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[Perspectives] Social medicine: lessons from Cuba

Midway through my third year of medical school, I had a class session to discuss the changes that would result from the US health-care reform bill. The lecture was part of our school’s attempt to educate us on the policies that would affect our careers. The session had only just begun when a classmate remarked, “I just want to know how much I’m going to get paid.” Laughter swept through the room, leaving only a few people looking surprised. Soon after, another classmate, a self-proclaimed future orthopaedic surgeon, raised his hand and asked, “Why are we paying primary care doctors more?” He went on to argue with one of the speakers, an up-and-coming primary care doctor, and insisted that the latter’s job would soon be replaced by nurse practitioners.