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About the author: Derek Thompson is a staff writer at The Atlantic and the author of the Work in Progress newsletter. He is also the author of Hit Makers and the host of the podcast Plain English.

B y the time Elizabeth Erickson was a freshman at Davidson College in 2002, she knew she wanted to become a doctor. Because she understood that the earliest health interventions are among the most important, she set herself on a pediatrics track. After four years of premed classes, she went straight to medical school at Wake Forest University, which took another four years. Then came three years of residency at Duke University, plus one final year as chief resident. In 2014, she joined the faculty of Duke’s School of Medicine. Her dream was realized at the steep price of 12 consecutive years of learning and training, plus about $400,000 of debt.

Erickson’s story would be exceptional in just about any other country. But it’s hardly unusual in the United States, which has the longest, most expensive medical-education system in the developed world, and among the lowest number of physicians per capita. There is a huge scarcity of primary-care doctors, like pediatricians, and many of us are operating in a scarcity framework without enough resources, Erickson told me. Continue reading

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