The enigma of RFK, and why it matters

Is it the worm or the rest of his brain talking?

In an age where headlines substitute for news and thinking, it’s pretty easy to react to RFK, Jr. as the presumptive head of HHS. He thinks Trump is like Hitler…wait, no he likes him now and is willing to stuff down cardiac-defying Big Macs to prove it. He’s antivax, apparently hoping for more polio. He dumped a bear carcass in NYC’s Central Park…you gotta ask what the worm was drinking that night.

And about the time you’ve developed a deep allergic reaction to the worm, this shows up. As women, we manage our own healthcare and usually that of spouses, kids, and often aging parents. And if you’re like me, you know what a terrible state of affairs primary care is: unsatisfactory doesn’t begin to describe it. Chronic care coordination without you forcing it? You’re kidding, right? Accessible? LOL! Prevention? Up to you, babe. Follow-up? Ha! And on and on.

So this article gave me pause. Because at the bottom of our primary care problems is this one: the way to make money in health care is NOT to be in primary care. You give up that million-dollar home anytime soon if you specialize in family practice, internal medicine, pediatrics or OB-Gyn. Or in non-surgical specialties like scarce gerontology and palliative care—both a huge need for our aging population—and allergy/immunology, endocrinology, rheumatology and infectious disease. In non-surgical specialties, you might get to be a millionaire by the time you die. In surgical specialties, particularly subspecialties like ortho and plastics, you’ll see that upper 10% wealth bracket* in plenty of time for the kids to go to college (*average 2023 income: $7M).

The state of primary care in the US is all about economics. So consider this:

Gifted article: https://wapo.st/3Zix1fK