OK, “myth” is a bit of an exaggeration. A study from 2014 by the Robert Graham Center found a U-shaped relationship between medical student debt and the likelihood of students going into family medicine. Actually, it was more of a saucer-shaped curve. Students who had debt > $150,000, but also those with little to no debt were less likely to enter family medicine residencies. The high debt part of the curve makes sense in that students who owe a lot of money or more likely to choose higher-paying fields. Think of the low debt group as the prestige group. These are the rich doctors’ kids (or similar) who have no significant debt load, but who view family medicine as a less prestigious or less important field.
A new study confirms how little student debt influences career choice. The researchers used data from the AAMC graduate questionnaire. They found the average medical education debt load was $179,000 in 2016 ($197,000 including undergraduate loan debt). Here are a few of the fields and their medical education debt loads: dermatology – $154,000, family medicine – $181,000, neurosurgery – $181,000, orthopedics – $184,000, radiology – $185,000.
Student loan repayment programs are not the answer to grow the family physician supply in this country. Medical students are actually smart. They can look past the training years and look at the job realities of practicing physicians. A job that pays better, is better respected, and not weighed down by the burden of klunky EMRs and meaningless quality measures are the keys to a better U.S. family medicine supply and a more cost-effective healthcare system.
“Medical students are actually smart.”
Ain’t it the truth?
The ones I wonder about are the AAFP leadership. They seem to have absolutely no understanding that the policies they so aggressively push (EMR, MU, MACRA, PCMH, and on and on) place the highest unpaid administrative burden on family physicians – that’s not the way to make this an attractive career path. And then they stonewall the membership when we want to have a serious discussion about the consequences of their ill-considered actions.
Any thoughts on how to get through to them?
I started a motion in a TAFP committee to go to the TAFP board to go to the AAFP to start to undo this mess. Wish us luck.
That’s great – thank you!
Every single AAFP initiative – past, present and future – needs to be evaluated for:
1. is it evidence based?
2. will it increase administrative and financial burden on family physicians?
3. have insurers committed to pay appropriately for the services involved?
Most of the above mentioned initiatives, hastily adopted and poorly considered, would fail all three standards.
The national leadership has walled themselves off behind an impenetrable wall of self-congratulatory PR releases. They only listen to CMS and large insurers. “Photo op leadership,” as a past AAFP president characterized them.