What do you think voters should do? How do we increase the number of doctors?
I guess what I'm suggesting is that the solution is not "increasing the number of doctors" but rather "increasing the number and types of providers". Some of those could be more MDs, but some of them could be other types of providers. We need to create alternate paths to MDs, and also increase the number of degree endpoints that result in similar kinds of independent practice authority within a given medical field. Let other types of providers provide a wider range of services — maybe with increased scrutiny over training pre and post degree, like MDs have.
My guess is there is probably a way to encourage fields to come up with ideas that any given person out there outside the field wouldn't think of.
Of course, the opposite happened because of demographics and increased lifespans.
Perish the thought that we have slightly too many doctors. That can never be allowed!
I can't believe they passed that shit with a straight face.
I'll repeat what I've said before: no other profession in America requires a literal act of Congress to fund the training of new members. What's so special about doctors? Let anyone open a medical school if they meet standards. Give anyone an MD if they pass the exams and do the residencies, like lawyers.
And while they're at it let doctors go to medical school straight out of high school like they do in every other country in the world (other than Canada, I think). You'll give every new doctor an additional 2 years in their career they would've spent in undergrad doing a useless "pre-med" degree (assuming medical school becomes 6 years of study after high school instead of 4 years after an undergrad degree).
Some schools do have accelerated combined BS/MD programs which can cut 1-2 years off the required total education.
Accelerated programs aren't the norm. They should be.
(And let's not have any stupid comments suggesting that residents should pay for it themselves. They're already tapped out in terms of student debt.)
I'm not advocating pulling the plug overnight without planning an alternative. That would guarantee a collapse as you said. But announcing an expiration of the program would heavily incentivize all participants to figure something out.
Residents make like $70k a year plus benefits. I'm sure the hospital bills their work for a lot more than that, even accounting for the time of attending physicians. Right now that profit margin probably subsidizes other loss-making activities in the hospital.
You have no clue what you're talking about here and are essentially making a hand-waving argument without any facts to back it up.
I'm not the only one.
"In Elisabeth Rosenthal’s excellent book, An American Sickness, she notes:
'The median cost to a hospital for each full-time resident in 2013 was $134,803. That includes a salary of between $50,000 and $80,000. Federal support translates into about $100,000 per resident per year. Researchers have calculated that the value of the work each resident performs annually is $232,726. Even without any subsidy, having residents is a better than break-even deal.' "
And
"In the old days, hospitals paid for resident training by building those costs into the bills they sent patients. But in 1965, Congress acknowledged resident medical training as a public good deserving of public investment, and firmly established federal funding for graduate medical education costs with the Medicare Act.
(What’s interesting is that Congress intended for the public funding to be temporary, with language in both the House and Senate reports noting that the funds were intended to last only “until the community undertakes to bear such educational costs in some other way.” Unsurprisingly, once governmental funds became available, hospitals have had little interest in undertaking how to bear these costs any other way.)"
https://thesheriffofsodium.com/2022/02/04/how-much-are-resid...
> they generally have to be directly supervised by an attending physician, which is expensive
The blog post argues that they also free up attending physicians to focus on the highest-compensated doctoring activities.
These roles should perform highly in-demand, relatively straightforward and repetitive tasks that don’t require complex medical decision-making, where training can be efficiently scaled up.
An example that currently doesn’t exist would be a specialist who can prescribe short term courses of drugs like methodone for opioid addiction as a bridge to longer term care by a doctor. This would enable us to have bridges to treatment readily available all over cities whenever an addict walks in ready, perhaps only for that moment in time, to start treatment.