Match Day Looms, Can Primary Care Once Again Show Gains?
Match Day 2012 is practically upon us. Me? I’m about 18 years removed, but the drama surrounding where I would be receiving my OJT after medical school was palpable. I still feel the goosebumps from that day; it’s that exciting and unnerving. Each year, I have tried to chronicle briefly what the tea leaves hold for primary care. Last year, there was some reason to hope for an increased representation of the collective discipline in the overall scheme of matches of graduates to training programs, but feelings were still mixed on the issue. Though, this year could be even more of the same.
As we approach health reform in this country, the need to increase the numbers of primary care physicians has never been greater. The White House has a stake in this interest, as the ACA will dramatically increase that need for presumptive increases in demand for this mode of care delivery. Last year, there was some wind in the sails of primary care. Many more medical students chose the discipline than were expected, citing looming changes via the ACA and the need to “make a difference” with respect to preventive medicine and public health. The WH has an initiative in place to address primary care’s dwindling numbers, but it is only a modest amount needed to stem the projected approximately 30,000-numbered provider deficit by 2015.
If representation compared to medical and surgical subspecialties continues on this uneven pace, healthcare costs will continue to rise as more and more people are guaranteed access to basic (primary) care under reform. Throw in the costs to Medicare (a significant funding source for most residency programs), one can only hope that changes (cuts) in reimbursement will not negatively affect those who continue to see such patients. While the entire fiscal future of healthcare delivery will most certainly not rest upon the primary care results of Match Day ’12, it will be interesting to see if last year spurs a trend.