Saturday, November 10, 2007

ER

So my rotation this month is in the ER. What a gross missuse of health care dollars. I am amazed.... amazed and disturbed. I have seen some terrible things, some cool things, but mostly have seen downright stupid things. I wish that I had an answer for the healthcare crisis that America faces. But I don't. One of the major problems that I see is people come to the ER for their primary care. You would think the answer to that would be easy, just get a doctor. But the reality is that these people who have no insurance pay less to go to the ER then they would to go to a family doc. What's more is that there is such a supreme shortage of family docs that they probably wouldn't be able to get an appoitntment for weeks as a new patient and for days even as an established patient. Leaving the natural choice of the ER. So why don't more people go into family medicine? Lots of reasons really. Money. We are at the low end of the physician totem pole as far as salaries go. Don't get me wrong, we still make a good living when all is said and done, but when you can work less hours and make 4x as much as a radiologist or dermatolagist... well you do the math. Respect. Family physicians are often considered inferior by their colleagues... their patients may love them but within medical society... its often another story. Part of this, I think, comes from the fact that family medicine is not a highly sought after residency. Across the country spots go unfilled in the family medicine match... this leads to taking less qualified applicants, international grads (some of whom are 5+ years out of medical school or boards) which leads to a general feeling of inferiority about Family residents. But I think some of it is more deep seeded. Afterall, didn't we all go into medicine with a family doc as our initial impression of an ideal doctor? I think that people forget that family med is a different sort of medicine. You don't have to know everything in family med... you just have to know enough. In fact it would be impossible to know everything about everything. That's why subspecialties evolved... the medical knowledge expanded and created a need for specialized physicians in specialty fields.... to be contiued...