Between The Lines State must deal with
negative medical trend Between The Lines There certainly was reason to celebrate last Friday in Vermillion. The new Andrew E. Memorial Medicine and Science Building on The University of South Dakota campus, except for a few needed external touchups and the construction of a parking lot, is complete. The structure is a thing of beauty, with an internal design that places it in the same league as a handful of other notably attractive buildings in South Dakota. Most importantly, however, is the activity that is going on inside the medical center. New classrooms and laboratories that contain state-of-the-art equipment have placed South Dakota on the cutting edge of medical education and research. We have good reason to feel proud of this accomplishment, and the bright future that lies ahead for medical training in South Dakota. We canâ�?�?t rest on our laurels, however. Lurking in the shadows are frightening trends that donâ�?�?t bode well with the demographics of our state. According to researchers, medical students are shying away from careers in general internal medicine, which could exacerbate the U.S. doctor shortage expected by the time the youngest baby boomers head into their senior years. According to a news report this week, only 2 percent of 1,177 respondents to a survey of students at 11 U.S. medical schools said they planned to pursue careers in general internal medicine, according to the new study. General internists provide a large portion of care for older and chronically ill patients, the authors write in the Journal of the American Medical Association. Yet, the rate of medical students opting for general internal medicine is declining as the number of older adults rises, they write. According to one estimate, the United States will have 200,000 fewer doctors overall than it needs by 2020, according to the new report. Meanwhile, the number of older Americans is expected to almost double from 2005 to 2030. Many medical students are turned off by the thought of caring for chronically ill patients and the amount of paperwork general internists must deal with, says lead author Karen Hauer, a general internist on the faculty of University of California-San Francisco. â�?�?They rated the intellectual aspects of the field highly, and they rated continuity of care appealing,â�? Hauer said. â�?�?When you put the whole package together, itâ�?�?s too hard.â�? The trend of declining medical student numbers in general internal medicine and family medicine has been occurring for five to 10 years at Sanford School of Medicine at The University of South Dakota, Janet Lindemann, dean of medical student education, told the Sioux Falls Argus Leader on Tuesday. While the overall number of internal medicine graduates has remained level the past three years, more are opting for specialties, she said. Pay is an estimated two to five times higher for a surgeon or anesthesiologist compared to a family physician or general internist, Lindemann said. The average medical school graduateâ�?�?s debt is $125,000, so students also choose specialties to help them pay off their debts, she said. â�?�?Theyâ�?�?re choosing these specialties because in some cases, they offer a better lifestyle, better hours â�?¦ and pay,â�? she said. While a shortage exists for all doctors, the deficiency is more noticeable in internal medicine and family medicine because that is the first line of care for many patients, especially in a rural state, Lindemann said. At the same time, the medical school fares well because it emphasizes family medicine. â�?�?Compared to a lot of schools, we graduate more primary-care doctors, but itâ�?�?s less than half of our class,â�? she said. Lindemann cited making physician salaries more equitable, lowering studentsâ�?�? debt and giving students a better understanding of the rewards of being a primary-care physician as ways to counter the shortage, as well as increasing the medical school class size. Today, South Dakota is in a much better position to address all of those issues, especially the latter one concerning increased class size, thanks to the new Andrew E. Memorial Medicine and Science Building.