What is the easiest solution to the primary care shortage? My thoughts inside.

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Mad Jack said:
Psychiatry is just as critical and just as underserved as primary care. You shouldn't feel bad at all.
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My school really pushes the primary care shtick (meh, that a bit harsh - they actually do a good job of it) for rural areas and I kinda spun my PS and secondary app in that direction, hence the guilt when turning down a full ride to go into primary care. They really need to up the ball on psych here. Our biggest area of research is neuroscience/psych and one of our only associated residency programs is psych. In the past two years ONLY TWO students have gone into psych. Over 15 times as many students went into ROAD and competitive surgery specialties (which is well over a quarter of the last two graduating classes combined).
 
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DermViser said:
Speaking of, this made me want to vomit: https://www.aamc.org/newsroom/reporter/march2012/276772/word.html

One of the biggest changes to the test in 2015 that will help medical schools make this assessment is a new section, the “Psychological, Social, and Biological Foundations of Behavior.” Testing students’ understanding of these areas is important, because being a good physician is about more than scientific knowledge. It is about understanding people—how they think, interact, and make decisions. Together with a solid foundation in the natural sciences, an understanding of behavior, perception, culture, poverty, and other concepts from psychology and sociology all contribute to the well-rounded physician. Of course, we want our doctors to understand how chemical compounds interact so our prescriptions do not have adverse interactions. But we also want our doctors to have good bedside manner, communication skills, and an ability to interact with people. After nearly 60 years, I still remember my pediatrician, Dr. Bramley—not for his class rank or MCAT exam score, but for his kindness, compassion, and how much he truly cared.

And what better way to measure kindness, compassion, and whether one truly cares, than on a multiple choice exam.
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I put my heart and soul into every multiple choice question I answer. Eliminating the obviously incorrect options is a very emotional experience.
 
DrHart said:
Why is satisfaction an issue? Doctors choose the area they want to go into. You could be dissatisfied with the amount of hours and low pay in the current system. Or you could handle the harder cases and spend more time doing administrative work. Or if you're smart you don't go into primary care. There is no simple answer in which everyone wins. If you restructure the current system to fit the demands- a PA based primary care practice would work. The current system doesn't.
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This whole freakin thread is about the PCP shortage which is a direct result of physician dissatisfaction. Doctors don't "choose" the area they want to go into. They match into it. Big difference. Also great jab with if you're "smart" you don't go into primary care. The administrative burden is imposed by the govt. making primary care "gatekeepers", not the specialty itself. You realize when people first entered the specialty, nearly all of medicine paid well right?
 
DermViser said:
Yes, not everyone hates primary care. In fact, Pediatricians tend to be very satisfied (not surprising as it's very gratifying to help sick children). Unfortunately, surveys bear out that General IM and Family Med docs tend to be the most dissatisfied and unhappy with their specialty.

HappinessFactorChart-532x630.png
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I would be so curious to see this data further broken down by people who applied & matched to the specialty they truly wanted vs all others. GS pay sure sticks out on that less happy end of the scale, and i'm sure it would be higher if you removed all the people who really wanted to do plastics, neurosurg, etc. But even with fields like neuro, I wonder how much the happiness is deflated by the people who went into it b/c it was the noncompetitive field they disliked the least.
 
Plecopotamus said:
I would be so curious to see this data further broken down by people who applied & matched to the specialty they truly wanted vs all others. GS pay sure sticks out on that less happy end of the scale, and i'm sure it would be higher if you removed all the people who really wanted to do plastics, neurosurg, etc. But even with fields like neuro, I wonder how much the happiness is deflated by the people who went into it b/c it was the noncompetitive field they disliked the least.
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Similarly, ID sticks out as a relatively low paid, but high satisfaction specialty.
 
Plecopotamus said:
I would be so curious to see this data further broken down by people who applied & matched to the specialty they truly wanted vs all others. GS pay sure sticks out on that less happy end of the scale, and i'm sure it would be higher if you removed all the people who really wanted to do plastics, neurosurg, etc. But even with fields like neuro, I wonder how much the happiness is deflated by the people who went into it b/c it was the noncompetitive field they disliked the least.
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Well they're all attendings, but it just goes to prove that salary number doesn't buy happiness. This is true in millenial medical students. They are willing to give up a certain amount of income and autonomy, for more work-life balance. The previous generation lived to work (not surprising going through the Great Depression, etc.) vs. millenials who "work to live".
 
