Letters to the Editor

March 27, 2008 - Medical Specialties and Our Health Care System (New York Times)

Re “For Top Medical Students, Appearance Offers an Attractive Field” (front page, March 19):

The fact that so many medical students are choosing lucrative specialties like dermatology over internal medicine should be a clarion call that our health care system needs an overhaul. It is unfortunate that a doctor can earn $2,000 per hour performing a cosmetic procedure while a primary care physician earns far less preventing and treating life-threatening diseases like diabetes and hypertension.

Payment disparities like this have turned our nation’s health care upside down, and fewer medical students are choosing specialties like internal medicine that focus on managing the health of the whole patient.

The trend is likely to continue given these disparities and colossal loans facing medical students. Our nation will face a health care crisis if we don’t do something now to stem this tide. More than ever, Americans need access to qualified primary care physicians to manage multiple chronic conditions as baby boomers gray and disease rates for obesity, diabetes and hypertension increase.

We will continue to press for a national physician work force policy and physician payment reforms. It is essential that internal medicine and other primary care specialties become more attractive career options for the brightest among our medical students.

Joel S. Levine
Christine K. Cassel
Philadelphia, March 23, 2008

The writers, medical doctors, are, respectively, chairman of the Board of Regents, American College of Physicians; and president and chief executive, American Board of Internal Medicine.

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