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Comment by tomfreemax | Hacker News Reader

I think these tools are the solution to the shortage of doctors, and will greatly improve performance by taking more parameters into account. Not sure though if a simple LLM can do that. (Shortage of doctors is a thing at least in DE and CH)

Doctors study like 10 years to follow a decision tree based on patient background and symptoms.

Especially in countries where education is harder to get by this can be useful, I imagine.

Then we transition from doctor to med-tech, like in the sci-fi movies.

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The solution to the shortage of doctors is to stop letting doctors decide the supply of doctors.

Its a special interest problem. Doctors organize, bribe/lobby politicians, limit licenses, make extra money/get more power, repeat.

The excuse 'there isnt enough surgeries', is a chicken and egg problem. More doctors lower the cost, making surgery more reasonable and not necessarily a last ditch option. Not to mention, we don't stop the number of civil engineers that graduate because 'there arent enough bridges'. You just have more people observing around the table.

Yep. That’s what we do. You hit the nail right on the head.

I saunter down to my local US senators house and bribe him, every month or so. Then our group created a fund where we bribe the president of the United States. We organized with all the other groups in the area and bribed the pope. Next we are going to find you in your house and bribe you.

Why have residency spots shrunk per capita? Why do unmatched grads have to work at mcdonalds but NP's and PA's can practice with more latitude than some residents?

(serious questions)

ACR for radiology is going on in Washington DC. Current staffing throughout the country is poor - over utilization of imaging and not enough radiologists. So we are lobbying for an increase in Medicare funding for residency positions (they are paid by Medicare). Also trying to get more J1 visas but that’s kind of dubious as we are taking physicians from another country who likely also needs physicians.

I have no idea why unmatched graduates are working at McDonald’s as you say. There’s always primary care positions open for the scramble last I checked. If they can’t get a spot there’s likely a real issue in their education or themselves. It’s a normal distribution of a population, MD or not.

I can’t speak to what NP and PA’s do - they have their own PACs and organizations. I know they want to increase their scope of practice and keep their liability low.

>So we are lobbying for an increase in Medicare funding for residency positions (they are paid by Medicare).

Hey taxpayers, can you pay for my grad degree too? Wait its worse, I actually profit during this period.

Don't worry that I'm the highest paid profession upon graduation.

You think you’ll be able to recruit more people into medicine by reducing compensation, keeping education costs the same, and also keeping medicolegal liability on the physician?

Residency as “profit” is a stretch. You tread water for 5 years. If you would like those apprenticeship years to go unpaid then I’m not sure how it increases the number of people who want to go into medicine.

>You think you’ll be able to recruit more people into medicine by reducing compensation

You don't need to recruit more, there is an abundant supply of people who want it.

>Residency as “profit” is a stretch.

Physicians are funny, a fantastic wage for the lower-middle class is considered 'treading water'. And its for education. Something every other degree pays for.

>I’m not sure how it increases the number of people who want to go into medicine.

This is not an issue, there are plenty of people who want degrees that don't involve math. The issue is number of licenses, not number of people who are capable of doing the job and want to.

Residents should absolutely be paid. Years of often times reaching 80 hours/week, treating patients, performing procedures, writing notes - all is valuable labor.

It is like saying we won't pay you for the first several years of your first dev job because it is primarily a ramp up / educational period.

What is true:

The labor isnt valuable thus cannot be billed and needs to be taken via taxes. It also means that whatever people are doing in residency, they don't need residency for. Licensure bullshit.

The labor is valuable and doesnt need to be taken via taxes.

You can't legally practice as a primary care physician without one year of internship, after which you get unrestricted licensed. If you're unmatched, no internship. Is that not correct?

Yea that’s right. You can scramble separately into 1 year internships. Those are really easy to get - but the unfilled spots are not in happy places. They’re usually more rural and surgical.

But like you said if you have a year under your belt you can work in an urgent care or the like.

I didn't realize they had that option. In general, I still find absurdity in what an NP can do vs an unmatched doctor. That's entirely incoherent.

Also, it's laudable what rads is doing, but didn't the AMA lobby for less residency spots?

You are using humor to distract from immoral behavior.

1) US Chamber of Commerce $1,882,365,680

2) National Assn of Realtors $849,607,903

3) American Hospital Assn $525,121,249

4) Pharmaceutical Research & Manufacturers of America $507,171,550

5) American Medical Assn $504,434,500

https://www.opensecrets.org/federal-lobbying/top-spenders?cy...

> The solution to the shortage of doctors is to stop letting doctors decide the supply of doctors.

I would certainly rather let decisions about certification of doctors be in the hands of doctors than anyone else. There's potential for a conflict of interest, but there's also expertise that isn't replicated anywhere else.

You are conflating two different ideas. Supply management and certification are not one and the same. You can have supply management without certification, and you can have certification without supply management. The parent only expressed concern over the supply management practice, not the certification practice.

My limited understanding is that residency programs are a bottleneck and they’re mostly funded by the federal government. I don’t think doctors have control over this?

Don't forget ten years of schooling to be bad at formal methods to step out of that decision tree:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9237793/ https://blogs.cornell.edu/info2040/2014/11/12/doctors-dont-k... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016704/ https://www.overcomingbias.com/p/doctor-there-arhtml

And many more.

go to r/residency or other doctor forums if you want to see the most repugnant combination of dunning kruger and condescension

If medicine is just following a decision tree why would we need LLMs to do it? Computers have been able to follow decision trees for 70 years or something.

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