http://medicaleducationfutures.org/blog/2009/03/2009-residency-match-the-primary-care-canary/ Essential Health Policy News for Med School Educators and Students Thu, 09 Sep 2010 05:54:37 +0000 http://wordpress.org/?v=2.6.2 http://medicaleducationfutures.org/blog/2009/03/2009-residency-match-the-primary-care-canary/#comment-4393 David Gary Smith Mon, 30 Mar 2009 14:21:31 +0000 http://medicaleducationfutures.org/blog/?p=108#comment-4393 As a general internist involved in resident educations for 30 years, the gradual (precipitous?) decline in primary care is neither surprising nor likely to change in the foreseeable future. Politicians in my neighborhood see non-MD/DO providers as the solution so why bother to address the concerns of the physicians. In all honesty, it is not clear to me even if we could increase the number of non-MD/DO providers that they would continue to work in our dysfunctional primary care system. The patient centered medical home is an intriguing but not yet proven salvation for our troubles. We have come a long way from Marcus Welby to ER or House as the mass media representation of attractive medical careers. My daughter asked me if Grey's Anatomy is an accurate picture of medicine today! My concern is the light at the end of the tunnel may be an oncoming AMTRAK special or that emergency measure to address primary care medicine's needs. As Paul Batalden has warned us, "every system is perfectly designed to achieve the results it is achieving”. I cannot even think of a good primary care site for my residents and students to experience the joys of good ambulatory practice. The time for incremental change is long gone. All I can say is stop fiddling while we are burning in the trenches. As a general internist involved in resident educations for 30 years, the gradual (precipitous?) decline in primary care is neither surprising nor likely to change in the foreseeable future. Politicians in my neighborhood see non-MD/DO providers as the solution so why bother to address the concerns of the physicians. In all honesty, it is not clear to me even if we could increase the number of non-MD/DO providers that they would continue to work in our dysfunctional primary care system. The patient centered medical home is an intriguing but not yet proven salvation for our troubles. We have come a long way from Marcus Welby to ER or House as the mass media representation of attractive medical careers. My daughter asked me if Grey’s Anatomy is an accurate picture of medicine today! My concern is the light at the end of the tunnel may be an oncoming AMTRAK special or that emergency measure to address primary care medicine’s needs. As Paul Batalden has warned us, “every system is perfectly designed to achieve the results it is achieving”. I cannot even think of a good primary care site for my residents and students to experience the joys of good ambulatory practice. The time for incremental change is long gone. All I can say is stop fiddling while we are burning in the trenches.

]]>