The Role of Medical Schools to Produce Primary Care Physicians and Its Future Challenges

8/14/2019 The Role of Medical Schools to Produce Primary Care Physicians and Its Future Challenges

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The Role of Medical Schools to Produce Primary Care Physicians and Its

Future Challenges

Rizky Kumara Anindhita

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A&stract!


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Recently, there is an implicit warning that primary care, the backbone of health care

system, is at grave risk of collapse and is facing a confluence of factors that could spell

disaster. Patients are increasingly dissatisfied with their health care ang with the difficulty of

gaining timely access to a primary care physicians. Many physicians, alternatively, are

unhappy with their jobs, as they face seemingly insurmountable task; the quality of care is

uneven; reimburement is inadequate; and fewer and fewer medical students are choosing to

enter the field of primary care.

ne of the parties those are responsible for what is happening to the primary care

practice is medical schools. !hey do not just need to produce ordinary graduates, but they will

need to produce graduates that will put themselves in the field of primary care services.

!o aim producing primary care"focussed"graduates, medical schools need to build up

strategies so that the problems faced by primary care can be overcome and thus community

health can be further improved.

#$% &R'() Primary health care, Primary care physicians, Medical schools

Introduction!

'uring the early and mid"*++s, a consensus emerged among physicians and health

care policymakers that the -nited (tates of merica would have a considerable surplus of

physicians by the end of the decade/*0. Most people believed that the surplus would be limited

to non"primary care physicians and that the supply of physicians planning to practice primary

care medicine would be barely adequate. !his view was supported by the decrease in the late

*+1s and early *++s in the number of graduating medical students who choose residency

training in specialities that could lead to careers in primary care practice.


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nly a few years later, studies are beginning to suggest that the country may soon be

facing an overall shortage of physicians /Fig! $0.

Primary care 'hysicians!

primary care physicians is a health care practitioner who sees people that have

common medical problems and also sees people who is well, at the moment, as a population

at riskand is often involved in population2s care for a long period of time /30. !his means that

primary care physicians sees everyone as an individual who is at the same risk as others of

getting a disease and that physicians will take this chance to promote and prevent this person

from getting sick in the future.

Primary care physicians act as the first medical responder contacted by a patient, this

important role is facilitated by the fact that primary care physicians have ease of

communication, accessible location, familiarity, and increasingly issues of cost and managed

care requirements. 4esides that, primary care physicians also act as a gatekeepers, who

regulates access to more costly procedures or specialistic needs.

Fig!$ (ata a&out the num&er students taking medical studies )internal* family

'ractice* and 'ediatrics!


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!he primary care physician will have to acts on behalf of the patient to collaborate

with referral specialists, coordinate the care given by varied organi5ations such as hospitals or

rehabilitation clinics, act as a comprehensive repository for the patient2s record, and provide

long"term management of chronic conditions.

6n general scope, we can conclude that primary care physicians act in the first barrier

of certain community which means that his7her role is very important to do health promotion

and also specific protection for the community.

Medical schools+ role on 'roducing 'rimary care 'hysicians!

!he road of a medical school graduates becoming into a primary care physicians start

as early as when they are given medical education in their medical schools. $ven when the

students are not in the medical school yet, this process starts. Roles played by the medical

schools determine the outcomes that they will get which is their graduates /80.

s being discussed before, the main concerned to the problem is how the current

medical schools produce competent graduates and getting them to go into primary care. !his

concerned has been well"thought by (tephen R. (mith. ccording to him, there are things that

medical schools can do to meet the workforce needs which is to increase the number of

primary care physicians.

Medical schools must recogni5e the current factors that discourage medical students

from getting primary care careers and then synthesi5e ways to overcome these barriers. Most

medical students in the -nited (tates of merica get a discouraging view of practice in

primary care as they observe harried primary care physicians who have too much to do and

too little time in which to do it. !hey also heard disparaging remarks about primary care

physicians from residents and faculty members, who e9tol narrowly focused e9pertise. !his

perspective about primary care physicians also make these students to see that specialists are


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at far higher levels than primary care physicians. !hese students are also intimidated by the

breadth of knowledge required for primary care.

Medical schools that are eminently committed to train graduates for primary care must

recogni5e that every decision they make should advance the mission of the school. !his

crucial point which is to establish the school2s mission depends on the founding dean of the

school and it is said that the founding dean would be better if it is a primary care physicians.

!herefore, the primary care mission will not deviate from what it should be /80. !aking such an

instance will require courage and commitment and must be e9plicitly supported by the

university president and the governing board of the medical school and its parent university.

!he initial test of this commitment will come in the way in which admissions are

handled. !he evidence that is available on factors predicting career choice indicates that

students who e9press a desire to serve underserved populations, demonstrate altruism, and

who are commited to social responsibility are more likely to go into primary care/80.

dmissions criteria need to be broadened beyond scores on the Medical :ollege dmission

!est /M:!0 to include these personal attributes. !he school should adopt an M:!"blind.0 &orld Aealth rgani5ation. &orld Aealth Report. 3B. vailable from)

http)77www.who.int7whr73B7overview7en7inde9.htmlaccessed Culy B, 3**.
http://www.nlm.nih.gov/medlineplus/ency/article/001939.htmhttp://www.paho.org/English/DD/PIN/ptoday12_nov05.htmhttp://www.who.int/whr/2006/overview/en/index.htmlhttp://www.nlm.nih.gov/medlineplus/ency/article/001939.htmhttp://www.paho.org/English/DD/PIN/ptoday12_nov05.htmhttp://www.who.int/whr/2006/overview/en/index.html

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The Role of Medical Schools to Produce Primary Care Physicians and Its Future Challenges