At this evening's "Crisis in Primary Care" event, we heard from Dr. James Petros (Director, BUSM General Surgery Residency Program) and Dr. John Abramson (Family Doctor & author of "Overdo$ed America") on the challenges facing the health care field as the result of a lack of focus on Primary Care.
Dr. Petros gave an overview of the physician workforce shortages from the perspective of a residency director. He mentioned that although there have been overall increases in residency placements, the number of new Primary Care practitioners graduated every year has actually decreased as more people specialize. He can see the results of this trend in the clinic as more advanced cases are seen than before...cases that should have been screened had the person had access to a primary care provider. "People just don't die on the bed anymore." said Dr. Petros, but surgical patients today are dying because of a paucity of post-operational follow-up.He mentioned that while data indicate that the lack of recruitment to Primary Care practice is due to perceived differences in lifestyle, compensation, and general support, anecdotally, it may also be due to perspectives within medical institutions of a lack of "sexiness" of primary care practice. Students asked whether this isolationism was being resolved by increased communication and cooperation in the physician community. They also wanted to know what kind of initiatives were being pursued to make Primary Care a more attractive option for students/residents.
Dr. Abramson extended the points made by Dr. Petros. He outlined an argument that today's "evidence-based" medical environment is too-heavily influenced by the pharmaceutical industry. He emphasized that, as stated by the American Law Institute, "the fundamental purpose of a corporation is to maximize profits and return those profits to its shareholders." He showed us a shift in the early 1980's where pharmaceutical companies became the major funders of clinical trials. Because of the now pervasive influence of the pharmaceutical industry, academic medical institutions place much more emphasis on the biomedical solutions (i.e. pharmaceuticals) even though evidence shows that in many cases these are just as much or less efficacious than non-biomedical treatments (i.e. diet and exercise).In responding to Dr. Petros' remarks on the perceived "unsexiness" of Primary Care, Dr. Abramson said that it is the non-biomedical aspects of the patient-physician relationship that are the "sexy" part of Primary Care. The trust, compassion, and respect that can be shared between a PCP and her patient are the very soul of medicine, and shifting our "folk medicine" to embrace these approaches to health care (in addition to the REAL evidence-based practices) is what makes Primary Care so "sexy."
We want to hear from you!! Add your comments about...
- What makes Primary Care "sexy" to you?
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