【正文】 eceives leans heavily toward medical or surgical procedures. A specialist who performs a procedure in a 30minute visit can be paid three times more than a primary care physician using that same 30 minutes to discuss a patient’s disease. Combine this fact with annual government threats to indiscriminately cut reimbursements, physicians are faced with no choice but to increase quantity to boost ine.Primary care physicians who refuse to promise quality are either driven out of business or to cashonly practices, further contributing to the decline of primary care.Medical students are not blind to this scenario. They see how heavily the reimbursement deck is stacked against primary care. The recent numbers show that since 1997, newly graduated . medical students who choose primary care as a career have declined by 50%. This trend results in emergency rooms being overwhelmed with patients without regular doctors.How do we fix this problem?It starts with reforming the physician reimbursement system. Remove the pressure for primary care physicians to squeeze in more patients per hour, and reward them for optimally (最佳地) managing their diseases and practicing evidencebased medicine. Make primary care more attractive to medical students by forgiving student loans for those who choose primary care as a career and reconciling the marked difference between specialist and primary care physician salaries.We’re at a point where primary care is needed more than ever. Within a few years, the first wave of the 76 million Baby Boomers will bee eligible for Medicare. Patients older than 85, who need chronic care most, will rise by 50% this decade.Who will be there to treat them?二There is nothing like the suggestion of a cancer risk to scare a parent, especially one of the overeducated, ecoconscious type. So you can imagine the reaction when a recent USA Today investigation of air quality around the nation’s schools singled out those in the smugly（自鳴得意的）green village of Berkeley, Calif., as being among the worst in the country. The city’s public high school, as well as a number of daycare centers, preschools, elementary and middle schools, fell in the lowest 10%. Industrial pollution in our town had supposedly turned students into living science experiments breathing in a laboratory’s worth of heavy metals like manganese, chromium and nickel each day. This in a city that requires school cafeterias to serve organic meals. Great, I thought, organic lunch, toxic campus.Since December, when the report came out, the mayor, neighborhood activists（活躍分子）and various parentteacher associations have engaged in a fierce battle over its validity: over the guilt of the steelcasting factory on the western edge of town, over union jobs versus children’s health and over what, if anything, ought to be done. With all sides presenting their own experts armed with conflicting scientific studies, whom should parents believe? Is there truly a threat here, we asked one another as we dropped off our kids, and if so, how great is it? And how does it pare with the other, seemingly perpetual health scares we confront, like panic over lead in synthetic athletic fields? Rather than just another weird episode in the town that brought you protesting environmentalists, this latest drama is a trial for how today’s parents perceive risk, how we try to keep our kids safe—whether it’s possible to keep them safe—in what feels like an increasingly threatening world. It raises the question of what, in our time, “safe” could even mean.“There’s no way around the uncertainty,” says Kimberly Thompson, president of Kid Risk, a nonprofit group that studies children’s health. “That means your choices can matter, but it also means you aren’t going to know if they do.” A 2004 report in the journal Pediatrics explained that nervous parents have more to fear from fire, car accidents and drowning than from toxic chemical exposure. To which I say: Well, obviously. But such concrete hazards are beside the point. It’s the dangers parents can’t—and may never—quantify that occur all of sudden. That’s why I’ve rid my cupboard of microwave food packed in bags coated with a potential cancercausing substance, but although I’ve liv