Growing up with a cardiologist dad, Anna always knew she wanted tobecome a doctor.
“I thought the best and the smartest pick something specific so that they can really master it.”
But at a school that’s mostly focused on specialties, her interest wasn’t well received.
“People would say, ‘Oh, wow, you’re such a competitive applicant.
You could do anything you want.
Why family med?'”
says Anna, who asked to use just her first name to avoid professional backlash.
“It made me think I wasn’t reaching my full potential.”
As boomers get older and AI upendswhite-collar work, this is really good news.
There’s even a term for the bad-mouthing of primary care: specialty disrespect.
That’s leaving Americanswithout enough doctorsto go around.
On Match Day, based on those rankings, the students learn whether they got into their preferred specialty.
“Some people were screaming, crying tears of joy.
Me and my friend were crying tears of sadness,” she says.
As a child, a dermatologist treated her for eczema, and the results gave her confidence.
She wanted to do the same for others.
Meanwhile, about 6.3% of applicants more than 1,200 med students were left unmatched.
It’s not surprising that so many people want to avoid primary care.
When third-year med students rotate through underresourced primary care practices, they witnesshow stressed out doctors are.
Even those who may have wanted to go into the field sometimes change their minds.
“I’ve been in situations where they’re saying, ‘OK, here’s a new patient.
“There are family practice clinicians who see upwards of 20 to 30 patients a day.”
They often spend hours after their appointments writing up clinic notes, she adds.
She and other researchers found otherwealthy countriesspent an average of $0.14 in 2021.
Part of the undervaluing of primary care is structural.
“That system is pretty biased against cognitive specialties and towards procedural specialties,” Jabbarpour says.
A primary care physician still makes a pretty good salary.”
A 2023 Medscape report said family doctors made an average of $255,000 in 2022.
That’s a far cry from the $619,000 average salary of thehighest-paid doctors, plastic surgeons.
Bias against primary care, like what Anna experienced at Georgetown, can also deter people.
Even among students who wind up in primary care, a good chunk of them don’t stay there.
Instead, many go on to subspecialize in fields like endocrinology or rheumatology or work in hospitals.
The first doctors most people meet are in primary care.
“Patients don’t have access to healthcare.
It’s really hard for them to get in to see their primary care doctor.
Because of that, we have higher rates of chronic disease.
We have higher mental health burden.
We have lower vaccination rates than we’ve ever had,” Jabbarpour says.
“It’s not good for patient health,” he says.
“It’s not good for the efficiency of how our resources get used.”
Some medical systems are already trying this.
Navathe says Medicare has tested similar pilot projects but would require approval from Congress to roll them out widely.
Medicare funding for graduate medical schools is another bottleneck.
“It’s going to these large academic hospitals, which aren’t necessarily primary-care-oriented,” Jabbarpour says.
“Most people are not going to the hospital to get their healthcare.”
She was one of only three who went into dermatology.
“We had all these people who just really love medicine for underserved populations,” she says.
“So we had all these clubs, organizations that were really geared towards primary care.”
Anna says she understands the instinct more experienced doctors have in wanting to protect students from negative experiences.
“You don’t want to be naive to the realities of their specialties,” she says.
But she wishes these topics were brought up in a more neutral way.
The next generation of doctors has a lot riding on them.
Manisha Krishnanis an Emmy award-winning journalist who covers healthcare.
She is based in Brooklyn.
