The joys of primary care

In 2023, the AOA reported that 57% of practicing DO physicians are in primary care specialties, including family medicine, internal medicine and pediatrics. The AOA also reported that, over the last two decades, the number of DOs pursuing non-primary care specialties has increased significantly.

In 2023, among DO residency candidates who secured placements via the NRMP, 57% were placed in primary care specialties, while 43% were placed in non-primary care specialties. The most common non-primary care specialties include emergency medicine, anesthesiology, OB-GYN, psychiatry and general surgery.

There are many compelling reasons to choose a non-primary care specialty, including following your interests, salary and lifestyle considerations. There are also many great reasons to pursue a primary care specialty, including the opportunity to treat a wide range of conditions, longitudinal relationships with patients and the chance to provide preventive care.

Throughout the specialty selection process, students are often encouraged to reflect on the core values of specialties they are interested in pursuing.

During this process, students may recognize many of the joys of primary care are the same ones that they experienced while shadowing prior to medical school and emphasized in their medical school applications and interviews.

As I continue to explore primary care, I wanted to share what I learned with my medical student peers. I spoke to two DOs in primary care to get their take on what these specialties bring to the table. Here are their thoughts on the many positives that primary care specialties offer physicians.

Providing longitudinal care

When shadowing in a family medicine clinic prior to medical school, I noted how the physician knew not only his patients, but also their partner, kids, parents and other extended family members. It was remarkable to me how strong his relationship with each patient had become because he had the opportunity to get to know them over time.

Jason Herman, DO,  shared how treating the full spectrum of life is as rewarding as it is challenging. “When I was considering residency and what I wanted from my career, I really enjoyed the idea of treating patients of any age with a wide variety of health concerns,” he said. Primary care physicians have to know a lot about a lot of things—systems, pathology and pharmacology, as well as the intersections between them all. Arriving at the correct diagnosis and not missing benchmarks or milestones for all different age groups is an accomplishment not to be diminished.

Ideal for those seeking cultural competency

Primary care physicians have the opportunity to treat patients of many different ethnic, racial and cultural backgrounds. Learning the customs and beliefs of all community members and then helping those patients navigate treatments that align with their beliefs is often a welcome challenge. In a recent study from the Journal of Family Medicine and Primary Care, it was noted “cultural competence will become the hallmark of high-quality public health systems, programs and research; more specifically in the area of family medicine and primary care.”

Chaseton Womack, DO, a family medicine resident, agreed. “One of the most rewarding parts of working with patients of varying backgrounds is exploring not only what I think will be an effective treatment plan, but also seeking the patient’s input while considering their beliefs and cultural traditions to find a plan that they can buy into,” he said.

Serving as the doctor

When people talk about visiting their doctor, they are often talking about needing to see their primary care physician. There is a level of trust that has to be present within the patient-physician relationship for patients to continually seek out your wisdom and guidance. You are a calm, cool and collected source of information and can provide answers to the trickiest health questions.

Helping underserved populations

Dr. Womack shared that another one of the most fulfilling motivations that led him to primary care was being able to serve as a bridge for underserved patients and get them started on the path toward receiving the care they need. He noted how he has seen many patients who cannot get appointments with subspecialized physicians because of roadblocks and lack of access, a problem well-noted in the Department of Health and Human Services’ Healthy People 2030 initiative.

“As primary care physicians we can help serve as the guide for each patient to advocate for them to get the care that they deserve,” he explained.

Educating on preventive care

Something that hopefully resonates with osteopathic students and physicians is seeking to provide preventive care options that enhance the body, mind and spirit connection. When someone is at their best, they can accomplish wonderful things. It is exciting to be an active participant in the journey to help them reach their health and wellness goals.

Another competing force for information is social media. It is packed full of information on preventive care medicine and supplements and can provide a combination of good, misleading and even untruthful advice. You can become a trustworthy guide in a patient’s search to find what will keep them healthy for years to come and help them avoid tips and tricks that may have dangerous side effects.

Guiding difficult conversations

At times, there will be opportunities to counsel patients on difficult conditions or habits that are negatively affecting their wellness. As mentioned above, a strong patient-physician relationship will create a safe space for dialogue and collaboration on a treatment plan. These conversations are something that should not be shied away from and, when properly addressed, can lead to massive improvements in a patient’s health. Oftentimes these conversations will not be a single encounter, but rather a process of working through different stages of change.

A personal decision

Deciding whether to go the primary or non-primary care route is a deeply personal decision. Students typically consider what they want to accomplish in their career and the type of patient-physician relationships they are seeking. Above all else, please remember that you have tremendous potential, you will make a difference either way, and you will be the physician a patient needs you to be. Maybe it is easier said than done, but seek to do what you love and stay true to the values that matter to you—wherever that leads you is where you will be needed.

Related reading:

From the classroom to the hospital unit: Putting my skills to the test in clinical rotations

Managing long-distance relationships in med school and beyond