Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: FRIDAY, October 8, 1993 TAG: 9310150375
SECTION: EDITORIAL PAGE: A8 EDITION: METRO
SOURCE:
DATELINE: LENGTH: Long
Today, there are approximately 20 medical and surgical specialties, of which only four are primary care.
Those four primary-care specialties are family practice (formerly known as general practice), general internal medicine, pediatrics and obstetrics/gy- necology. Additionally, there are approximately 66 subspecialties which come from 20 main specialties.
Instead of retraining physicians and surgeons, medical schools could place more emphasis on primary care. A medical education is very expensive, and if it's earned at a private medical school, the cost can exceed $100,000. That's why many physicians choose to practice in higher-income specialties and subspecialties.
Teaching hospitals could reduce the number of residency openings in certain specialties and subspecialties while increasing the number of residency openings in the four primary-care specialties.
Internal medicine and pediatrics, for example, have approximately 12 subspecialties each (e.g., cardiology, gastroenterology, etc.). Subspecialties can take between one and three years of training beyond the primary three-year residency. Physicians who practice only their subspecialties could begin to provide primary care as well, without retraining. The vast majority of them are board certified in both their primary specialty and subspecialty anyway. Many more patients could be treated if medical (not surgical) subspecialists incorporate primary care into their practices.
Additionally, more incentive should be given to physicians if they are to be encouraged to practice in primary care. It's highly likely, in my opinion, that if we have many more physicians in primary care and if insurance paperwork is greatly reduced, we'll get more thorough care, i.e., less rushed and less waiting-room time. It's also possible that emergency-room visits for non- emergency care will decrease by having access to primary care in the first place.
WILLIAM G. BRANNON
GALAX
Nothing to crow about
WHAT HAVE Oliver North and George Allen got to crow about?
Allen wants to know what Mary Sue Terry did with her last job. What did you do with your last job, Mr. Allen? No one ever heard of you until you decided to run against Ms. Terry. After the Reagan years of 1980-1992, I would be kind of quiet.
Two deficits have been the greatest of all-time history - money and trade. During this 12-year period, I will never forget all of the jobs lost, factories shutting down, and people losing their life savings, homes, cars and everything else on account of foreign countries flooding our markets with their merchandise.
MONROE TIPTON
DUGSPUR
Keep rail idea on one track
THERE seem to be many alternatives for rail service to the Roanoke Valley and not just one. Private enterprise, such as the Virginia Central Railway, could be encouraged to consider linking Roanoke with Clifton Forge via Buchanan or with Charlottesville via Waynesboro.
Since many communities have no public bus, train or plane service whatsoever, it leaves those citizens having to elicit private transportation.
Our communities need to work with singularity of purpose, and not a "see how much the government can spend" policy. This type of policy spends away our children's future, which we're supposed to enhance and nurture.
HAROLD P. WILLIAMS JR.
MARTINSVILLE
North has the experience
I NOTICED that Oliver North has declared himself a candidate for the U.S. Senate. He h as all the qualifications and experience to be a politician.
He'll have a lot more experience if elected than other politicians elected for their first term; the Iran-Contra affair gave him all the experience he needs to lie to, steal from and cheat the American public.
He has firsthand experience in how to destroy evidence. If he's elected, I wonder if he'll take his paper shredder with him to the Senate.
CARL R. PADGETT
SALEM
How will they treat state workers?
I DON'T think Virginians are interested in who made which television commercial. What we would like to know is what Mary Sue Terry and George Allen plan to do for Virginia and its people.
All I've heard so far is gun control and how the jails and prisons should be run.
I do agree with Ms. Terry's idea about how prison inmates should be treated as far as privileges go.
But I would also like to know what she and Allen plan to do for state employees who make up a big percentage of the voters. We are really tired of carrying the burden of past governors of Virginia who campaign to lower the state budget.
ROSETTA FRENCH
RADFORD
by CNB