Cardiologist arrest - medical schools educate too many medical specialists and not enough general practice and family physicians
Categories: Medical Family PracticeIf a certain New Yorker had gone to medical school instead of into comedy, he’d undoubtedly be a family doctor.
“I don’t get no respect,” Rodney Dangerfield, M.D., might mutter. “Other day I’m going to work. Halfway through the crosswalk I see this classmate of mine, guy’s a neurosurgeon. He’s driving the big car. He’s wearing the diamond Rolex. He’s got the hundred-dollar haircut. I wave my lunch bag at him. I say, |Hey, how come you’re driving a Bentley and I’m hoofing it?’ He gives me one of those little Tom Brokaw grins and says, |Money talks and GPs walk.’ I’m telling yuh, I don’t get no respect.”
For America’s general practice and family physicians, the imaginary Dr. Dangerfield’s riff is a cruel truth. Patients love them, but academically and professionally, medical general practitioners (GPs) have little stature and are rapidly becoming an endangered species. In contrast to other industrial nations, where doctordom divides evenly between general and specialized practitioners, 70 percent of the doctors in the United States are specialists. “Right now we have about 100,000 more specialists than we need and 100,000 too few primary care doctors,” says George Lundberg, M.D., editor of the Journal of the American Medical Association.
Never has the United States so desperately needed family physicians; not only are they the first line of defense against disease and trauma but they are vital in combating the huge costs of specialized health care. They are as important for what they decide not to do–such as order expensive lab tests, imaging scans or surgery–as for what they do, which is perform simple and less costly in-office procedures and write prescriptions. One hour of a cardiologist’s handiwork clearing deadly clots on the surgical table costs many times more than a preemptive visit to a physician who measures– and tells you how to lower–your cholesterol level. A worst-case analysis suggests that our preponderance of specialists could cost the United States $240 billion of the $800 billion spent annually on health care.