I’m returning home from a conference for continuing medical
education. Schooling never ends
for a doc. It’s a good thing
because as medical advances are made, standard of care and treatments change
with new research and discoveries.
Practices based in tradition are challenged to see if there is real evidence
to support their continued use.
So anyways, as I sat in a room full of family medicine
physicians reviewing basic dermatology issues often seen in primary care, I was
struck with many thoughts… thus prompting this post.
It takes an average of 3 to 6 months to get my patients in
to see a dermatologist. Everyday,
at least 30% of my patients come to see me for dermatology related issues. The better I am at recognizing and
treating various rashes and recognizing skin cancer, the more I can help my
patients save time and money. In
fact, it probably helps overall health care costs for the country.
This applies to other fields as well… such as ortho, cardiology,
endocrinology, etc. So this is a
shameless plug for medical students to consider entering this field. Minus all the paperwork stuff that we get
bogged down with… I find it extremely rewarding. It is never boring and there is such a variety of things we
do everyday… like taking skin
biopsies, suturing wound closures, incising and draining abscesses, injecting
cortisone into joint spaces, or just being there to listen when someone is
having an emotional personal life crisis!
In fact, psychiatry is the other field that I find very difficult to get
my patients in to see.
There is so much to know to be a competent primary care
physician but it also takes a calm, warm bedside manner. This is often challenging in the midst
of pressures to see more patients in less and less time. Whether the recent healthcare law
changes will affect the quality of care given is for a whole other post.
So I worry when I read things about more mid-level providers
(nurse practitioners and physician assistants) taking over the role of primary
care physicians. Nothing against
mid-levels, I’m sure there are many very competent folks out there… but the
amount of time spent in schooling and the type of schooling is just
different. Why are there so few US
medical student graduates going into primary care? Well that is for another post as well, but it is all sadly
related to money. Our dermatology
and psychiatry colleagues make twice or sometimes even more the amount the salary of
an average primary care physician and medical school debt is medical school
debt.
Well, if I had to do it again, I would not change
fields. For my type of
personality, I like having the variety of things I come across everyday. And unlike our emergency room
colleagues (who also make about twice the salary) I also like the potential
to cultivate relationships with my patients.
So for what it is worth, I love family medicine! I think there is a very important role
family docs can play in helping patients achieve overall good health without
breaking the bank.
