The U.S. is flowing within a sea of crises ‘- including economic meltdown, two wars abroad and global warming. Now, we have a crisis within a crisis ‘- the shortage of primary care physicians in the failing U.S. health care system.

A primary care physician is someone who links their patients to the world of health care. They learn everything about their patients, from their personal relationships to their diabetes.

Rachel Gotbaum, in a National Public Radio documentary, said, ‘at the turn of the 20th century, these were family doctors who worked in their community, handling patients’ day-to-day medical needs, including surgery. By the end of World War II, the country had recognized the value of medical specialists.’

Since then, doctors have been entering specialist fields at an alarming rate, leaving primary care in shambles. They are pursuing fields like anesthesiology, cardiology or pulmonology. A specialist-based system is devastating our health care and it stands in the way toward reaching a universalized health care system.

Primary care works because it allows doctors insight into the patient as a whole. This allows them to see the patient’s family situation, work life and other personal factors, while in turn allows the patient to create a trusting relationship with their doctor.

In the specialist-based system, care is focused on one ailment or disease. In the primary care method, patients are given continuous treatment that focuses on their particular human circumstance.‘

With a holistic understanding of patients and through strong doctor-patient relationships, doctors cannot only cure patients, but prevent future ailments. A hospital in Alaska decided to switch to a person-based health system, by connecting every individual and family to a specific staff member.

The increased resources spent on catering to the individual was more than compensated soon after the reorganization when visits to the emergency room dropped 50 percent and referrals to specialists by 30 percent. Waiting times were also reduced significantly.‘

Robert L. Dickman, a professor at Tufts Medical School, wrote in The Boston Globe, ‘Increased quality and decreased costs can be directly correlated to the number of primary care physicians in relation to specialists. Many Western healthcare systems have ‘hellip; worked to achieve a ratio close to 50-50. In the United States, it is more like 30-70. Today fewer than 10 percent of U.S. medical students have expressed an interest in the primary care disciplines.’

In Massachusetts General Hospital, patients cannot even gain access to a primary care provider. All the primary care providers are booked, and people are left without a guide through the health care system.‘

Gotbaum said, ‘At Massachusetts General Hospital twenty-five percent of the patients who come to the E.R. don’t have a primary care physician. Others are here because they couldn’t get in to see their doctor. It’s an expensive way to practice medicine: the costs to be treated here are three to five times higher than in a doctor’s office.’

The World Health Organization recognizes the need for primary health care in our globalized world. In the ‘World Health Report 2008,’ it stated, ‘people are increasingly impatient with the inability of health services to deliver levels of national coverage that meet stated demands and changing needs ‘hellip; few would disagree that health systems need to respond better ‘- and faster ‘- to the challenges of a changing world. PHC can do that.’

The work of a primary care physician is tough. The high demands put on these physicians through long work hours and poor pay actually makes one of the biggest joys of medicine ‘- caring for patients ‘- less appealing. A survey of primary care physicians across the nation showed that most would not pursue primary care if given another chance.‘

Vishal Joshi, a doctor at the Burgdorf Health Center in Farmington, Connecticut, in the NPR interview said, ‘in Canada, the primary care physician is more respected, is given the tools and given support he requires to do his job in a fulfilling manner, not only for him but for his patients. Here in the United States, one feels he’s more successful if he was to have a specialty, rather than staying in primary care. Primary care has been relegated towards the backwaters, almost, of the American health care model. The system is almost fighting against the primary care physician which is very unfortunate.’

Primary care lacks the pizzazz of cutting-edge technology or the thrill of saving someone who is facing almost certain death. The difference in salary is also significant.

Primary care physicians can expect to start off at a salary of about $135,000 and a specialized physician can expect to make $200,000 plus.

‘ With the desperation of paying off medical school debt, the choice of specializing is a no-brainer.

President Barack Obama has recognized the need for more primary care physicians in our nation. These physicians will need to get higher salaries, more support from medical schools and greater recognition for the work they do.

The field needs to be reinvigorated to restore it to its proper place and to win back our place as one of the healthiest nations in the world.

Ebad Rahman is a Collegian columnist. He can be reached at [email protected].