Fewer and fewer medical students are choosing to go into primary care fields despite the emphasis and growing need for more internists and family practitioners. When choosing a medical specialty, medical students have many factors to consider: lifestyle, personality match, competitiveness, length of training, and salary (compensation) are some of the major considerations. Let's break down each of the considerations a poor medical student must make when choosing a career:
Lifestyle: The generalist's lifestyle, while not the greatest, is also not the worst. In terms of hours worked, it is not as demanding as something like surgery or obstetrics.
Personality: All sorts of personalities could fit into a primary care field such as family practice, internal medicine, or pediatrics. Wasn't the whole reason for going to medical school was so you could help patients?
Competitiveness: If you choose not to go into family practice because of competition, you probably never should have made it into medical school.
Length of Training: With generalist training only needing three years as opposed to the five plus years required of specialists, this should be considered an incentive to go into primary care.
Salary (Compensation): The average earnings of a primary care doc is about 55% of the average earnings for all other non-primary care specialties. Here, I think we've identified a reason for the primary care shortage.
There are many reasons why fewer med students are choosing to go into primary care, but the financial aspect must be a huge consideration. If I'm graduating with $180,000 of medical student loans, having deferred gratification by going to college, med school, and then residency, and am looking to buy a house and raise a family in the near future, why would I go into primary care, when I could make double or even triple as much as a specialist?
According to the AAMC, family practitioners can expect to make about $142,200 after three years of residency where as a radiologist's salary can see $325, 438 after five years of residency. Sure, the training to become a radiologist is two years longer, but for those extra two years, you can potentially see more than a doubling of your income.
The fact is, medical training is long and grueling. Individuals pursuing a medical degree have made huge investments into our futures and hope to see a good return on investment or ROI. Specializing takes just a few more years and produce greater returns; I've already come this far, what's a few more years? Show me the money! So to answer the question posed in the title of this article, YES more medical students would choose primary care if they were compensated better!
Medical students and young physicians should make career decisions based on their interests and skills, instead of being influenced to a great extent by differences in earnings expectations associated with each specialty. Yet there is extensive evidence that choice of specialty is greatly influenced by the under-valuation of primary care by Medicare and other payers compared to other specialties.
As the old adage goes, "Do what you love and the money will follow." I wonder how much in student loans that guy must have had or how long he spent in school. While I enjoyed my family practice and pediatrics rotations in medical school, I also enjoyed radiology and orthopedic surgery. But after evaluating what was most important to me, I decided that spending time with and supporting my family would bring me the most fulfillment. Luckily, I loved radiology and so far it has happened to be a perfect fit.