tag:blogger.com,1999:blog-7255776707298393367.post591276793366038748..comments2023-10-09T06:23:42.682-07:00Comments on Saving Money and Surviving the Healthcare Crisis: Why Medical Students Should Choose Primary Care - Not for the Reasons You ThinkDavis Liu, MDhttp://www.blogger.com/profile/15320315964654209559noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-7255776707298393367.post-92011270166656109002010-11-23T00:57:30.085-08:002010-11-23T00:57:30.085-08:00thanks for your blog. i'm in the middle of FM ...thanks for your blog. i'm in the middle of FM interviews, a 4th year student. i've had my doubts about FM through and through- having considered all the more lucrative/better-respected specialties in my head, knowing that i am competitive enough for them. i chose FM in the end, in spite of classmates & even attending MDs telling me to do otherwise-- partially because i think, like you, i'm also a hopeful believer in the brighter future to be had in primary care, even for physicians. but at the same time, i see that we could be on the verge of losing a voice in all of this reform, and it truly scares me. the pressure to save money is so strong that even the gov't seems to want to hear what what it wants to hear -- that NPs and PAs are quality substitutes. that we don't need to invest more in FM recruitment, etc.<br /><br />sadly, the comment above about primary care going in the way of walmart is so true. my friend was just at a walmart conference in arkansas for his work last week, and passionate discussions about providing low cost care at walmart minute clinics is surely in the works. how do FPs play a role in all of this? could you articulate this more?<br /><br />please keep writing what you're writing. i really hope that we can communicate the message of the importance of *quality* primary care better to the public & to the well-intentioned leaders that often have too many competing voices around them to know the difference between good health reform & a failed system.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7255776707298393367.post-25299294978560125702010-05-20T14:11:33.906-07:002010-05-20T14:11:33.906-07:00You make some interesting points, but I believe, a...You make some interesting points, but I believe, as an above commenter already pointed out, that the "undercutting" you described as applying to surgeons and radiologists is happening here to primary care physicians to an even greater extent. There is an entire workforce of nurses who have been told that, with just two years of online courses, they can be the equivalent of a primary care physician. The ANA is batting for them, and the government, for now, is believing them. <br /><br />If you want to talk about GM and historical trends, I'd say that primary care is going, not the route of Toyota, but the route of Walmart. Quality sacrificed for cost, with a large, powerful institution throwing their weight around to secure their agenda.<br /><br />Current twenty-somethings grew up in the 80's and 90's, the beginnings of the volume overloaded primary care shenanigans that are rampant now. Most of these people did not have a strong relationship with a physician, and as they get older, they will be using the minute clinic and urgent care for their needs. Don't get me wrong, they will complain about it all day, but they wont realize there was a different way, because just as the green movement is growing and people are beginning to reject processed foods, Walmart still reigns over the local grocer. Because people don't care about quality.-boldly|broken-https://www.blogger.com/profile/07597254681124704688noreply@blogger.comtag:blogger.com,1999:blog-7255776707298393367.post-14816025609561326612010-03-31T22:33:01.331-07:002010-03-31T22:33:01.331-07:00Looking to the past to predict the future denies r...Looking to the past to predict the future denies reality. Hospital medicine and hospitalists didn't exist until about 15 years ago. Emergency medicine was started in the 1970s. Cardiac stents has changed the practice of cardiothoracic surgeons. Google didn't exist until 10 years ago. International travel wasn't commonplace until deregulation started the momentum.<br /><br />In other words, past experience is ok for weather prediction, but is only a jump off point and not particularly helpful in envisioning the future.Davis Liu, MDhttps://www.blogger.com/profile/15320315964654209559noreply@blogger.comtag:blogger.com,1999:blog-7255776707298393367.post-81500679999846635392010-03-31T20:00:14.140-07:002010-03-31T20:00:14.140-07:00"They are extrapolating the future world base..."They are extrapolating the future world based on their past experiences rather than envisioning the future."<br /><br />This is because they are smart. Few will base their entire future on pure speculation rather than by examining historical trends. One does not predict tomorrow's weather based upon imagination, rather, tomorrow's weather is best predicted by observing today's weather, and yesterday’s, etc. It's easy to look back from a position of comfort and security as an established professional and fantasize about how people should think, but it's another matter when you're the student looking forward into an uncertain future.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7255776707298393367.post-19830842620838898112010-01-23T11:33:38.222-08:002010-01-23T11:33:38.222-08:00I think primary care is going to be handled by nur...I think primary care is going to be handled by nurse practitioners and physicians assistants. Family medicine will disappear as it becomes obsolete.Anonymousnoreply@blogger.com