DermViser said:
This whole freakin thread is about the PCP shortage which is a direct result of physician dissatisfaction. Doctors don't "choose" the area they want to go into. They match into it. Big difference. Also great jab with if you're "smart" you don't go into primary care. The administrative burden is imposed by the govt. making primary care "gatekeepers", not the specialty itself. You realize when people first entered the specialty, nearly all of medicine paid well right?
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Sorry I just don't understand your argument. I thought the conversation moved to looking for solutions to the problem. Policy changes, which affects doctor satisfaction, like you said, lead to the shortage. But I'm saying that doctor satisfaction won't affect policy, which is why I think changing the way primary care is structured is more of a solution than paying PCP more or offering accelerated programs/ incentives for people to go into primary care.

Doesn't really matter what medicine used to look like. If it needs to change to accommodate policy changes then you shouldn't fight it. Just my opinion... Sorry you sound pretty bitter about it.

*also I thought you apply to programs to be matched with? It's not like you take a personality test and they say you need to go into primary care. You have a choice on what to apply to.
 
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DrHart said:
Sorry I just don't understand your argument. I thought the conversation moved to looking for solutions to the problem. Policy changes, which affects doctor satisfaction, like you said, leading to the shortage. But I'm saying that doctor satisfaction won't affect policy, which is why I think changing the way primary care is structured is more of a solution than paying PCP more or offering accelerated programs/ incentives for people to go into primary care.

Doesn't really matter what medicine used to look like. If it needs to change to accommodate policy changes then you shouldn't fight it. Just my opinion... Sorry you sound pretty bitter about it.
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I'm not a PCP so I'm not "bitter" about anything. Do you not understand that people MATCH into a specialty? The fact that you believe that PCPs want to be team administrators shows you know nothing about why they're dissatisfied. The actual clinical work is not what those who are in primary care are complaining about. Here's an idea, quit putting further regulatory burden of checking off boxes, meaningful use, and a whole bunch of other crud on them. That's a start.
 
WillburCobb said:
My school really pushes the primary care shtick (meh, that a bit harsh - they actually do a good job of it) for rural areas and I kinda spun my PS and secondary app in that direction, hence the guilt when turning down a full ride to go into primary care. They really need to up the ball on psych here. Our biggest area of research is neuroscience/psych and one of our only associated residency programs is psych. In the past two years ONLY TWO students have gone into psych. Over 15 times as many students went into ROAD and competitive surgery specialties (which is well over a quarter of the last two graduating classes combined).
Click to expand...

Isn't there only like 1 psych residency in nodak?
 
DermViser said:
Well they're all attendings, but it just goes to prove that salary number doesn't buy happiness. This is true in millenial medical students. They are willing to give up a certain amount of income and autonomy, for more work-life balance. The previous generation lived to work (not surprising going through the Great Depression, etc.) vs. millenials who "work to live".
Click to expand...
I know they're all attendings. My curiosity comes from previously seeing data on ED doc burnout (which is lower if you pull out FM docs practicing EM) as well as the apathy among neuro residents (who will become apathetic neuro attendings) at the less competitive programs where I interviewed.
 
DrHart said:
Sorry I just don't understand your argument. I thought the conversation moved to looking for solutions to the problem. Policy changes, which affects doctor satisfaction, like you said, lead to the shortage. But I'm saying that doctor satisfaction won't affect policy, which is why I think changing the way primary care is structured is more of a solution than paying PCP more or offering accelerated programs/ incentives for people to go into primary care.

Doesn't really matter what medicine used to look like. If it needs to change to accommodate policy changes then you shouldn't fight it. Just my opinion... Sorry you sound pretty bitter about it.

