for them to pursue a rewarding career in Primary Care.
