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Northwest Voices

Seattle Times letters to the editor

December 22, 2008 at 4:00 PM

Med-school tuition breaks

It’s all relative

The other day, you endorsed Sen. Karen Keiser’s plan to provide medical-school tuition breaks to students entering primary-care specialties, such as family medicine, pediatrics and internal medicine [“Tuition breaks for family docs,” editorial, Dec. 19 ]. While her idea is certainly a helpful one, it will fall far short of its goal, simply because the long-term financial rewards of specialty care far surpass the costs of tuition.

I’m a family physician. I enjoy what I do, but I work in a system that is designed to reward specialty care and procedures at a far higher rate than primary care. Any intelligent student can see that the financial compensation for specialty care is many times the compensation provided to primary-care providers, especially if there are diagnostic or surgical procedures to perform. Even when there is no procedure involved, specialists are compensated at a much higher rate than primary-care physicians for the identical service.

When a student projects those rewards for even a few years, the benefits of choosing specialty care far exceeds the cost of medical-school tuition.

The senator wants to promote primary care, and I applaud her. But I hope that she sees that the issues go far beyond tuition. Her proposal won’t accomplish much, until America decides that providing complex care in a primary-care setting is worth as much as the same care in a specialist’s office, or perhaps as much as a single diagnostic procedure.

— Doug Trotter, Snohomish

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