Who Chooses to be a Family Physician

Abstract

The US population is predicted to increase by 18% between 2005 and 2025. The over 65 population will increase by 73% during this same period.1 These are contributors the predicted shortage of primary care physicians in the United States. The American Academy of Family Practice (AAFP) has predicted a 51% shortage of 40,000 primary care physicians by 2020.2 It is understood that family physicians are more likely to practice as generalists, and along with general internal medicine and pediatrics, provide 52% of all ambulatory visits in the United States. These visits include 80% of all hypertension visits and 69% of all diabetic and COPD visits.2 Efforts to expand allopathic medical school size by 30% are well under way across the United States. In 2009, 7.5% of US medical school graduates were first year family medicine graduates, compared with 8.2% in 2008 and 8.3% in 2007.9 Osteopathic medical school numbers and class sizes are growing rapidly with a nine-fold increase in number of osteopathic students in the last 40 years and nine new osteopathic medical schools (including branch campuses) in the past five years.4 Attention must be paid to the types of physicians produced with this expansion. The factors that affect medical students’ choices regarding specialty choice are varied and complex. Positive influences such as strong family medicine role modeling and aggressive recruitment for family medicine tend to help students select family medicine careers. Negative influences, such as educational debt and lifestyle, have also grown in importance to medical students.16 The Affordable Care Act has identified primary care physicians as the foundation for cost effective, efficient care for our nation. It is imperative that medical educators work to influence students’ choices as well as promote public policy that would support such a choice.