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      1. Primary care in the 21st Century

        My chest swelled with pride as I read the advertisement on one of the front ad pages of this week's New England Journal of Medicine: "The Board of Trustees of Quinnipiac University Extends Congratulations on the Accreditation of its FRANK H NETTER MD SCHOOL OF MEDICINE"|."?

        Please understand, ordinarily ads do not cause my chest to swell with pride. However, I had just sat down to dinner and opened this week's NEJM (yes, sometimes I read it at dinner, but only if I'm dining solo) after returning from a committee meeting at which we had voted on admitting the first group of students to the first class of the first new U.S. medical school to open in 30 years. Frank Netter is one of 12 new medical schools actively pursuing accreditation. There are perhaps 10 more under consideration.

        The unfortunate reality, however, is that we are facing a shortage of primary care doctors on the order of more than 125,000 over the next 10 years. The 60 students that The Frank Netter School will admit to next year's class will not even make a dent.

        I had a very interesting conversation a few weeks ago with one of the student candidates I interviewed about how primary care medicine needs to change. He had a background in technology much deeper than the average doctor, let alone the average medical student. We discussed how the current outdated practice model can be streamlined. Students like this at least provide me with some hope that we can adapt.

        In my opinion the "medical home"? model is not a viable solution unless we intend to build an additional 125,000 of them. Maybe the construction industry can produce them. I don't think even another 12, or for that matter 22, new medical schools can.

        In the meantime, while we wait for this new crop of medical students to mature (seven years minimum, realistically more than 10), First Stop Health aims to fill the gaps in care prevalent within the current "system."? We are working to develop the databases, methods, and systems that will enable the average American to access high quality, affordable healthcare in the first half of the 21st Century.

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