Posted on January 4, 2012
By David Kountz, MD, Jersey Shore University Medical Center
Many of you have probably not heard of Marcus Welby, M.D. Dr. Welby was a fictitious doctor on a TV show in the early 1970s. He treated a variety of problems — breast cancer, addiction to painkillers, depression, Alzheimer’s disease, and epilepsy — and was loved by his patients. He was, in many ways, the quintessential family doctor.
I don’t have to tell you that it is harder and harder to find Dr. Marcus Welby today. Primary care has fallen out of favor with today’s medical students. The number of US medical school graduates going into family medicine has dropped by 50 percent since 1997. The reasons are pretty clear — much lower pay than specialists, paperwork generated by insurance companies, medical school debt, and a lack of primary care role models. Most of the education of medical students in their last two years takes place in hospitals like Jersey Shore, where they are much more likely to interact with specialists. The issue of medical school debt is staggering. Students leave school owing $140,000 – $200,000, and their earning potential is much greater if they go into a specialty. Not much of a choice.
The lack of primary care hurts all aspects of the health care system. Specialists are often asked to address primary care issues and may not be comfortable doing so; patients miss out on key preventive tests such as immunizations and health screenings; and many Emergency Rooms can’t focus on the sickest patients, as they are overwhelmed treating patients with less serious problems.
At Jersey Shore, we are working with our academic partner, Robert Wood Johnson Medical School, to develop a pilot program beginning next summer that pairs first year students with primary care physicians who practice locally. We want students to learn the joys of primary care early in their medical school careers. We have also instituted a loan repayment program for our resident physicians to encourage them to pursue a career in primary care in our community. Hopefully every little bit will help.
While I grew up with Marcus Welby, M.D., my daughters watch ER and Grey’s Anatomy. No family physicians – just emergency room specialists and neurosurgeons. As the familiar saying goes…art imitates life.
—David Kountz, MD is Senior Vice President, Medical and Academic Affairsm at Jersey Shore University Medical Center; and Professor of Medicine and Associate Dean, Robert Wood Johnson Medical School. He can be reached at email@example.com.