As I know you are a causal reader of my freshly-minted blog, I thought perhaps I could direct this message to you, Mr. President. My question is related to the passing of our (note: although it was purely a one-sided congress affair, it is all of ours for good or for bad) new health care reform bill. As a current doctor-in-training, one who will be making a decision in the next couple of months on my residency/future medicine path, I am in need of a little bit of guidance from you.
With the new health care bill passing, ensuring another 32+ million Americans
insurance coverage, what measures have you taken in this bill to ensure that there will be enough trained physicians to help provide basic care to these individuals and families? I see a system currently that requires medical students to undertake a big financial and time risk to attend medical school and then residency- a sacrifice that mostly attracts those with a true passion for helping those in need. If we expand the number of individuals that can receive care on a regular basis, protected by the blanket of this new insurance plan, shouldn't we make it our number one priority to train individuals to match this new population seeking care? Any action taken now in 2010 will, at the earliest, result in changes 7-10 years down the road, well after this new bill takes effect. I celebrate your ability to organize this effort and accomplish this much-needed reform, but we must do more on this front.
I have gathered a few of my thoughts on some things that you left out of your reform bill (how is that possible with 2,074 double-spaced pages?), so please take careful note as you plan your next big 'bipartisan' bill formulation.
1) Encourage shortened Pre-Med undergrad programs - Allow students to go to 2 years of undergrad and then straight into medical school (cutting out 2 full years of training- adding these years onto the end of these individuals careers). Brown University has such a program- one of very few across the nation. I started medical school @ 25...meaning I'm for sure in my thirties before I can actively participate in the workforce, as is the case with most of my classmates.
2) Subsidize medical education - Easier said than done, but essential if you expect to have us students to really go into our career decisions in medicine with open minds/hearts. I have a wife and children, I do not have the luxury of incurring $120,000 of debt at a public med school, and then chose to pay $80-100,000/yr. for malpractice insurance if I go into OB/GYN or risk 21% medicare cuts (a future blog about this!) if I go into family practice/internal medicine...all of which are primary care specialties essential to the success of this new bill.
3) Expand medical school classes - Starting a medical school requires millions upon millions of dollars, which most states cannot afford now (a future blog about this too!). I am from a state without a med school, but luckily a neighboring state's medical school invites me to attend their school on subsidies from my state. I am one of only 20 and every year my medical school attempts to expand that number to double for a price of only tens of thousands per student...yet my state's government refuses. I would recommend to you, Mr. President that this be an easy way to expand classes NOW. The applicants are out there....the national acceptance rate to medical school is only ~60%...that leaves 40% out there that can help with the physician shortfall we are currently experiencing.
Well I have other ideas, but you have other more important things to do, like securing nuclear disarmament from Chile, Mexico, and Canada...among others. I thank you for reading this entry and look forward to seeing your comments below, Mr. President.