The American Medical Association would sooner let the whole thing burn than allow that to happen
The AMA has been lobbying for MORE residency slots for decades.
Or you’re saying they failed at the made-up goal you wish they had, and therefore failed?
The job was to increase the number of doctors by increasing the number of residency spots. The poor folks have been lobbying for 30 years, but they are just not too good at it, gosh darn it.
What you’ve done is constructed an argument where no matter what position the AMA takes, they are the bad guys.
> salaries depended on my lobbying taking its time to produce as little of a result as possible
This doesn’t make sense. How would the AMA board communicate this to their voting members when all of their communications say that they doing all they can to increase resident funding.
How about the first board to vote to change their position 30 years ago? How would the voting members know that they were planning on slow walking their new position?
Do you think they have a secret doctor only communication channel where they tell them “don’t worry guys we’re not trying that hard”. Because without that if your premise is correct all of the members would have voted them out ASAP.
Also how is the AMA (which only represents about 15% of doctors btw) preventing hospitals from effectively lobbying for an increase? They have a huge financial interest in more resident funding.
It's nice of you to talk to me like a child (thanks daddy!), but there's no secret comms channel needed. If an AMA official publicly came out with a platform of "let's cut your salaries in half!" they would not last long. And if there was no public announcement - their effort would be shot down behind the scenes. Simple as that.
https://www.fsmb.org/siteassets/advocacy/policies/states-wit...
I hear people say "we need more doctors" all the time. It would seem to me, the people deciding how many new doctors we train per year, are doctors. Their pay is proportionate to their scarcity, if we had 5x as many doctors, existing doctors would make far less.
Imagine if existing software engineers got to decide how many juniors entered our profession each year. I think things would look very, very different.
I think it's time we stop allowing institutions to rule. We elect our leaders to lead. They need to start fucking leading, or people are going to start voting for some radical alternatives.
One area where we can perhaps legitimately criticize the AMA is for their lobbying state governments to limit the scope of practice for lower licensed PA/NP clinicians. While some of their concerns about care quality and patient safety might be legitimate, the reality is that we're not going to have enough primary care doctors to ensure adequate patient access. Some of that work has to be delegated down.
I feel I made this distinction very clear in my comment, so I'm surprised to see you repeat it. I make it clear that it is our elected officials which hold the power, *but who have deferred that power to institutions like the AMA.* For example, the AMA and Association of American Medical Colleges jointly sponsor the Liaison Committee on Medical Education (LCME), which accredits US MD programmes. LCME accreditation is extremely consequential because most state licensing boards require graduation from an LCME-accredited US programme, and LCME accreditation establishes eligibility for the USMLE and ACGME residency programmes. This gives the accreditation system considerable influence over expansion. LCME standards require a school to admit only as many students as its resources can support, including faculty, facilities and clinical training capacity. Schools must also notify the LCME when class-size increases exceed specified thresholds, currently a cumulative increase of 10% or 15 students, whichever is smaller, relative to the class size at the previous full accreditation survey.
Congress decides how many slots get funded and they have been way too slow to fund them.