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Comment by bad_haircut72 | Hacker News Reader

I wanna say yes but to be fair, I cant prove it. I think without licencing we would get reduced length degrees & more people like nurses transitioning into primary care physicians - and I think that would be fine for a lot of conditions

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I don't think licensure is really that much of a barrier, though. One of the huge trends going on is that nurses are increasingly replacing doctors in primary care. In my market it's unusual to have an actual doctor as a primary care provider. These nurses just go through some additional training for a PA or NP license and it's still a great deal cheaper than medical school.

This happens to me (my PCM is a nurse) but funnily enough my costs haven't gone down. Those nurses still work under a qualified doc, who will never look at your file until youre nearly dead, but theyre still getting a cut believe you me.

They’re not ‘getting a cut’ unless they directly own the clinic. What you’re seeing is a cost-cutting measure increasing the bottom line for whoever owns the clinic. Physicians are forced to agree to ‘supervise’ midlevels as a condition of their employment these days.

I replied to your other comment but wanted to reply here to say that this is also probably a fair point. I guess I dont really see doctors as employees taking orders (dont doctors mostly own their own practice?) since theyre so highly paid, but probably thats how being a software dev looks to others aswell.

Im curious if you think malpractice insurance is also a significant, unnecessary cost? What if we made it harder to sue doctors? On the flip side, malpractice is still a real problem - probably not one that will be fixed by removing medical licences :D just hoping you see this comment since I am genuinely interested in your answer

In the last decade, private practice rates for doctors has dropped from ~60% to ~45%.

By me in FL, it's hard to find a doctor that actually has a private practice now. Most are corporate owned clinics where doctors are just employees.

The US only allows a specific number of people to enter medical training each year to be doctors. This is the reason we pay so much.

The financial incentives a specialist headache doc has whos spent the time and money to get to where they are would never tell a patient to eat less and radically adjust your diet for your ailment to go away, they wouldn't have patients coming back to them and they would go broke (that education was super long and expensive). I like the uncanny idea of getting rid of training requirements and let the free market handle it.

That kind of change though would leave someone with the bag and tends to never get voted or happen so we stay stuck in the over priced pharma, insurance, beating around the bush health game were in. Everyone is incentivezed to keep the bandaids rolling. Don't tell people their drug habits (I mean eating habits) are killing them.

Ohh wait, we got a new pgp blocker for you!

How about just skip breakfast.....

Letting the free market handle it equals letting quacks handle it. I really doubt quacks will be any more incentivized (or qualified) to do right by their patients.

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