SPOTLIGHT ON YOUR SOCIETY
to the medical students.
I recall my attraction towards primary care internal medicine. I
admit, I did not receive much encouragement to practice primary
care while a student. Internal medicine residency seemed only a
means to an end, a fellowship, when I started my intern year at
Georgetown University Hospital in Washington, DC. Yet, it was not
until then that I encountered a group of practicing internists who
encouraged me not to narrow my focus too hastily on one particular
area of medicine. These attending physicians, whom I continue to
hold in high esteem, would readily admit that they had felt a loss of
too much of medicine when considering a focus on one specialty.
They remained pleased with their choice to stay in primary care and
see the breadth of medicine walk through their door each day. This
breadth and depth excited them, as it would eventually me. I believe
it is no coincidence that a breathtaking majority of my residency
class went on to practice hospitalist or outpatient primary care,
quite a remarkable thing in 2009 and, certainly, today.
When I returned to Louisville to practice primary care, my path
was, disappointingly, not paved with such loud voices of encour-
agement and enthusiasm. The specifics are not important to lay out
here, but I undoubtedly witnessed others look down their nose at
primary care, clearly forgetting the vital importance of quality first
line and preventive medicine. However, hearing the words, “Primary
care is a thankless job,” in the boardroom of the Medical Society, and
watching a room full of physicians shake their head in agreement,
was the most jarring. I realized quickly this stereotype was perva-
sive in the general medical community and in medical education.
Moreover, if our own colleagues didn’t encourage a career in primary
care, how and why would we ever expect our medical students to
even express an interest. Yet I opine, quite to the contrary, primary
care may very well be the most thankful branch of medicine and
certainly has potential for remarkable rewards. Primary care, in its
most basic element, is a long-term working relationship between
a patient and physician that can be rivaled in few other medical
specialties. Through these long term relationships, a physician will
see patients through difficult and scary times, happier and healthier
times, and through seasons of life. Primary care physicians may grow
their practice to care for entire families, across multiple generations.
These patients will present with an amazing variety of pathologies,
syndromes, disorders and illnesses first learned in medical school,
and a primary care physician gets to see it all.
Medical students need to hear a positive message from practic-
ing physicians, across all specialties, as certainly there is seemingly
infinite discouragement to practice medicine with omnipresent
complexities and challenges in medicine today. Specialty Speed
Networking allows encouraging voices to be heard, even if, at times,
they are spoken in a raw and honest way. More urgently, students
have the opportunity to hear that it is acceptable and respectable to
practice primary care medicine. Yes, it is, indeed, OK to be a primary
care doctor. While the salary may not top the MGMA surveys (what
field with any shred of altruism encourages its students to follow only
the money anyhow?), this certainly does not equate to a thankless
specialty. The reward of caring for patients across generational and
pathologic domains while experiencing the fulfillment of personal
and long-term relationships is ubiquitous in primary care medicine.
I, again, look forward to this year’s Speed Networking Event and I
applaud the continued programming by the medical society. The
event is a wonderful opportunity to plant a seed of positivity into
the mind of a future doctor.
Dr. Kolter is a practicing internist with Baptist Health.
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