By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    medicare part d benefits
    Everything that You Need to Know About Medicare Part D
    August 15, 2022
    Best Ways to Boost Your Immune System this Winter
    Best Ways to Boost Your Immune System this Winter
    November 15, 2022
    back pain issues
    Ways to Treat Constant Back Pain
    August 21, 2023
    Latest News
    How Probate Planning Shapes the Future of Your Estate and Family Care
    July 17, 2025
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    More On Wellness Programs To Improve Health and Reduce Costs
    January 25, 2012
    Privatizing Social Security and Medicare: Who Can Defuse Political Dynamite?
    June 12, 2011
    Study: Risk of Death in Elderly Patients with Dementia Doubled with Some Antipsychotic Medications
    February 26, 2012
    Latest News
    How IT and Marketing Teams Can Collaborate to Protect Patient Trust
    July 17, 2025
    How Health Choices and Legal Actions Intersect After an Injury
    July 17, 2025
    How communities and healthcare providers can address slip and fall injuries with legal awareness
    July 17, 2025
    Let Your Lawyer Handle the Work Before You Pay Medical Costs
    July 6, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Debt Does Not Drive Specialty Choice
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Medical Education > Debt Does Not Drive Specialty Choice
Medical Education

Debt Does Not Drive Specialty Choice

Clese Erikson
Clese Erikson
Share
6 Min Read
SHARE

 

 

Whenever the adequacy of the future primary care workforce is discussed, invariably someone links the declining numbers of medical students entering primary care to student debt. We see this in: questions to President Obama; testimony to Congress; New York Times articles and editorials; a piece in Newsweek on the primary care shortage; a briefing posted by the medical student section of the AMA; reports issued by foundations; formal policy statements from physician associations; or in recent blog posts by medical students on the topic. All this, despite the fact that empirical research has failed to establish any such relationship. To wit, no one has definitively established what so many assume.  

Saying It Does Not Make It So

More Read

Vegetarina Dental Concerns Marielaina Perrone DDS
Oral Health Concerns For Vegetarians
Super Nurse: 4 Pointers to Help You Become a Truly Extraordinary Nurse
Professions of Interest in the Medical Field
Be Inspired: 3 Ways to Originate the Content Your Patients Want
Herbal Supplements and Dentistry

Many observe the widening salary differential between primary care physicians and most specialists, the declining number of medical students entering primary care today, and the continued increase in medical education debt, and make an unsubstantiated leap in logic to conclude that indebted students are less likely to consider a career in primary care. In truth, research has confirmed no such connection. A 2003 meta-analysis that explicitly assessed the quality of published research on debt and choosing to specialize in family medicine concluded that the relationship was unclear. A more recent attempt to prove this relationship fared no better.

This is not to say that reduced student debt is undesirable, or that it would have no effect. The rising level of medical school debt concerns us greatly as a barrier to medical school entry. Nonetheless, there is simply no clear and convincing body of proof that it has any bearing on whether or not medical students ultimately choose careers in primary care. Reducing or even eliminating medical school tuition, as suggested in a New York Times editorial,might make it more feasible to go to medical school, but there is no evidence that eliminating tuition or minimizing debt burden would transform incoming students’ specialty choice preferences.

 The Truth Is Complicated

The choice of specialty, primary care or otherwise, is a complex decision that is based on multiple factors, including students’ interest in the specialty, exposure to the specialty (positive and negative), relationships with mentors and role models, interest in work-life balance, compensation goals, gender, race/ethnicity, and rural background, among others. While debt may play a minor role in the decision, evidence suggests it is largely trumped by these other considerations. So a constant beating upon the debt drum will only mislead all who are interested in increasing the production of primary care physicians in this country.

The recruitment of more students into medical school who are inclined to pursue primary care, including more from rural backgrounds and more married students and women, could result in more medical school graduates practicing primary care. Reducing the gap in physician pay scales would also likely induce more students to enter primary care, and it is undoubtedly a necessary part of any strategy to address the nation’s primary care shortage. Indeed, we believe that primary care should be reimbursed more rationally. But this does not mean that debt is driving potential physicians away from primary care practice.

Medical school students will continue to choose careers that appeal to them. Both the medical home model and other system redesign incentives included in the Affordable Care Act that focus on improving care coordination offer potential options for increasing satisfaction levels and interest in the field. The nation also needs to establish medical care models that will allow the next generation of primary care physicians to have the controllable schedules they need and so clearly desire. These opportunities for enhancing primary care are time-sensitive, though, and we fear that focusing so much attention on a single policy lever, such as medical school debt, will cause us to fail to take advantage of them.  We have hopes that the Patient Protection and Affordable Care Act will improve primary care practice and pay, but much more still needs to be done.

 

—Mr. Dill is a Senior Data Analyst at the AAMC’s Center for Workforce Studies. His current work focuses on physician demand, access to care, workforce projections modeling, and physician workforce diversity. He received his Master of Public Affairs and Policy from Rockefeller College, and he is currently pursuing his Ph.D. in Sociology through the University at Albany, SUNY. He is a guest blogger for the AAMC-powered Wing of Zock, and can be reached at mdill@aamc.org. Clese Erikson and Henry Sondheimer also contributed to this post.

 

 

TAGGED:primary care physiciansstudent loans
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

Grounded Healing: A Natural Ally for Sustainable Healthcare Systems
How IT and Marketing Teams Can Collaborate to Protect Patient Trust
Global Healthcare Policy & Law
July 17, 2025
paramedics in surgical gloves and masks
How Health Choices and Legal Actions Intersect After an Injury
Health care
July 16, 2025
a woman giving a key
How Probate Planning Shapes the Future of Your Estate and Family Care
Health
July 16, 2025
a woman with kinesio tapes on her back arm
How communities and healthcare providers can address slip and fall injuries with legal awareness
Health care
July 16, 2025

You Might also Like

Health ReformMedical DevicesMedical EducationMedical EthicsMedical Innovations

Here’s Why Plastic Surgery Shouldn’t Be Taboo Anymore

June 3, 2019
Data via ACPM 2010
Medical DevicesMedical EducationMedical InnovationsMobile HealthPublic HealthTechnology

5 Keys Ways to Improve Medication Adherence

May 1, 2015

Conference Season Approaching – Prepare for Landing

August 8, 2012
nursing program
Medical Education

7 Tips to Picking the Best Nursing Program

September 7, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?