*also I thought you apply to programs to be matched with? It's not like you take a personality test and they say you need to go into primary care. You have a choice on what to apply to.
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There's a difference between applying for a specialty, and being able to match into a specialty, or risk going unmatched.
 
DermViser said:
Speaking of, this made me want to vomit: https://www.aamc.org/newsroom/reporter/march2012/276772/word.html

One of the biggest changes to the test in 2015 that will help medical schools make this assessment is a new section, the “Psychological, Social, and Biological Foundations of Behavior.” Testing students’ understanding of these areas is important, because being a good physician is about more than scientific knowledge. It is about understanding people—how they think, interact, and make decisions. Together with a solid foundation in the natural sciences, an understanding of behavior, perception, culture, poverty, and other concepts from psychology and sociology all contribute to the well-rounded physician. Of course, we want our doctors to understand how chemical compounds interact so our prescriptions do not have adverse interactions. But we also want our doctors to have good bedside manner, communication skills, and an ability to interact with people. After nearly 60 years, I still remember my pediatrician, Dr. Bramley—not for his class rank or MCAT exam score, but for his kindness, compassion, and how much he truly cared.

And what better way to measure kindness, compassion, and whether one truly cares, than on a multiple choice exam.
Click to expand...

LMAO, wow. Even though I'm not surprised that someone from the AAMC would say something like that, holy ****....WOW. This is the perfect epitome of everything that drives me crazy about med school and the process to become a doctor. The fact people can actually believe stuff like this is unbelievable.

If the AAMC was really after selecting for kind, compassionate, doctors who really care they'd devise alternate ways for people to prove they can be good doctors because tests only select for a certain subset of people and whether or not a portion of people have the capacity to be great doctors is something I wonder.

Also, how the hell is making a 4 hour exam into a 7-8 hour exam and tacking on a **** ton more sections. where is the logic? Aside from better being prepared for the step 1. The whole system needs to be reworked, but I doubt that's gonna happen ever. Not much to do aside from roll w/ it.
 
touchpause13 said:
Isn't there only like 1 psych residency in nodak?
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Yup. 15 spots which are mostly filled by IMGs and FMGs who usually leave the area once they graduate. They've managed to turn around their family practice residency program and almost have it back to what it was in the 80s and early 90s. They just need to to do the same with psych, IM, and surgery.
 
mrh125 said:
Also, how the hell is making a 4 hour exam into a 7-8 hour exam and tacking on a **** ton more sections. where is the logic? Aside from better being prepared for the step 1. The whole system needs to be reworked, but I doubt that's gonna happen ever. Not much to do aside from roll w/ it.
Click to expand...
😆😆😆😆:laugh::laugh::laugh::laugh::roflcopter::roflcopter::roflcopter::roflcopter:
 
DermViser said:
I'm not a PCP so I'm not "bitter" about anything. Do you not understand that people MATCH into a specialty? The fact that you believe that PCPs want to be team administrators shows you know nothing about why they're dissatisfied. The actual clinical work is not what those who are in primary care are complaining about. Here's an idea, quit putting further regulatory burden of checking off boxes, meaningful use, and a whole bunch of other crud on them. That's a start.
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Let's take a deep breath, okay?

I never said that PCPs "want to be" anything. All I'm offering up is a possible solution that allows PAs to see patients in situations that a doctor would normally handle.
If, like you said, we just take the "crud" off the PCPs, it's not like that stuff disappears. If you allow a PCP to work a 9-5, lower reimbursements don't seem so bad because the stress of the job decreases. This could also lead to increased satisfaction. So far your solution is to "take the crud off the PCPs" and I'm not criticizing you or trying to fight. I'm just offering up my two cents.
 
WillburCobb said:
Yup. 15 spots which are mostly filled by IMGs and FMGs who usually leave the area once they graduate. They've managed to turn around their family practice residency program and almost have it back to what it was in the 80s and early 90s. They just need to to do the same with psych, IM, and surgery.
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Yeah I actually went to the FM residency for healthcare exclusively in college because that was the only way I could get an appointment in a decent time frame.

I would consider doing my residency there but I hate altru so much and I'm worried about the quality.
 
touchpause13 said:
Yeah I actually went to the FM residency for healthcare exclusively in college because that was the only way I could get an appointment in a decent time frame.

