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

[realpatriot71]

12 years after HS is the industry standard, 4 undergrad, 4 yeards of med school, 1 year internship, and at the very least 3 years of training in specialty.

This country starts physician training later in life because it makes more sense and selects for maturity. How mature were you at 22, the age most European physicians graduate?

[RLK]

Did you know that in nearly all OTHER countries, medicine is a highly focused UNDERgraduate degree?

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I don't think that's a good idea.

[WilliamWallace1999]

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

Upon what factual information do you base your statements. The AMA doesn't have a damn thing to do with medical school admissions and residency education. The AMA is begging for membership, not trying to keep people out. Being in or out of the AMA doesn't have a damn thing to do with medical liscensure or credentialing by the insurance industry. If you want to know who the real culprits are, I will share a poorly kept secret with you:

IT'S THE GOVERNMENT AND THE INSURANCE INDUSTRY STUPID....

They are the ones that control EVERYTHING about the supply of physicians, the cost of services, the regulation without reason, and delivery of care. Patients AND doctors are now insignificant cogs in a machine being manipulated by others. This is not paranoia, but a stark realization of fact.

Know the true enemy my friend.....

[kdmhcdcfld]

If I'm not mistaken, that "AA" doc was that particular doctor who was admitted to UC-Davis School of Medicine over an academically-superior Alan Bakke (of the infamous Supreme Court case.)

This doc was championed by the left as a positive virtue of the benefits of AA. They were/are fully aware of how he butchered some of his patients (I think one or two of them may have died - but I'm not 100 perecent on that), but they are nowhere to be found to issue a retraction.

[WilliamWallace1999]

Hey dipshit, take Aleve. It's over the counter and it is the same thing as Naproxyn.

[realpatriot71]

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".

It seems to be a popular misconception. I wonder why states require so much education and training - for the fun of it?

[Mamzelle]

Hillary worked to shut down medical schools in the notion that fewer doctors meant lower costs. How's that for wisdom from a grad from Yale Law school?

This "AMA Union" (to which most doctors now refuse to pay dues) issue is the dead horse that End the Hypocrisy has been beating for months. I surmise a frustrated applicant to American medical schools...and there are many alternatives open to EtH if he would only choose to quit kvetching and get to work. He could go overseas, join the service, get a PA, become a chiro...

Educating physicians is very expensive, which is why we have to import so many foreign docs to take care of our patients. (The Union Conspirators, for some reason unavailable to Endthe, provide the testing facilities to qualify foreign docs. Is this protectionism?) EndtheHypocrisy won't acknowledge that a med student must have more than classrooms and books. He must be affiliated with a major teaching institution, must have labratories and lab personnel, must have an expensive cadaver to dissect so he can learn on someone already dead. The cadavers require their own pathologists and morticians for maintenance. All you need to educate a law student is a classroom, library, and some broken-down lawyers to "teach".

It's not cheap to educate a nurse or a PA, either.

We could always change the qualifications required to license physicians....

[realpatriot71]

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.

I agree here, but I do think that many people have no clue as to certain prescription drug interactions. You should at least have to get cleared by the pharmacist - mix some drugs and you can die.

[End The Hypocrisy]

>>>>In England, Canada, India, Pakistan, Mexico, the Carribean, and South America; medical education is a post graduate process that follows the university experience. <<<<


I am aware of at least several inaccuracies in that assertion, Mr. Doc. Would you care to make some corrections, since you're so eager to criticize others for "total disinformation"?

Meanwhile, as for the following logically fallacious comparison:

>>>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.
<<<


Res ipsa loquitur (Latin for "it speaks for itself"). I reiterate that doctors get paid comparatively little abroad, but they want to be doctors anyway. Discrediting them because crime takes place in some foreign lands is like my saying that U.S. doctors are bad because Catholic priests molest children. More Latin for you: NON SEQUITUR.

Service isn't ideal overseas, but is it with the overpriced aspiring golfers we're forced to rely upon for our medical needs thanks to the protectionism here in the USA?

[TomB]

The article has EVERYTHING to do with alleged causes for the shortage of doctors, does it not?

It has NOTHING to do with the "alleged causes for the shortage of doctors". It is about tort reform.

What's wrong with expanding upon the analysis, after initiating with and including direct quotes (and not calling it an excerpt)?

There is a space above the line for the article and below the line for "expanding upon the analysis". Of course, that is irrelevant because you didn't bother to post the article anyway.

I came to the thread because I thought it was an article from the Washington Times. Instead, I get ONE SENTENCE from the article, then your (unattributed) diatribe.

At least make an attempt to be honest.

[anoldafvet]

My son is a second year medical student at Indiana University School of Medicine. After he completes AT LEAST 10 years of schooling, he will be at least $125,000 in debt. That means at current tax rates he will have to earn upwards of $250,000 just to pay off his loans.
He spends about 6 hours per day sleeping, the rest of the time he studies. I can tell you that he is not in medicine for the money but because he loves it! He has a B.S. degree in Electrical Engineering, a 4.0 average, and could write his own ticket with any number of companies (even in these tough times), yet he still wants to be a doctor. I know that may be hard to believe, but all of his friends feel the same way. The day he started on the road to becoming a doctor, the dean of the medical school told all the students that if they were in it for the money, they were in the wrong profession. Don't kid yourself that ANYONE can be a doctor or that we can "cut corners" and still get quality medical care, it won't happen. The main reason for the high cost of medical care today is the Trial Lawyers and the RATS. The lawyers sue everyone in sight and the RATS pass legislation to improve HMO's by MANDATING everything under the sun. There's no free lunch anywhere and if you think things are better overseas, try getting sick over there.

