Dinosaurs

I am convinced that the folks in Washington do not understand that primary care is currently an intensely unpopular choice of profession. There have been some massive shifts in popularity of some medical specialties, but the universal theme has been that primary care has waned.

People think it's all about debt burden, but it's not. It's nowhere near that simple. And if you want to prove it to yourself, look at the hospitalist vs the traditional internist. Finding traditional internists (folks who do both clinic and hospital work the same day) are a dying breed heading to extinction. In fact, primary care internists are harder to find in general. And it's no wonder.

Seeing hospital patients in the morning, doing clinic in the afternoons, call every 3 or 4 days, who wants that lifestyle? Compare that to the hospitalist, who is on one week, off the next. A week off is virtually unheard of in traditional practices, but it's the norm for hospitalist work. And hospitalist pays better too.

People fondly remember the days of doctors who do home visits, with a nostalgia entirely unwarranted, and I expect that in our lifetimes, patients will reflect on the days when their regular doctor would see them in the hospital too. But that is going the way of the dinosaurs.

And the true shame of it is that a lot of hospitalists burn out, even with the free time and the extra pay. And that's why I tell people to pick something that makes you happy, because money and lifestyle can't make you happy. It just gives you more time and resources to hate your life.