I would consider doing my residency there but I hate altru so much and I'm worried about the quality.
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The GF FM residency is the only one affiliated with Altru. Psych or IM it would be through Spamford in Fargo (though between that and Altru I don't know which is the lesser of two evils). The FM residency in Bismarck isn't affiliated with any healthcare systems either. Also the care I received at the resident clinic growing-up >>>>>>>>>>>> than any of the healthcare systems I've gone to in Nodak since. Unfortunately, with the exception of the FM program the other residency programs definitely leave something to be desired in terms of quality. Supposedly its next on the Dean's agenda of things to address (and so far his track record has been pretty impressive), but only time will tell.
 
DermViser said:
😆😆😆😆:laugh::laugh::laugh::laugh::roflcopter::roflcopter::roflcopter::roflcopter:
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in terms of length meh. in other ways it probably doesn't do jack ****. i'm trying to make the aamcs sound reasonable in one way lol.
 
mrh125 said:
LMAO, wow. Even though I'm not surprised that someone from the AAMC would say something like that, holy ****....WOW. This is the perfect epitome of everything that drives me crazy about med school and the process to become a doctor. The fact people can actually believe stuff like this is unbelievable.

If the AAMC was really after selecting for kind, compassionate, doctors who really care they'd devise alternate ways for people to prove they can be good doctors because tests only select for a certain subset of people and whether or not a portion of people have the capacity to be great doctors is something I wonder.

Also, how the hell is making a 4 hour exam into a 7-8 hour exam and tacking on a **** ton more sections. where is the logic? Aside from better being prepared for the step 1. The whole system needs to be reworked, but I doubt that's gonna happen ever. Not much to do aside from roll w/ it.
Click to expand...
Bureaucrats will say anything to justify their nonsense! I was mad at the system too, but I let it go after getting my MIGHTY acceptance(s)...
 
BestDoctorEver said:
Bureaucrats will say anything to justify their nonsense! I was mad at the system too, but I let it go after getting my MIGHTY acceptance(s)...
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haha I will be significantly less mad when I get into med school, and chill as hell once I get a good score on step 1.
 
WillburCobb said:
The GF FM residency is the only one affiliated with Altru. Psych or IM it would be through Spamford in Fargo (though between that and Altru I don't know which is the lesser of two evils). The FM residency in Bismarck isn't affiliated with any healthcare systems either. Also the care I received at the resident clinic growing-up >>>>>>>>>>>> than any of the healthcare systems I've gone to in Nodak since. Unfortunately, with the exception of the FM program the other residency programs definitely leave something to be desired in terms of quality. Supposedly its next on the Dean's agenda of things to address (and so far his track record has been pretty impressive), but only time will tell.
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Yup. In the grandest of forks you gotta suck it up and deal with altru. I swear the care I got from the residents was way better than what I got from their main clinics tho
 
I know!

Let's urbanize all of the rural underserved areas to make them more attractive to primary care doctors.

haha. But seriously, I'm interested in primary care. I obviously can't say where I'll wind up this early in the game, but my top three interests right now are internal medicine, family medicine, and neurology. However, there's not much one can do to convince me to serve in a rural area. By and large, the types of people that medicine attracts don't tend to be the types of people who want to live rural lifestyles.

Maybe fix the system so that going into medicine is more attractive and more realistic to rural types of folks.
 
mrh125 said:
haha I will be significantly less mad when I get into med school, and chill as hell once I get a good score on step 1.
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Ah, a gunner in training.

You do know Step 1 is not a golden ticket right? See you have these things called rotations where you actually have to interact with attendings, residents, and patients and graded accordingly.
 
DermViser said:
Ah, a gunner in training.

