Lost Assets

What American medicine needs, many servers agree, are primary-care doctors whose scope is the whole patient. But only one-third of the nation's doctors are general practitioners.

Not only are medical positions going unstaffed, but medical schools are missing a valuable re-source--the well-rounded students who are typically attracted to primary care. They are more likely to have arts and humanities backgrounds and varied life experiences, says Michael Rosenthal, M.D., a professor of family medicine at Jefferson Medical College in Philadelphia. "They approach medicine with an interest in knowing patients and how their emotions and life-styles influence their health."

Rosenthal asked students who had already chosen their specialties to reveal what they would be doing if they weren't doctors. Those who chose technical specialties, like anesthesiology, listed banking, business, law. "Primary-care students said day-care counselor, carpenter, filmmaker."

Are primary-care types taking up technical specialties and creating kinder, gentler surgeons? Not necessarily. Rosenthal thinks they are not going to medical school at all.

Part of the problem is economic. Recent surveys out of Jefferson Medical College show that $180,000 a year (a typical income of a specialist), a reasonable work schedule, and a revamped recruitment system might help fill the void. Some 700 graduating students from six medical schools said they are interested in primary care but chose other specialties be-cause of life-style, salary, and the $75,000 of debt that 40 percent of them accrue.

But money and life-style aren't everything. Medical schools demand students with hard science backgrounds and outstanding GPAs entrance ex-arms--the profile of students likely to pass on primary care. Perhaps an admissions policy that fits the liberal-arts, primary-care profile is in order.

ILLUSTRATION