6 ms·

America’s aging population is leading to a doctor shortage crisis

56 points by spking 7y ago

Madmallard 7y ago
Nope there's no doctor shortage. There is hospital administration greed and crappy working conditions where patient throughput is valued above all else leading to doctor burnout. I am angry at whomever wrote this for fueling the wrong argument and possibly trying to detract from the real issue.
- SkyPuncher 7y ago
  The doctor shortage isn't really about hospitals. It's a huge issue with family and primary care physicians, particularly in rural areas. Paper work requirements and misguided reimbursement goals are making it unsustainable for doctors not involved in large health systems.
- deleted 7y ago
  [deleted]
zelon88 7y ago
Well the medical debt bubble has gotta burst eventually. My guess is right before it does the state of healthcare in the US will be so bad that women will be giving birth in minute clinics because everyone will be priced out of hospitals by then. We won't have a shortage of anything until we fix our shortage of insurance providers.
NTDF9 7y ago
Rural America really really needs more doctors. The amount of time it takes to get an appointment to diagnose anything is crazy long already.
dantheman 7y ago
The doctor shortage has to do with the American Medical Associate (AMA), a cartel, that successfully lobbied to reduce the number of residencies available for doctors. They also make it difficult for new medical schools to be created -- this is intentional, since as a cartel they want to limit the number of doctors so that they can demand hire wages. https://www.forbes.com/2009/08/25/american-medical-association-opinions-columnists-shikha-dalmia.html#15cc1fd42f28 https://www.forbes.com/2009/08/25/american-medical-associati...
- EGreg 7y ago
  And yet people like Ben Shapiro continue to insist that it is single payer that will lead to less doctors... If doctors collectivize, then shouldn’t patients?
  - lucifirius 7y ago
    Single payer in the UK has already led to doctor shortages, so I'm not sure what point you're trying to make. There's many ways to get to a shortage, cartels and single payer are but two.
    - seppin 7y ago
      > Single payer in the UK has already led to doctor shortages Source? The only news i've read of shortages are Brexit related.
      - goatinaboat 7y ago
        There have been “shortages” of doctors and nurses forever, the usual newspapers were panicking about it in the 80s (source: was there, read them). Probably someone will be along in a minute to say they remember it from the 60s too! Fun fact: the doctors were the biggest obstacle to the foundation of the NHS and they disappear into private practice at the first opportunity.
        seppin 7y ago
        That's a lot of talk. How many people in the UK don't have access to medical care due to, say shortages vs how many in the US die every year b/c they cannot afford care?
    - 9HZZRfNlpR 7y ago
      It's similarly capped in the UK. Upper middle class always knows how to protect their wages, only programmers want voluntarily more people competing for their wages. It's so welcoming field. Also it costs tons, can't compare it with America but compared to other fields. Hence they import doctors when there are shortages.
pinacarlos90 7y ago
Is it just me that feels like recently the word “crisis” is being overused? not just online but by the media also
taxicabjesus 7y ago
The doctor shortage would be lessened if medical resources were allocated more intelligently. As it is, doctors have a tendency to make work for themselves. The system needs lots of doctors simply to keep their charade going. We all get to a point where we need less doctoring, not more. During the 'obamacare' debates some stupid politicians called this transition in the goals of treatment "death panels" [1], but the realists on the other side of the aisle didn't figure out how to intelligently point out that sometimes letting people die gracefully is kinder than subjecting them to every possible medical treatment. My brother works with old people in Arizona. He's paid a salary, and makes a game of trying to spend his employer's resources efficiently. On a recent visit I noted his comment about how he's just doing palliative care. Most doctors aren't on salary, and are paid via the standard medicare "fee-for-service" (FFS) [2] model, which is a good way to make people profitable to their medical providers. [0] My earlier comment about my mom's elderly friend's predicament: https://news.ycombinator.com/item?id=20224523 https://news.ycombinator.com/item?id=20224523 [1] https://en.wikipedia.org/wiki/Death_panel https://en.wikipedia.org/wiki/Death_panel [2] https://en.wikipedia.org/wiki/Fee-for-service https://en.wikipedia.org/wiki/Fee-for-service
fhsm 7y ago
Shouldn’t this point to the actual report not thin reporting on its publication? https://news.aamc.org/content/downloadable/209/ https://news.aamc.org/content/downloadable/209/ [PDF, by way of CDN redirect] Or at least the (interested sponsors) press release on the study linked in this news article? https://news.aamc.org/press-releases/article/2019-workforce-projections-update/ https://news.aamc.org/press-releases/article/2019-workforce-...
Merrill 7y ago
It appears that Medicare keeps the fee for an office visit low. This causes the doctors to schedule frequent, short exams. They also do frequent diagnostic tests to increase revenue per visit. Less frequent, more thorough visits would seem to be more efficient for all. Lots of senior care is pretty elastic, since most visits result in no change in drugs or procedures for the patient. They are simply monitoring chronic and/or progressive conditions.

