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And every time the government tries to do something to encourage doctors to go into underserved areas, claims of Communism are thrown about.

(01-27-2014 05:11 PM)UAB Band Dad Wrote:  The other side of the coin is that if they raised the reimbursement for family practitioners they'd get more of them. Frankly, with the push to more preventative medicine, properly done primary care docs can save the system lots of money. Figure on more nurse practitioners as well, although they make my doc's head explode by skimming off the easy quick patients, leaving him the complex and more time consuming ones. He works just silly hours trying to get it all done, the paperwork has become just insane.

As long as kids come out of school with a quarter million in debt they're going to head straight for specialty work, even if you set aside the greed factor.

It's not "greed." When you know you're going to be >200k in debt in your early to mid thirties, with no savings, and being at least 7 years behind your cohorts in terms of generating a real salary, you're going to go into a field that allows you to generate the most income. That is unless you absolutely love primary care and couldn't imagine yourself doing anything else.

For the rich, silver spoon kids who had their parents pay their entire way through school, maybe there is an element of greed.

Even then, I haven't met many doctors who have gone into a specialty purely for the money. If you do that you're setting yourself up for a lot of disappointment.

According to the link from earlier (http://www.uab.edu/medicine/home/campuses), all first and second year students are still in Birmingham. I would argue that the first year class should expand and have them in Tuscaloosa with a Family Medicine-focused curriculum. Eventually, they'll probably become separate schools, around the same time UAB gets its own board

(01-27-2014 01:40 PM)UAB Band Dad Wrote:  We very badly need more students to go that way, much more than we need more dermatologists or something else that pays more.

Agreed... but we need more dermatologists as well. The only reason we don't have more is because they artificially deflate the number of residents (artificially increasing demand).

By the "greed factor", I mean that there *are* med students whose choices are at the very least influenced by wanting to go into the specialties that make the most money. I understand the debt, the deferred payoff, all of it, and I agree that if a student picks what he wants to do based on money alone he's making a poor choice. I'm just saying that there are people who flat out rule out family practice based on the difference in earning potential, period.

I've helped train many third years over the last fifteen years, even if I am just the help.

I don't have a problem with derm or cardiology (other than maybe the stereotypical god complex of cardiologists and surgeons, and even then I don't hold peoples lives in my hand the way they do) or any of the specialties in general. I'm just saying that the committee that determines overall reimbursement structure could do a lot of good if they upped the FP money some.

I agree. Family med, peds, and internal med are all extremely important.

Lifestyle is very important too. A lot of people go into less demanding specialties, even if they pay less money, just to be able to have something resembling a normal life. Who wants to work 100 hours a week and be on call every third night? What kind of life is that?

(01-27-2014 09:35 PM)GreenMississippi Wrote:  According to the link from earlier (http://www.uab.edu/medicine/home/campuses), all first and second year students are still in Birmingham. I would argue that the first year class should expand and have them in Tuscaloosa with a Family Medicine-focused curriculum. Eventually, they'll probably become separate schools, around the same time UAB gets its own board

(01-27-2014 01:40 PM)UAB Band Dad Wrote:  We very badly need more students to go that way, much more than we need more dermatologists or something else that pays more.

Agreed... but we need more dermatologists as well. The only reason we don't have more is because they artificially deflate the number of residents (artificially increasing demand).

That's always been the way it is. First and second years are in bham for their classroom/didactic years. Third and 4th year is when you actually start seeing patients. That's when students break off to their respective campuses.

The present system structure was the result of a compromise reached when George Wallace originally wanted to have 4 separate medical schools in each of Mobile, Tuscaloosa, Huntsville and B'ham and settled for two, one in B'ham (since the 1940s) and a new one in his favored city of Mobile. To keep the other major cities happy, the split system was set up so that Huntsville, Tuscaloosa and B'ham could have a share of the medical school's curriculum.

Some western states have had to form interstate compacts in order to afford ONE medical school between them. Good medical education is VERY expensive for any state. Ours absorb a huge amount of the SETF every year.

Did anyone notice that a Black Belt hospital has announced it is closing its OB/GYN facility so local patients will have to drive to Tuscaloosa, Montgomery or Meridian,MS when their "time" comes. The three cities mean a drive of about 60+ miles - perhaps in a hurry.