Earlier this year, I went to my primary care doctor for my annual physical. Typically, I would walk into his stand-alone office building, talk with his receptionist, and take a seat in the waiting room where unique works of art hung on each wall. Then, after a few minutes, I would be called back and greeted by a very special office assistant: my doctor’s golden retriever. He would wag his tail vigorously, and I would happily pet his head as he led me back to the exam room. It was an interaction that had occurred for years and was one that made my doctor-patient experience exceptional. However, this year, no such interaction occurred. Instead, due to rising costs and the Electronic Medical Record (EMR), my doctor was forced to sell his practice and become an employee of a major regional hospital company. And, unfortunately, his golden retriever was not allowed on the payroll.
When I asked my doctor how these changes had affected him, he was despondent. He told me to “avoid medicine” and to “choose another career.” I would bet most current medical students have had similar words spoken to them. Yet, they entered medical school and did not heed the warnings of our past mentors. There could be many reasons for this: a passion for science and learning or the altruistic motive of helping others during their most vulnerable moments. Perhaps we young medical students do not know what we are getting ourselves into. However, it is important for us now to recognize that we will play a vital role in shaping the future of healthcare. The healthcare economy is arriving at a crossroads that will need extraordinary leadership to make sure that it does not derail in the upcoming years. That leadership must come from us, the future doctors of America.
One of the detriments of medical education is that we are not exposed to disciplines outside of science (at least not very often). In the 2019 AAMC data on medical school applicants and matriculants, 58% of applicants applied with a “biological sciences” major. Similarly, 57% of matriculated applicants (those accepted into medical school) majored in “biological sciences.”[1] While it is vitally important to understand the basic sciences of medicine, future doctors should also be exposed to fields such as economics, public policy, and basic finance. The medical school curriculum is densely packed with information, but it has historically lacked exploration into fields outside of the basic sciences.[2] However, this is changing. Medical schools are increasingly lecturing on healthcare policy, insurance, and economic changes. While knowledge is key for doctors to understand the healthcare system, it will take doctors using that knowledge to change the healthcare system.
A 2011 study found that hospitals with physician CEOs outperformed non-physician CEOs in hospital-quality outcomes.[3] It is important to note that correlation does not equal causation, but it would make sense that hospitals run by physicians, on average, perform better. We are increasingly seeing medical students obtain dual degrees in MD/MBA and MD/MPH. Medical students are adapting to the current change and attempting to play an active role in how the future of healthcare policy will look. Now more than ever, we need physician leadership that can navigate the complex world of medicine, business, and public policy.
My primary care doctor seems to be a relic of the past. A time when doctors could tailor their practice to how they wanted and have the freedom to be their own boss. Perhaps that time is gone forever—left behind in a field that is changing exponentially. However, I do not believe this has to be true. The fundamental issues of healthcare can, and will, be solved if physicians lead the way in the coming decades. At a time when so many physicians are burnt-out with their current situations, it is necessary to come up with distinctive solutions to the problems. Instead of passively idling by while our field changes, we must broaden our intellectual horizons and become creative. The problems with healthcare are enormously complex, difficult, and maddening, but this should not stop us from facing them head-on. Because, future physicians are the solution to problems in healthcare.
- “MCAT and GPAs for Applicants and Matriculants to US Medical Schools by Primary Undergraduate Major, 2019-2020.” 2019 Facts: Applicants and Matriculants Data. AAMC. Retrieved from: https://www.aamc.org/data-reports/students-residents/interactive-data/2019-facts-applicants-and-matriculants-data.
- Duffy TP. The Flexner Report—100 years later. Yale J Biol Med. 2011;84(3):269-276.
- Goodall AH. Physician-leaders and hospital performance: is there an association?. Soc Sci Med. 2011;73(4):535-539. doi:10.1016/j.socscimed.2011.06.025
Aaron Dowell is a member of the University of Arizona College of Medicine-Phoenix Class of 2024. He graduated from the University of Evansville in 2020 with a degree in Neuroscience. He plans on obtaining his MD/MBA dual degree and is interested in reducing physician burnout, leadership, and healthcare-market trends. In his free time he enjoys hiking with his wife, weightlifting, training Brazilian Jiu-Jitsu, and bowhunting. Contact information: aarondowell@email.arizona.edu