If there's a shortage of doctors, why not allow more Americans to become one? (My title)

The Washington Times ^ | Nov. 18th, 2002 | Wash Times Editorial

[End The Hypocrisy]

"According to the American Medical Association, 12 states face serious dangers of doctor shortages due to spiraling insurance costs." Isn't this the same protectionist AMA that's now being sued for antitrust violations regarding its residency program? Are we sure the AMA's excessively restrictive admissions system isn't mainly to blame for the lack of doctors? Did you know that in nearly all OTHER countries, medicine is a highly focused UNDERgraduate degree? It's less costly and lucrative to become a doctor abroad, and people pursue medicine much more for a love of medicine than of money. Doctors abroad aren't nearly as eager to quit, unsurprisingly. Meanwhile, medical services overseas are better than the AMA would have us believe. Millions of Americans have already chosen to retire abroad, despite language barriers. Do you know any such expatriates whom you could ask to compare medical services (and costs) here and abroad? Do they think that excessive fees here are justified by purportedly better medical services? Or are we simply paying the price of the AMA's protectionism, while resulting U.S. doctors care much more about golf courses and holiday parties than they do about patients whom they must be bothered with long enough to repay loans?

[End The Hypocrisy]

I respect medical doctors' abilities considerably, even if reportedly very few actually selected their profession for more than the love of money and status (which are unique to U.S. doctors). Thanks to the forces of globalization, though, increasingly well-traveled Americans are discovering what the protectionist AMA doesn't want us to: that the quality of medicine in other countries is better than they have traditionally led us to believe. I definitely don't advocate Hillary-care socialized medicine, just greater competition for the right to serve patients. Why should doctors have to spend so much to get to join the highly protected ranks of AMA-sanctioned professionals?

I don't advocate opening the medical profession to more well-meaning but incompetent quacks, either. But other countries seem to have demonstrated that the love of medicine (even when money's not guaranteed) is often enough to make adequate health care accessible. By the way, nurses here have increasingly discovered how simple most doctors' tasks actually are to perform. Do you know any with whom you could confirm this? Are all the admissions hurdles U.S. doctors are forced to surmount worth the excessive fees that we're subsequently forced to attempt to pay? Ask your expatriate or nurse acquaintances, and please share their intellectually honest reactions with us. Meanwhile, let's see how the antitrust litigation against the AMA proceeds. Since last Spring, the AMA has already reacted by easing residency requirements down to a "mere" 80 hours per week. The doctor shortage remains though... Is anyone surprised?

[End The Hypocrisy]

How about some "union-busting," for American society's sake?

[End The Hypocrisy]

ping

[pabianice]

We've tried that. It's called "affirmative action," and it's cost tens of thousands of Americans their health, lives, and wallets. One such case was in the news recently -- an AA "doctor" who had been thrown-out of medicine for butchering women during cosmetic surgery. He was subsequently killed during a car-jacking.

[End The Hypocrisy]

>>>We've tried that. It's called "affirmative action"...<<<

There's a thread devoted to that quack of a doctor, here:

http://www.freerepublic.com/focus/news/731046/posts

It's a crime that worthwhile candidates were turned away from the relatively few AMA-accredited medical schools while "candidates" such as him were given the golden key by the protectionist AMA. It's hypocritical, isn't it?

[NautiNurse]

This thread is a vanity through and through. One sentence taken out of context from an editorial to promote your vanity does not make front page news.

[joesnuffy]

If you want the very best in diagnosis come to America...

If you want the very best care..go to Europe..

AMA means no competition..affirmative action in med schools and limited classes and unreal high tution certainly doesnt help matters..

Much of the family practice crisis could be obviated by Nurse Practitioners and PA (Physician Assistant) programs if restrictions were limited and tort law reformed.. (and lawyers muzzled in many cases)

A 4.0 is not necessarily a great predictor of who is going to make a better doctor...as a person carrying a 3.0 ,working a job ,supporting a wife & kids might be better suited to doctoring than some 4.0 rich kid punk...with attitude..

Fluency in english wouldnt hurt either...imo

[Willie Green]

How about some "union-busting," for American society's sake?

Now you're talking!

Most Americans (including so-called "conservatives") don't recognize that "professional" organizations, such as the AMA, function as national "unions". And the monopolistic regulatory control these unions exert over our society serve as a severe detriment to our nation.
The American Bar Association likewise damages our economic productivity and prosperity.

Hang the unionized lawyer thugs!

[End The Hypocrisy]

NautiNurse, do doctors deserve to get paid multiples of what you get paid even for performing the same work? That's some union they have, isn't it? Have you ever wanted to try and change things, if not for your own salary's sake then for the well-being of those who are priced out of being able to afford medical care by the anticompetitive practices that we peculiarly still overlook?

This general topic has inspired a couple of different front page articles on today's issue of WashingtonTimes.com, by the way.

