Mark D. Schwartz, MD; William T. Basco, MD; Michael R. Grey, MD, MPH; Joann G. Elmore, MD, MPH; Arthur Rubenstein, MBBCh
Rekindle: from Old Norse, kynda, to start (a fire) burning; to stir up, arouse, to cause to glow, or illuminate; and from Middle English, to bring forth young (1).
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Advocate Lutheran General Hospital
May 14, 2005
Employ the Invisible Hand
Schwartz et al offer many constructive suggestions to stimulate medical student interest in generalist careers. However, I offer an additional idea. Mobilize the invisible hand of Adam Smith toward elevating internal medicine, pediatrics, and family medicine on students' ranking lists for the matching program. Simply increase the salary for residents in these specialties. Free market economics uses price changes to signal variations in supply and demand. There is no real justification for the tradition of paying residents equally, regardless of specialty.
Loan forgiveness programs are also desirable, but the reward comes too far into the future. Also, the signaling effect of a significant variation in resident salaries among the specialties should not be underestimated.
Schwartz MD, Basco WT, Grey MR, Elmore JG, Rubenstein A. Rekindling Student Interest in Generalist Careers. Ann Intern Med. 2005;142:715-724. doi: 10.7326/0003-4819-142-8-200504190-00040
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Published: Ann Intern Med. 2005;142(8):715-724.
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