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Excessive working hours are used as an excuse by medical cartel to justify practices that drive down the supply of providers through licensing requirements, and

Excessive working hours are used as an excuse by medical cartel to justify practices that drive down the supply of providers through licensing requirements, and drive up salaries for doctors and everybody else up the chain. "See how hard we are working and how long we had to stay in school? We deserve to charge $500 for a 10 minute visit". "An acne cream that Europeans get over the counter for $5? We studied for 10 years and we know best what's safest for patients, so they HAVE to go to us first to get a $300 prescription." This is literally the arguments that medical associations have been using to lobby state and federal agencies to keep the status quo. What needs to be done is a dramatic shift of power away from doctors in the medical industry. Flooding of medical labor markets with mid-levels - nurses, PAs, RAs, PTs - and relaxing respective scope of practice laws. Physicians will fight to death against new competition, even if it means killing themselves with unreasonable working hours. https://www.auntminnie.com/Forum/tm.aspx?m=581583 https://www.auntminnie.com/Forum/tm.aspx?m=581583 "Don’t teach your mid levels procedures... Ultimately, a mid level that can do procedures, even easy ones, are your competitors." https://www.politico.com/agenda/story/2017/10/25/doctors-salaries-pay-disparities-000557 https://www.politico.com/agenda/story/2017/10/25/doctors-sal...

oarabbus_ 7y ago
Excellent comment. The AAMC and AACOM quite literally fit the definitions of cartels, artificially restricting the supply of medical doctors. Also, it's the 21st century - why do doctors (more specifically, hospitals) generally work 9-5 M-F? Viruses and bacteria don't take the weekends off. Not to mention when people need to see a specialist, they need to wait weeks or even months for an appointment. Why? It's absurd. With a larger supply of doctors and something like 7am-10pm daily hours, it would result in a massive net benefit to society.
- jac241 7y ago
  "The AAMC strongly supports bipartisan GME legislation introduced in both the House of Representatives and the Senate, the Resident Physician Shortage Reduction Act of 2019 (H.R. 1763, S. 348)" - https://news.aamc.org/for-the-media/article/gme-funding-doctor-shortage/ https://news.aamc.org/for-the-media/article/gme-funding-doct...
- citboin 7y ago
  “...it's the 21st century - why do doctors (more specifically, hospitals) generally work 9-5 M-F” What country do you live in? In the USA hospitals are open and staffed for emergencies 24/7/365. I’m a Radiology Technologist who works in an ER and Surgery- and I’ve never worked less than 48 hrs per week. I work 2300hrs-0700hrs. If you are talking about viruses and bacteria, that’s usually not an emergency issue and yes, you CAN wait until normal business hours (unless you’re septic)
  - oarabbus_ 7y ago
    I live in the USA. Oh, you mean the same ER that will slap you with a several thousand dollar invoice (only after the services are provided, of course) after a 3 hour wait? Well that's a related but different story I won't get into at this time. If I have have an infected tear duct (in fact, I do) requiring a visit to an ENT specialist (for example), it's frankly absurd that the next appointment requires a 2-6 week wait. And then it also affects the work day because ENTs docs are only available 9-5. Why aren't there two shifts of doctors: 7am - 3pm, and (as an example) 12pm-8pm? At least I work a computer-based job; what about a construction worker or other blue-collar worker who has to take an entire day off because they can't log in and continue work remotely (and if you know blue collar folks, this is the reason many will skip preventative care until they are critically ill)? Your argument seems to be "well you won't lose the eye or go blind so it's fine" and that simply isn't how we should be viewing healthcare. And just for posterity's sake, I've spent years at hospitals and medical device companies, my background is in biomedical engineering, and I'm not what you'd consider a layman in this area.
perl4ever 7y ago
"Flooding of medical labor markets with mid-levels - nurses, PAs, RAs, PTs - and relaxing respective scope of practice laws" Well, I don't have any insider knowledge, but from a healthcare consumer perspective, it sure seems like doctors have gotten scarce and NPs are doing everything these days. I don't know how the money flows in a group practice with one doctor and everybody else is not, but I'd be curious about how it works.

oarabbus_ 7y ago

Excellent comment. The AAMC and AACOM quite literally fit the definitions of cartels, artificially restricting the supply of medical doctors. Also, it's the 21st century - why do doctors (more specifically, hospitals) generally work 9-5 M-F? Viruses and bacteria don't take the weekends off. Not to mention when people need to see a specialist, they need to wait weeks or even months for an appointment. Why? It's absurd. With a larger supply of doctors and something like 7am-10pm daily hours, it would result in a massive net benefit to society.

jac241 7y ago
"The AAMC strongly supports bipartisan GME legislation introduced in both the House of Representatives and the Senate, the Resident Physician Shortage Reduction Act of 2019 (H.R. 1763, S. 348)" - https://news.aamc.org/for-the-media/article/gme-funding-doctor-shortage/ https://news.aamc.org/for-the-media/article/gme-funding-doct...
citboin 7y ago
“...it's the 21st century - why do doctors (more specifically, hospitals) generally work 9-5 M-F” What country do you live in? In the USA hospitals are open and staffed for emergencies 24/7/365. I’m a Radiology Technologist who works in an ER and Surgery- and I’ve never worked less than 48 hrs per week. I work 2300hrs-0700hrs. If you are talking about viruses and bacteria, that’s usually not an emergency issue and yes, you CAN wait until normal business hours (unless you’re septic)
- oarabbus_ 7y ago
  I live in the USA. Oh, you mean the same ER that will slap you with a several thousand dollar invoice (only after the services are provided, of course) after a 3 hour wait? Well that's a related but different story I won't get into at this time. If I have have an infected tear duct (in fact, I do) requiring a visit to an ENT specialist (for example), it's frankly absurd that the next appointment requires a 2-6 week wait. And then it also affects the work day because ENTs docs are only available 9-5. Why aren't there two shifts of doctors: 7am - 3pm, and (as an example) 12pm-8pm? At least I work a computer-based job; what about a construction worker or other blue-collar worker who has to take an entire day off because they can't log in and continue work remotely (and if you know blue collar folks, this is the reason many will skip preventative care until they are critically ill)? Your argument seems to be "well you won't lose the eye or go blind so it's fine" and that simply isn't how we should be viewing healthcare. And just for posterity's sake, I've spent years at hospitals and medical device companies, my background is in biomedical engineering, and I'm not what you'd consider a layman in this area.

perl4ever 7y ago

"Flooding of medical labor markets with mid-levels - nurses, PAs, RAs, PTs - and relaxing respective scope of practice laws" Well, I don't have any insider knowledge, but from a healthcare consumer perspective, it sure seems like doctors have gotten scarce and NPs are doing everything these days. I don't know how the money flows in a group practice with one doctor and everybody else is not, but I'd be curious about how it works.