[stubernx98]

Having experienced the healthcare systems in Canada, England, Germany, Norway, Russia(in this case I had to send a doctor with my crew), Africa, Australia(best), and Asia(God help you), I will take the US anytime. Doctors are being forced out of medicine due to over regulations, high cost of malpractice insurance(due to Trial Lawyers with the complicity of the Democrats).

Though, I agree the AMA, like other professional organizations(and unions) tend to protect their own, and make it harder to get in.

Rush is fulminating on this now. The Democrates want a single payer system so they can control you and your vote.

[Future Useless Eater]

I think it is mostly a shortage of doctors willing to
work for peanuts.

I think a doctor needs roughly 12 years of post-high-school-training at an enormous cost
... you doctors chime in and correct me if you like

The doctors have about $100,000 in loans as a resident
and get paid like janitors.

the cost of the extra schooling is a negative compared to
what they would have started earning after lets say a 4-year
science degree. (that plus they have ~no income during those
last 8 years compared to the science major that DOES
start getting an income after 4 years)

it takes a long time, maybe 15-20 years to overcome
the difference in earnings.

with Hillary/Al Gore's single payer plan, doctors would
be paid even less.
[all the while our sports entertainers
will keep getting multi-millions per year and we will
keep building for them half-billion dollar colliseums
in every major city using tax dollars]

A large chunk of todays doctors will not recommend for
their children to go into medicine because of poor
reimbursement for their talents.

[End The Hypocrisy]

>>>If you want the very best in diagnosis come to America... If you want the very best care..go to Europe..<<<

I have heard from academics on a few occasions that the more doctors there are, the more supposed ailments supposedly exist which are suddenly diagnosed as being "urgent" health problems. But that was back before HMOs and insurance rationing (or discontinuation) came about and made such self-aggrandizing practices less lucrative. While I think there should be more doctors (as long as they're COMPETENT), I wouldn't want to see the emergence of more supposed ailments that we're shamed into thinking we're too poor to be able to treat. It's fine if doctors want to laugh their way to the bank, golf course, and riviera....as long as there are plenty of other doctors who can gladly service angry customers like us. Right now there's so little competition it's a joke (except to Americans, who are only starting to wake up).

[TomB]

How about posting the real article?

Tort reform and the new Congress

One of the top issues that needs to be on the agenda for the next Congress (and many state legislatures as well) will be tort reform — in particular, the problems resulting from escalating jury awards in medical malpractice cases that have shaken the American medical system, Sen. John Ensign, Nevada Republican, told The Washington Times.

But Mr. Ensign, perhaps the Senate's most tenacious proponent of medical-liability reform, made clear that a battle lies ahead on Capitol Hill. In September, the House voted overwhelmingly for such legislation, only to have a parallel Senate bill sponsored by Mr. Ensign bottled up by the Democratic majority.

One positive sign, Mr. Ensign says, is that a number of recent liability insurance-related problems are driving home to the public the need for reform. The state's only Level-I trauma facility, located at the University of Nevada Medical Center in Las Vegas, was forced to shut its doors following the mass resignations of surgeons, who said they risked bankrupting their families if they were hit with a seven-figure lawsuit from increasingly aggressive personal-injury lawyers. Level-I trauma centers — staffed around the clock with a variety of specialists to provide care to seriously injured patients, including victims of shootings, stabbings and car accidents —are an integral part of this country's first line of defense against catastrophic terrorist attack.

Fortunately, the Nevada facility reopened. In August, Gov. Kenny Guinn and the Nevada legislature agreed on a compromise plan aimed at resolving the problem. The new law placed a $350,000 cap on pain and suffering damages, with two exceptions, added at the insistence of trial lawyers: "cases of gross malpractice" and cases deemed to be "exceptional circumstances" — however defined.

While the legislation was a step in the right direction, it clearly left some serious liability-related problems unresolved, among them the serious shortage of OB/GYNs in the greater Las Vegas area. Nancy Allen, 48. had to wait six months to have suspicious lumps removed from her uterus and ovaries because she could not get an appointment for surgery. In an interview with the Las Vegas Review-Journal earlier this month, Mrs. Allen said she would still be awaiting a hysterectomy had she not stormed into her doctor's office and refused to leave until the procedure was scheduled. Meanwhile, the Clark County (Las Vegas) OB/GYN Society said that 30 obstetricians have either left town, retired early or stopped delivering babies in recent months because they cannot find malpractice insurance or afford the soaring rates.

Nevada is hardly the exception. According to the American Medical Association, 12 states —among them New York, New Jersey, Florida, Ohio, Oregon, West Virginia, Mississippi and Texas —face serious dangers of doctor shortages due to spiraling insurance costs.

"This one's going to be a tough one," Mr. Ensign says of the prospects for the enactment of tort reform in the next Congress. The best thing going for his side is that "we've got a great president with a great bully pulpit" that can be used to negate the lobbying power of groups like the American Trial Lawyers Association, Mr. Ensign said.