[Marysecretary]

I have a wonderful doctor from Jordan who trained in New York State but I do have to listen very carefully in order to catch everything he says. Professors are the same. We've had some professors who, it seems, could barely speak English. And we expect our students to learn from them? When the Affirmative Action officer at the time suggested to the minority professors that lessons to improve their language and diction skills were available, she was roundly criticized because she did racial profiling. Well, it's the Africans and other minority professors who had the problem. PC! Makes me crazy.

[End The Hypocrisy]

>>>How mature were you at 22, the age most European physicians graduate?<<<

Mature enough to graduate in the top 5% of my class at a Top ranked university, AND open-minded enough to realize that the upcoming years of graduate school were basically going to be a protectionism-laden obstacle course that practically all other countries know better than to try and require after age 22 instead of before it. School isn't cheap in the USA, but it's a money-making industry for some so there wasn't much I could do then. But this is now.

[End The Hypocrisy]

>>Did you know that in nearly all OTHER countries, medicine is a highly focused UNDERgraduate degree? <<

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>>>I don't think that's a good idea.<<<


And the status quo here in the USA somehow is?

[Marysecretary]

I believe HMO's have been a large part of why young men and women don't continue or don't go into medicine as a profession. They can't get paid like they used to. Remember when a doctor's visit was $5.00??? I do! thought it was terrible when it went up to $10.00! How naive I was then.

[Willie Green]

We could always change the qualifications required to license physicians....

There may be beneficial opportunities with this approach if it can be accomplished objectively.
There are many, many, routine health-care tasks that do not require the full blown expertise of highly trained specialists.

[End The Hypocrisy]

http://www.cnn.com/2002/HEALTH/05/08/medical.residents.ap/index.html

WASHINGTON (AP) -- Hospitals and medical groups have conspired for years to limit competition for young doctors, forcing them to accept low wages and long workweeks in the first years of their careers, according to a class action suit filed Tuesday in Washington.
"Resident physicians must accept these conditions because they have no alternative," the plaintiffs said. "No other employer will hire them and completing residency is required for specialty certification, a necessity in the practice of modern medicine."
Though the suit doesn't seek a specific financial award, the nation's already-strained health care system could be ordered to pay substantial damages and be forced to change the way it trains doctors.
For Paul Jung, a health policy fellow at Johns Hopkins University, the issue isn't financial. Unlike many of his friends, Jung, a plaintiff, had almost no debt after medical school. Watching colleagues struggle to pay back loans on $40,000 salaries and working 100-hour weeks took a toll, he said.
"I'm not here to make any money or to have what I think is the correct residency program imposed on everybody else," Jung, 32, said in an interview. "I want to make sure that every student in the country has a say in their residency program, in their salaries and working conditions."
Currently, the National Resident Matching Program, one of the defendants, puts residents and hospitals together based on lists submitted by both sides. All parties agree in advance to accept the match without negotiations on wages or hours.
As a result, the plaintiffs are suing on antitrust grounds. They say fifty years ago, the medical establishment decided that free competition in recruiting and compensating resident physicians was "undesirable" because the number of positions to be filled outpaced the number of candidates and could drive up salaries.
"Creating the matching program enabled employers to obtain resident physicians without such a bidding war, thereby artificially fixing, depressing, standardizing and stabilizing compensation ... below competitive levels," the plaintiffs charge.
The chief tool in the years since, court documents say, is a survey distributed regularly among hospitals which exchange "competitively sensitive information" on salaries.
The suit says that based on the survey, the Association of American Medical Colleges, another defendant, published an annual report titled "Survey of Housestaff Stipends, Benefits and Funding." It includes national and regional average salaries for various years of postgraduate employment, according to the suit.
"Defendants and others have illegally contracted, combined and conspired among themselves to displace competition in the recruitment, hiring, employment and compensation of resident physicians," according to the complaint, filed in U.S. District Court for the District of Columbia.
Lawyers for the National Resident Matching Program, the Association of Medical Colleges declined comment, saying they hadn't yet see the suit.
Copyright 2002 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

[Spyder]

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.

Amen. I was/have been a PT for 22 years, and have been doing medical transcription for 3 years now. I can attest to the vast difference between MDs and nurse practitioners/PAs just by typing their dictation. A PA is wonderful for allergic rhinitis, as well as triage and entry-level care, overall probably 70% of visits to physicians. If I know what I want (such as a referral to an orthopod or a rheumatologist) I'm fine with a PA, but for a problem I don't have a clue about, give me an MD or a DO any day.

The PA/NP lack of education/knowledge shows up dramatically in their dictations. I've typed some good ones (who work in specialty offices mostly), but a lot are terrible with their drug pronunciations and make frequent dictation errors. I agree with regard to the AMA - it's hardly a union and really doesn't have that much say over things. The number of docs produced depends on how many students the schools crank out - if a lot of folk want in, the schools eventually raise the number of seats or drop them accordingly.

I know a lot of PTs who started out pre med but switched, usually because of not wanting the lawsuits, the malpractice insurance, and also because of wanting more personal time.

[TomB]

I reiterate that doctors get paid comparatively little abroad,

Considering the average pay for physicians in this country is under $150,000, what do you think would be fair?

BTW, I don't consider $150,000 excessive.

[End The Hypocrisy]

Soon thereafter, the AMA recommended reducing residency workweeks to "merely" 80 hours. They're not in cahoots with those other organizations that were expressly named in that CNN article?