A Bump on the ROAD to Health Reform

Preface: These notable and quotable remarks appeared in today’s New York Times.

In today’s Doctor and Patient column, Dr. Pauline W. Chen writes about the image problem that primary care specialists face. Dr. Chen recounts the story of a respected medical school colleague who chose the primary care route, and the disparaging comments that followed.

Unfortunately those comments would not be the last ones I would hear disparaging primary care. Even today, similar beliefs persist among medical students and trainees, though they have long since been condensed, reduced to an oft-repeated acronym among those choosing specialties: I’m heading for the ROAD (radiology, ophthalmology, anesthesia and dermatology).

That ROAD has had devastating effects on the physician work force in the United States. … According to one study published last year in The Journal of the American Medical Association, as few as 2 percent of medical students are choosing to step away from the ROAD or from other similar “high prestige” and competitive specialties in order to pursue general internal medicine. The statistic has the power to bring even the best efforts at reform and universal coverage to a grinding halt.