Healthcare's Biggest Issue: What to do with Primary Care?

There is agreement among most healthcare officials and experts that the most important and challenging issue facing the future of the industry is the disintegration of primary care. The field has become underpaid, overworked, and has had some serious issues with recruiting its own next generation; the latter partly due to the former. Aside from the lack of medical students pursuing primary care, our current batch are bailing out of the field or opening boutique/alternative practices to keep the bills paid. It has become cliche to talk about "once the baby boomers start getting sick, forget it," but I personally repeat this to everyone I speak to about healthcare.

In the first days of of my first year of medical school I remember the professors taking a poll of who wanted to enter what specialty. Literally, I saw two hands go up for primary/family medicine and surely my school is not alone in these kinds of figures. I don't blame students for having the desire to earn more and its not just that, what we as students hear of primary care makes us cringe. Of course we want to help people (at least most of us) but who wants to spend half of their career on the phone dealing with managed care or insurance companies. We want to spend our time taking care of people, doing what we will be trained to do, and deal with less beauracracy. My point is this, we have a huge problem, and the problem lies within the system not within the physicians or students.

The discussion and debate rages on. Obviously politics and elections plays a big role, but aside from Obama's election and its affect on these issues there have been pushes from all sides to reform if nothing else how we deal with primary care. There needs to be incentive to go into the field and there needs to be reimbursement changes. Lots of good ideas are proposed, and again there needs to be a compromise as a change in payments has affects across the professional board. This is evident by the recent uprising of specialists toward the Baucus healthcare reform legislation. The specialists are insiting that this reform unfairly cuts their salaries to pay primary care doctors more. Surely this is a valid argument, any profession would be against legislation that literally cuts their salary the moment it is signed. So we need to do this carefully, patiently yet swiftly, and we need to compromise. But above all something needs to be done or the backbone of the system will start crumbling, or rather imploding.

Check out the NEJM debate on this issue HERE.