The Doctor Shortage

Anyone considering a career in medicine should read today's article in the New York Times about the doctor shortage. The Obama administration's challenge is to increase the number of doctors needed to care for the millions of uninsured patients in our country and the increasing number of elderly individuals. Under Obama's plan, these people will all have coverage. Who will care for them?

One proposal is to shift Medicare payments to increase the fees paid to primary providers and decrease what is allotted to high paid specialists. Of course, the specialists are not thrilled with this idea. While working in the emergency department (ED) recently, one plastic surgeon was walking through the ED asking if we had any procedures. When I asked the surgeon why he was being so uncharacteristically aggressive, he said "Well, we are all about to be "Obamafied" which won't be good for my bottom line." Interesting perspective, huh?

The article also mentioned the motivation for medical students to pursue higher paid specialties (including subspecialties of internal medicine) because many students graduate with so much debt -- on average more than $140,000. Primary care providers are paid the least of any other physicians so greater financial incentives are needed to motivate students to choose this career path.

I encourage my clients to consider careers in primary care. While the financial incentives may not be as great, primary care physicians, in contrast to popular belief, often feel they have a better work/life balance than many of their higher paid colleagues who choose "lifestyle specialties." And, since many couples are now part of two income families, money should be less of a consideration. And when we all get "Obamified," as my plastic surgery colleague suggested, the gap between who is paid what, may narrow.

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