56 points by spking 7y ago

Nope there's no doctor shortage. There is hospital administration greed and crappy working conditions where patient throughput is valued above all else leading to doctor burnout. I am angry at whomever wrote this for fueling the wrong argument and possibly trying to detract from the real issue.

SkyPuncher 7y ago
The doctor shortage isn't really about hospitals. It's a huge issue with family and primary care physicians, particularly in rural areas. Paper work requirements and misguided reimbursement goals are making it unsustainable for doctors not involved in large health systems.
deleted 7y ago
[deleted]

zelon88 7y ago

Well the medical debt bubble has gotta burst eventually. My guess is right before it does the state of healthcare in the US will be so bad that women will be giving birth in minute clinics because everyone will be priced out of hospitals by then. We won't have a shortage of anything until we fix our shortage of insurance providers.

NTDF9 7y ago

Rural America really really needs more doctors. The amount of time it takes to get an appointment to diagnose anything is crazy long already.

dantheman 7y ago

The doctor shortage has to do with the American Medical Associate (AMA), a cartel, that successfully lobbied to reduce the number of residencies available for doctors. They also make it difficult for new medical schools to be created -- this is intentional, since as a cartel they want to limit the number of doctors so that they can demand hire wages. https://www.forbes.com/2009/08/25/american-medical-association-opinions-columnists-shikha-dalmia.html#15cc1fd42f28 https://www.forbes.com/2009/08/25/american-medical-associati...

EGreg 7y ago
And yet people like Ben Shapiro continue to insist that it is single payer that will lead to less doctors... If doctors collectivize, then shouldn’t patients?
- lucifirius 7y ago
  Single payer in the UK has already led to doctor shortages, so I'm not sure what point you're trying to make. There's many ways to get to a shortage, cartels and single payer are but two.
  - seppin 7y ago
    > Single payer in the UK has already led to doctor shortages Source? The only news i've read of shortages are Brexit related.
    - goatinaboat 7y ago
      There have been “shortages” of doctors and nurses forever, the usual newspapers were panicking about it in the 80s (source: was there, read them). Probably someone will be along in a minute to say they remember it from the 60s too! Fun fact: the doctors were the biggest obstacle to the foundation of the NHS and they disappear into private practice at the first opportunity.
      - seppin 7y ago
        That's a lot of talk. How many people in the UK don't have access to medical care due to, say shortages vs how many in the US die every year b/c they cannot afford care?
  - 9HZZRfNlpR 7y ago
    It's similarly capped in the UK. Upper middle class always knows how to protect their wages, only programmers want voluntarily more people competing for their wages. It's so welcoming field. Also it costs tons, can't compare it with America but compared to other fields. Hence they import doctors when there are shortages.

pinacarlos90 7y ago

Is it just me that feels like recently the word “crisis” is being overused? not just online but by the media also

taxicabjesus 7y ago

The doctor shortage would be lessened if medical resources were allocated more intelligently. As it is, doctors have a tendency to make work for themselves. The system needs lots of doctors simply to keep their charade going. We all get to a point where we need less doctoring, not more. During the 'obamacare' debates some stupid politicians called this transition in the goals of treatment "death panels" [1], but the realists on the other side of the aisle didn't figure out how to intelligently point out that sometimes letting people die gracefully is kinder than subjecting them to every possible medical treatment. My brother works with old people in Arizona. He's paid a salary, and makes a game of trying to spend his employer's resources efficiently. On a recent visit I noted his comment about how he's just doing palliative care. Most doctors aren't on salary, and are paid via the standard medicare "fee-for-service" (FFS) [2] model, which is a good way to make people profitable to their medical providers. [0] My earlier comment about my mom's elderly friend's predicament: https://news.ycombinator.com/item?id=20224523 https://news.ycombinator.com/item?id=20224523 [1] https://en.wikipedia.org/wiki/Death_panel https://en.wikipedia.org/wiki/Death_panel [2] https://en.wikipedia.org/wiki/Fee-for-service https://en.wikipedia.org/wiki/Fee-for-service

fhsm 7y ago

Shouldn’t this point to the actual report not thin reporting on its publication? https://news.aamc.org/content/downloadable/209/ https://news.aamc.org/content/downloadable/209/ [PDF, by way of CDN redirect] Or at least the (interested sponsors) press release on the study linked in this news article? https://news.aamc.org/press-releases/article/2019-workforce-projections-update/ https://news.aamc.org/press-releases/article/2019-workforce-...

Merrill 7y ago

It appears that Medicare keeps the fee for an office visit low. This causes the doctors to schedule frequent, short exams. They also do frequent diagnostic tests to increase revenue per visit. Less frequent, more thorough visits would seem to be more efficient for all. Lots of senior care is pretty elastic, since most visits result in no change in drugs or procedures for the patient. They are simply monitoring chronic and/or progressive conditions.