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> Don't several medical lobbying groups actively coerce the government to limit the number of new doctors that can be minted, both overall and in given areas of

> Don't several medical lobbying groups actively coerce the government to limit the number of new doctors that can be minted, both overall and in given areas of practice? Not really. The AMA is often blamed for limiting the number of medical school slots available, but they have nothing to do with that - it's capped by the AAMC, which has been very deliberately raising the number of medical school positions in the US for over a decade now. But even if that cap were lifted altogether, the number of practicing physicians would be completely unaffected, because we already have more MDs than we have residency slots available. Increasing residency programs would require funding, and currently Medicare is the source of funds for residency programs. Hospitals would typically make a loss on residency programs otherwise; contrary to what some people believe, they're actually quite expensive to operate.

opo 10y ago
>...Hospitals would typically make a loss on residency programs otherwise; contrary to what some people believe, they're actually quite expensive to operate. How does that work? Residents make very little money and do a lot of work. How are they not a profit center for hospitals?
- chimeracoder 10y ago
  > Residents make very little money and do a lot of work. How are they not a profit center for hospitals? Residents start their first year knowing literally nothing about practicing medicine. Medical school teaches the foundation, but you learn the practice during residency. In addition, the ratio of attending physicians to residents is capped by law (i believe it's 3:1). Would a startup want to hire three fresh-out-of-high-school interns for every full-time employee? I can't think of any company that does this. At some point they'd get up to speed, yes, but in the short term they'd be a huge drag.
  - opo 10y ago
    >Residents start their first year knowing literally nothing about practicing medicine. If this is true, it really indicates that how we train medical practitioners needs to be reformed. (If true, maybe there should be different programs for people wanting to become medical researchers vs those who treat patients.) >In addition, the ratio of attending physicians to residents is capped by law (i believe it's 3:1). Are hospitals actually at that 3:1 ratio? The AAMC seems to be saying the limiting factor right now is the limits on medicare subsidies for residents: https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html >...Would a startup want to hire three fresh-out-of-high-school interns for every full-time employee? Probably closer would be companies hiring engineering students straight out of college. Those college projects the students did generally aren’t anything like the work they will be doing. Companies don’t hire at a 3 to 1 ratio, but they do hire them and they pay them more than residents get paid and don’t get subsidies from the government to do so. I was originally replying to your comment: >...Hospitals would typically make a loss on residency programs otherwise; contrary to what some people believe, they're actually quite expensive to operate. Thinking about it, I guess if hospitals don’t bill patients for work done by residents, then they would obviously need to paid by the government (or someone else) but I don’t know if that is how it works.

opo 10y ago

>...Hospitals would typically make a loss on residency programs otherwise; contrary to what some people believe, they're actually quite expensive to operate. How does that work? Residents make very little money and do a lot of work. How are they not a profit center for hospitals?

chimeracoder 10y ago
> Residents make very little money and do a lot of work. How are they not a profit center for hospitals? Residents start their first year knowing literally nothing about practicing medicine. Medical school teaches the foundation, but you learn the practice during residency. In addition, the ratio of attending physicians to residents is capped by law (i believe it's 3:1). Would a startup want to hire three fresh-out-of-high-school interns for every full-time employee? I can't think of any company that does this. At some point they'd get up to speed, yes, but in the short term they'd be a huge drag.
- opo 10y ago
  >Residents start their first year knowing literally nothing about practicing medicine. If this is true, it really indicates that how we train medical practitioners needs to be reformed. (If true, maybe there should be different programs for people wanting to become medical researchers vs those who treat patients.) >In addition, the ratio of attending physicians to residents is capped by law (i believe it's 3:1). Are hospitals actually at that 3:1 ratio? The AAMC seems to be saying the limiting factor right now is the limits on medicare subsidies for residents: https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html >...Would a startup want to hire three fresh-out-of-high-school interns for every full-time employee? Probably closer would be companies hiring engineering students straight out of college. Those college projects the students did generally aren’t anything like the work they will be doing. Companies don’t hire at a 3 to 1 ratio, but they do hire them and they pay them more than residents get paid and don’t get subsidies from the government to do so. I was originally replying to your comment: >...Hospitals would typically make a loss on residency programs otherwise; contrary to what some people believe, they're actually quite expensive to operate. Thinking about it, I guess if hospitals don’t bill patients for work done by residents, then they would obviously need to paid by the government (or someone else) but I don’t know if that is how it works.