Federman agrees with this idea. He says:"Reimbursement policies of the past sixty yearshave rewarded surgeons who perform a certainprocedure better than physicians who take the timeto counsel patients."

Ronan says the market forces that elevatedspecialties have turned into cultural beliefs thatlook down on primary care physicians.

Efforts at the national and medicalschool level may have contributed to an increasein student interest in primary care.

Jonas, Drey, and McCahan believe that greaternumbers of students are expressing interest andapplying for primary care internships andresidencies.

Nirav R. Shah '94 will attend SUNY-BuffaloMedical School in the fall and says he has astrong interest in primary care. "Clinton's healthplan has not necessarily given the financialincentives, but it made the field moreattractive," he said. "Now, colleges push for morestudents that are interested in primary care."

Paveljit Bindra '94 will enter Harvard MedicalSchool and believes that "doing primary care is apersonal choice." Although Harvard focuses onresearch, he does not think he will be swayed formhis goal of becoming a generalist.

Many students believe that entering any medicalfield, but especially primary care, must be anindividual choice. "It would be a waste if peoplewere dragged into primary care," says Drey.

Vinch says, "Even within primary care, peopleare drawn to different fields for differentreasons. It's hard to pinpoint why. It's basicallyup to the individual."

Drey and Vinch both voice opposition toguaranteed student loans that are tied toobligatory time as primary care givers in anunderprivileged area.

Vinch says the loans "discriminate on ethnicand on socioeconomic backgrounds," and do notguarantee that a doctor will continue to practiceprimary care.

"You might want to regulate exposure, but notchoice," Ronan says. "There are various levelswhere you can impact change and use bothincentives and regulations."