Why primary care doctors are shrinking in the U.S.

Medical student Luis Manriquez said he's been told that primary care doctors are less respected as physicians.

Parija B. Kavilanz
CNNMoney.com

Luis Manriquez and Katherine Glass share a common - and increasingly rare - ambition: They both want to become family doctors.

"As a primary care doctor, you are a gatekeeper of the medical system," said Manriquez, 26, who with Glass is a first-year student at the University of Washington School of Medicine. "Primary care is where you can have the most immediate impact in affecting patients' lives by managing their health."

Still, Manriquez realizes that he's setting himself for considerable challenges.

For one thing, as a family doctor, Manriquez will probably make one-fourth the salary of a specialist while trying to pay down $140,000 on average in medical school debt.

"That's why only the most committed pursue primary care. Kudos to them," said Jonathan Weiner, professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

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