Rethinking the roles

I think the issue shouldn't be primary care physicians versus specialists, but more rethinking the way the two realms of medicine interact.  There have been many great points already made in previous posts, so I'll try to keep it short and simple.

First off, I don't think restricting people from specializing is the answer to anything.  I don't think it has really been proposed, but hypothetically, if it were, that would discourage people from excelling in specific fields, and being the best doctor they could be.  Bad idea.  I do think there should be a shift in the way that people think of primary care physicians.  Naturally, because specialists are just that - specialized in a particular field - they are more highly regarded.  People don't credit their PCP with curing them of cancer - that credit, as it should, goes to the oncologist.  But what if more people viewed their PCP as the reason they were referred to the specialist - like the gatekeepers to the more specialized fields.

It has been proposed in various health care reform bills to make it mandatory for everyone to have a PCP, internist, or pediatrician, from whom they would receive referrals to specialists when the need arises.  This makes perfect sense to me.  Why would you, the generally non-medically educated person, be able to just call up your local whatever specialist at will, if there may not be anything "special" wrong with you?  If your PCP had to refer you, you'd have to go to them first, which would create a higher demand for the PCP, as well as making sure they were thought of as necessary in medicine.  If medical students saw the future of a PCP career as essential as a cardiologist in this nation of extremely high cardiovascular disease rates, maybe it would make the medical students view the primary care field a bit higher.  Also, with requiring referrals, PCPs could get paid more, where specialists may make a bit less, but it could even out the "pay gap" between PCPs and specialists across the board.

I think that a lot of people do specialize because they are extremely gifted, which I highly commend and think specialists are a vital part of medicine.  But if becoming a PCP was made very essential to the medical field while these future doctors are in medical school, maybe we'd have a bigger pool of primary care physicians entering the profession.  Maybe the medical schools in this country should think about this as they try to increase enrollment by 30%, as the AAMC has suggested is necessary to offset the rising demand for physicians.  I think PCPs are somewhat undervalued, not just simply monetarily, and that if the payment/referral system changed, the PCP issue could change as well.