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> One thing that would help is letting non-MD’s, such as nurses or physicians assistants, do more “doctor” things. An alternative scenario is to train doctors

> One thing that would help is letting non-MD’s, such as nurses or physicians assistants, do more “doctor” things. An alternative scenario is to train doctors more quickly and effectively for primary care positions. Currently, to become a family practice doctor, you need 4 years of undergrad, 4 years of medical school (much of it not geared towards primary care), and then 3 years of residency. Instead, students could be started earlier, with immediate exposure to primary care (working internships) and education focused towards practical medical aspects of primary care. It would take far less than 11 years and arguably give them much more exposure and training that's directly applicable. I'd wager you'd get both higher quality care and lower costs.

sliverstorm 9y ago
It still makes sense to have a hierarchy of capabilities. You see this in many places in medicine, e.g. EMT, EMT-I, paramedic, with the RN-MD divide being one of the more notable gaps. IMO the fact that RN's wind up with tacit approval to perform certain proceedures and make certain decisions that the MD is nominally supposed to, is a clue it would indeed be suitable.
seem_2211 9y ago
I don't understand the requirement for the initial 4 years of undergrad before you enter medical school here. All it seems to do is increase the debt burden for doctors & their time it takes to get into actually practicing medicine.
dguest 9y ago
I can't agree more with this, especially with respect to undergrad. I've taught hundreds of undergrads about ohm's law so that they could go on to become doctors. And that was one of the more useful skills they learned. They also took classes on western legal theory and renaissance art and modern Russian literature. Don't get me wrong: some doctors need hard science skills, but while I want my neurologist to understand ion channels I don't need that from my orthopedic surgeon. As for the liberal arts base, personally I'd rather have a doctor who entered medical school 4 years earlier, and had a chance realize that med school wasn't for them 4 years earlier. With our current system, acing the MCAT means that you will be a doctor if you want to be one. And once you're in medical school you've sunk too much into education to back out and try something else.

sliverstorm 9y ago

It still makes sense to have a hierarchy of capabilities. You see this in many places in medicine, e.g. EMT, EMT-I, paramedic, with the RN-MD divide being one of the more notable gaps. IMO the fact that RN's wind up with tacit approval to perform certain proceedures and make certain decisions that the MD is nominally supposed to, is a clue it would indeed be suitable.

seem_2211 9y ago

I don't understand the requirement for the initial 4 years of undergrad before you enter medical school here. All it seems to do is increase the debt burden for doctors & their time it takes to get into actually practicing medicine.

dguest 9y ago

I can't agree more with this, especially with respect to undergrad. I've taught hundreds of undergrads about ohm's law so that they could go on to become doctors. And that was one of the more useful skills they learned. They also took classes on western legal theory and renaissance art and modern Russian literature. Don't get me wrong: some doctors need hard science skills, but while I want my neurologist to understand ion channels I don't need that from my orthopedic surgeon. As for the liberal arts base, personally I'd rather have a doctor who entered medical school 4 years earlier, and had a chance realize that med school wasn't for them 4 years earlier. With our current system, acing the MCAT means that you will be a doctor if you want to be one. And once you're in medical school you've sunk too much into education to back out and try something else.