President Bush's willingness may well make the difference in the next Congress.

Seems like the article has NOTHING to do with what you are bellyaching about. This should be posted under vanities.

[End The Hypocrisy]

>>>I think a doctor needs roughly 12 years of post-high-school-training at an enormous cost <<<


Empirical data from overseas suggests otherwise, much to the protectionist AMA's chagrin.

[Jesse]

Your post is filled with inaccuracies.

From personal experience and from studies I've read, most doctors select their profession rather early on...many in high school or before. Money wasn't the driving issue then. As for status, I think a better word is independence. I was interested in medicine from grade school, and wanted to be in charge. As one goes on in medicine, you find that you aren't as in charge as you think.

The AMA doesn't really have a whole hell of a lot to do with the day to day practice of medicine, medical education, or medical licensing. I haven't belonged to the AMA since I was a medical student, and only about 30-40% of doctors belong to the AMA.

The residency work hours requirement was an outgrowth of state laws in New York which were enacted following the highly publicized death of a woman from meningitis, I believe. Purportedly, the resident was "too tired" to make the diagnosis. Many hospitals now use physician extenders to provide in house care. Me, I would rather have a tired doctor.


"Nurses have discovered how simple most doctors tasks are to perform." Huh?

There is not a global physician shortage. However, their are regional shortages and specialty shortages. Training more physicians does not automatically translate into lowered costs or charges, and in some cases it is probably not possible to increase the number of specialists, because the costs of the training programs are so prohibitive.

BTW, the federal government has a lot more to do with the numbers of physicians in training than the AMA...Medicare pays for physician training, and it pays for only so many slots in so many specialties.


I've been in this business for over 20 years, and one thing I have learned is that there are a lot of people who think what we do is "simple". You don't know what you are talking about.

[LibWhacker]

Doctors are like everyone else. They go where the jobs are (forget starting up your own private practice . . . The insurance will kill you before you even see one patient) and where the money is; i.e., large metropolitan areas. In many of these areas there's actually a glut of doctors, not a shortage.

One of the things I'd like to see is a drastic relaxation of the requirement that a person have a prescription before being able to buy his medications. You shouldn't have to shell out a bazillion bucks to a doctor every time you need some naproxyn, for example.

[WilliamWallace1999]

Total disinformation. The AMA doesn't have anything to do with medical school or residency admissions. Less than half of U.S. physicians even belong. Protectionist, gimme a frikken break dude. Medical school slots and residency slots are going UNUSED in this country because everyone wants to be a lawyer. If you think today's graduates are gonna get rich, you don't know a thing about recent cuts in doctor pay. Sure there are a few getting rich, but the majority of us have seen nothing but falling pay for the same work over the last ten years. Expenses have kept climbing while the pay is falling, you do the math and see how long that will last. As for your altruistic foriegn medical graduates, what have you been smoking? They are consumed with greed and can't wait to grab the golden ring as fast as they can. Ethics doesn't seem to have the same meaning for someone from a country where they breed suicide bombers.
Your statements about the length of medical education in foriegn countries also is full of half-truths. In places like Russia, doctors are no better trained than EMT's in the U.S., so yes they get out quicker. In England, Canada, India, Pakistan, Mexico, the Carribean, and South America; medical education is a post graduate process that follows the university experience.

Mindless AMA bashing is most unbecoming.

NO, I am not a member. Just a piss-ant country doc with an attitude.

[End The Hypocrisy]

>>>Seems like the article has NOTHING to do with what you are bellyaching about. <<<


The article has EVERYTHING to do with alleged causes for the shortage of doctors, does it not? What's wrong with expanding upon the analysis, after initiating with and including direct quotes (and not calling it an excerpt)? What we have here is the UNtold story that we bother to visit FreeRepublic.com for in the first place. Would you care to weigh in on the issues, though?

[End The Hypocrisy]

>>>There is not a global physician shortage. However, their [SIC] are regional shortages and specialty shortages. <<<


Globally, there is no physician shortage even as U.S. doctors are complaining about the self-imposed one here in the USA.

>>>From personal experience and from studies I've read, most doctors select their profession rather early on...many in high school or before. Money wasn't the driving issue then.<<<


A tenured medical school professor from a reputable Top 20 institution told me that he met, during 10 years of teaching, maybe 3 students who were in med. school for the love of medicine instead of merely money and status. After a decade he gave up and switched over to serve on the engineering faculty.

[End The Hypocrisy]

>>>One of the things I'd like to see is a drastic relaxation of the requirement that a person have a prescription before being able to buy his medications. You shouldn't have to shell out a bazillion bucks to a doctor every time you need some naproxyn, for example.<<<


Ah but wouldn't the protectionist medical mafia lose one of its biggest cash cows then?