“I thought you were pre-med” (What’s the difference?)

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Wouldn’t it be fun, or at least less stressful, to pursue a medical career in one of those third world countries with lower expectations? Just hang a shingle on the nearest palm tree or ant mound, check the supplies of local herbs, healing crystals, and knock-off Cipro, pour a glass of rum, and wait for the business to roll in.

At least that’s my lean after reading this Forbes article, “Why Primary Care Is The Loneliest Specialty For Doctors, And What We Can Do About It” from which I gleaned…not much.

The author advises:

  • Direct entry into med school, with no requirement for an undergraduate degree, to lessen those troublesome loans. (Is there really no value in demonstrating to admission committees purportedly seeking excellence that one has some intellectual background, and a capacity to achieve long-term, complex goals?”
  • “Cut the fat” and shorten the med school curriculum. Get rid of the Krebs cycle and molecular interactions…and replace them with “more coursework in medical ethics/finance/politics.” (Whose ethics, and whose politics?? We already know whose finance.)
  • Focus on apprenticeship with proven mentors, “seeding a deep relationship that nurtures the passion for primary care.” (I did med student mentoring for years, and typically got the highest marks of over 100 preceptors for over a decade. Okay, I’m bragging. But in the last half I told the students exactly what I thought of primary care, so we would have to screen future mentors pretty carefully).

Author Jae Won Joh, MD might have missed a couple of points. Primary care docs often come by respect and timely responses from specialist colleagues with enough difficulty as it is. Will the neurosurgeon be as quick to call back the 3-year wonder primary care “doc” as he would a colleague who at least had slogged through the same first 4 years? Will the cardiologist rush to the ER on the advice of a “quickie” grad, or pawn it off on the ER doc? (Okay, that’s a trick question – he’ll throw it on the ER doc either way but we don’t care, we’re there anyway).

The interesting thing about this article is that it ignores it’s own title, and never tells us why PriCare is the “loneliest.” A link from this article tells us that Texas Tech has a program allowing students to finish in 3 years, get extra clinical time, scholarships, a guaranteed family practice residency spot, and a free iPad (giving the owner something to play Solitaire on or check Facebook while waiting for their deposition). These disconnected observers all seem to equate “lonely” with too much debt/not enough money. So how exactly will going into primary care fix that? Any “doc” thusly produced will be even more pliable, and obligated to a system that will increasingly screw them. And forget hanging with the other physicians in the doctors’ lounge – they’ll make the new “Easy Bakes” eat at the LELT table.

  3 comments for ““I thought you were pre-med” (What’s the difference?)

  1. Kurt
    May 19, 2016 at 3:31 pm

    Not much left for primary care. Before a cardiology fellow is finished, they have five or six job offers. FP? Some claim DPC is the guiding hope but expect someone to come out of training
    in debt, pick the “right” geographic area to setup a DPC practice and perhaps go into further debt?
    Pick the wrong area with the “wrong” payer mix and bankrupt city here you come.
    Only thing going for DPC is if one can get it going and established, they can give the one finger peace sign to the ABFM, MOC and recert exams and simply maintain themselves with 50 hours of CME a year to satisfy state requirements.

  2. Madelyn Sieraski
    May 15, 2016 at 2:59 pm

    Once this was the accepted path for primary care wouldn’t the specialist be next? Certainly don’t need the primary care residency if you are going to be cardiologist or GI just go from medical school to the fellowship. Skip all the “fat”.

    A lot of the “fat” I learned in school has helped me understand new treatments, procedures and diseases. Today’s “fat” maybe tomorrows essential knowledge.

  3. Thomas Guastavino
    May 14, 2016 at 6:33 am

    Don’t we have primary care providers following this accelerated track already? They are called PAs and NPs.

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