You do know Step 1 is not a golden ticket right? See you have these things called rotations where you actually have to interact with attendings, residents, and patients and graded accordingly.
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Not a gunner. When I was in ochem I realized how much I couldn't stand this competition business and formed a study group, cooperated with others and like 15 of us all got A+S. We can all succeed without having to **** others over.
Step 1 isn't everything but I'm taking things one step or a few steps at a time. Step 1 stands out to me as a very crucial factor and that's why I keep bringing it up.
 
ninjaman22 said:
and what if none those happen? are you going to keep annoying people here?!
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If you're actually going to get annoyed by the fact that I'm asking questions you need to stop reacting to literally everything and seriously harden your skin. I'm here to learn and I help others out. If that bothers you oh so much I hate to be this exceptionally blunt to you but there's a ****ing ignore button, learn how to use it.
 
mrh125 said:
If you're actually going to get annoyed by the fact that I'm asking questions you need to stop reacting to literally everything and seriously harden your skin. I'm here to learn and I help others out. If that bothers you oh so much I hate to be this exceptionally blunt to you but there's a ******* ignore button, learn how to use it.
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These threads have a ********** ignore button?? How do I not see it? God dammit I could have saved myself from the misery!
 
ninjaman22 said:
These threads have a ********** ignore button?? How do I not see it? God dammit I could have saved myself from the misery!
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Or you could develop something called self-control and not click them. It's not hard. I will give you a walk through for ignore me. Click my username, go to my page and ignore.

Thank you. I have no use for moany people who can't contribute anything constructive so I'm happy to help you out 🙂
 
mrh125 said:
Or you could develop something called self-control and not click them. It's not hard. I will give you a walk through for ignore me. Click my username, go to my page and ignore.

Thank you. I have no use for moany people who can't contribute anything constructive so I'm happy to help you out 🙂
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LOL brah y u so mad? take a chill pill buddy
 
mrh125 said:
Or you could develop something called self-control and not click them. It's not hard. I will give you a walk through for ignore me. Click my username, go to my page and ignore.

Thank you. I have no use for moany people who can't contribute anything constructive so I'm happy to help you out 🙂
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Lol or you could stop making them brah
 
touchpause13 said:
Lol or you could stop making them brah
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I'm going to keep asking questions as long as I find them important and need answers. If you can't handle it, that's your problem.
 
I know some schools offer scholarships to students who plan on becoming primary care physicians.
I'm sure that's a great incentive for students who have even considered primary care.

I don't think you can just give primary care physicians more $ lol that's socialism
 
ninjaman22 said:
These threads have a ********** ignore button?? How do I not see it? God dammit I could have saved myself from the misery!
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I wish. I've been wanting it for some of these other threads...
 
Chipster. said:
Except this wasn't a question, it was a piss poor "solution" to a problem you know nothing about.
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Everyone starts from somewhere and I'm not going to pretend I know everything. It's called learning, actively thinking, and Im sure I could easily find something you know less about than I do and spew the same ****. Go jerk yourself off somewhere else, I'm sure you're great and so useful, but Idgaf about your self masturbatory bs. If you don't like my questions you can **** off bottom line. You have no one else except yourself to blame for incessant whining.
 
mrh125 said:
Everyone starts from somewhere and I'm not going to pretend I know everything. It's called learning, actively thinking, and Im sure I could easily find something you know less about than I do and spew the same ****. Go jerk yourself off somewhere else, I'm sure you're great and so useful, but Idgaf about your self masturbatory bs. If you don't like my questions you can **** off bottom line. You have no one else except yourself to blame for incessant whining.
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that-escalated-quickly-anchorman-gif.gif
 
Chipster. said:
Not a lot of people like you, do they?
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Life ain't a popularity contest so personally they and you can both **** themselves. Your transparent petty egoism and Inability to understand others perspectives is going to make you one ****ty obtuse doctor.
 
mrh125 said:
Life ain't a popularity contest so personally they and you can both **** themselves. Your transparent petty egoism and Inability to understand others perspectives is going to make you one ****** obtuse doctor.
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**** are these forums for pre meds? I must've made a wrong turn on the internet highway.
 
Chipster. said:
**** are these forums for pre meds? I must've made a wrong turn on the internet highway.
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Yea where else could you and all the other inane sycophants moan at people for asking questions, understanding things differently from you and assert your supposed superior knowledge while giving each other handjobs under the table lmao
 
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