Big Medical Organizations Still Don't Understand Why Medical Students Don't Choose Primary Care

In Internal Medicine News Online is this gem of an article about how our fearless leaders are trying to attract more students into primary care fields. According to Michael Whitcomb MD, Senior Vice President of Medical Education for the American Association of Medical Colleges (AAMC), and Steven Weinberger MD, Senior Vice President for Medical Knowledge and Education at the American College of Physicians (ACP), and someone anonymous from the American Academy of Family Practice (AAFP), the reasons students don't go into primary care include:

• "the way students see primary care"
• students don't see "the proper management of chronic care patients"
• "students often don't recognize the gratification of building relationships over many years"
• students don't have "access to competent role models in family medicine"

Some still-dedicated medical school faculty who toil with ever less support from medical schools (even as tuition rises much faster than inflation) might feel insulted by the leaders of the AAMC, ACP, and AAFP who think they aren't demonstrating "proper management of chronic care patients," and aren't "competent role models."
For a good response see KevinMD:
" Graduates today finish with more debt and higher practice costs than at any time in the history of U.S. medicine, while facing a resource-constraining reimbursement system that has been racheting down physicians' incomes for many years now. Let the researchers puzzle over this: why would anyone want to go into a field where every indication is that the annoying stressors become ever more burdensome while the costs of operating a practice rise relentlessly and reimbursement is nearly flat. "
As Medical Rants put it:
"Understanding student decision making is not rocket science. Kevin does primary care - and he understands what our leaders apparently do not understand. "

Well, actually, Dr Weinberger of the ACP also said that "repairing the payment system, reducing administrative hassles, articulating the value of internal medicine, and redesigning training to better meet the scope of practice" are also important.

But it still seems like the leaders of the organizations that are supposed to support primary care don't understand the pressures on primary care physicians. The rising tide of paperwork and bureaucracy are far more than "hassles." The AAMC, ACP, and the AAFP should fight to support physicians' core values, not merely "articulate" the value of primary care and market it as "attractive"

The relatively small Society of General Internal Medicine recognized that primary care physicians face "chaos," not just "hassles." (Its annual meeting this year has the explicit theme of "Out of Chaos.") But the bigger, powerful, better funded AAMC, ACP, and AAFP still don't get it.