4 ms·

I'm currently going through medical school right now, and I don't particularly see anything too radical with your proposal. It's true that in this situation whe

I'm currently going through medical school right now, and I don't particularly see anything too radical with your proposal. It's true that in this situation where we need more healthcare professionals, the prerequisite training is extremely unrealistic and creates a huge bottleneck in terms of meeting demand. What is required is a new class of regulation to surround those (temporary?) healthcare workers, providing licensure during public health emergencies. The difficult situation is that this means a lowering of the standard of care given, which I believe many doctors may not support, although desperate patients most certainly will. Due to the protective nature of the multiple boards/colleges of physicians, it may be better to create an independent organization for certification. However, would we be willing to subsequently dismantle these organizations?

salawat 7y ago
>The difficult situation is that this means a lowering of the standard of care given, which I believe many doctors may not support, although desperate patients most certainly will. Aren't we really already lowering the standard of care given in the case of being overly reliant on chronically overwhelmed physicians? And I don't think there would actually be any appreciable drop in standards of care, as the entire process would revolve around basically focusing the lightly trained on a hyper-specific subset of statistically relevant medical issues with the assumption of "escalate if something we didn't train you on happens." You're still getting care from fully licensed professionals. Eventually. They just have more hands to be where they can't. >Due to the protective nature of the multiple boards/colleges of physicians, it may be better to create an independent organization for certification. However, would we be willing to subsequently dismantle these organizations? Good question. I'd air on the side of not dismantling the program if for no other reason than it seems to me we're already having trouble getting medical practitioners out of schools and into the field doing good with our current system. (Limited rotation slots for entrants per year, the securitization of the debts of hopefuls being made worse by getting unlucky with being delayed multiple-cycles from entry into the industry). The primary concern I have is that I think that the college/board systems may be too fragile to the point they represent more of an economic gatekeeper (by artificially constraining supply) rather than a balloon holding up the standard of care. Then again, I have no numbers whatsoever with regards to how many "bad practitioners" are weeded out of the system by virtue of licensing authorities with which to back that up; merely a vague personal hunch probably fuelled by a dislike for needlessly rigorous licensure systems. Plus I have no idea the social/career advancement issues such an organization would create. Would long enough service in this context translate to full licensure after a time? How long should that take? Does it make sense to maybe integrate the two disparate systems as one at some point and maybe formulate a way where highly restrictive entry-level licensure has a proof of experience based and continuing education process by which further advancement toward unsupervised, independent practice is slowly developed toward? What would that look like? Is it feasible? Is it worse than we have now? I don't know. I do know that in our current predicament though, we may be literally killing off our societal immune system through overwork; and the only way to overcome that, is through more hands.

salawat 7y ago

>The difficult situation is that this means a lowering of the standard of care given, which I believe many doctors may not support, although desperate patients most certainly will. Aren't we really already lowering the standard of care given in the case of being overly reliant on chronically overwhelmed physicians? And I don't think there would actually be any appreciable drop in standards of care, as the entire process would revolve around basically focusing the lightly trained on a hyper-specific subset of statistically relevant medical issues with the assumption of "escalate if something we didn't train you on happens." You're still getting care from fully licensed professionals. Eventually. They just have more hands to be where they can't. >Due to the protective nature of the multiple boards/colleges of physicians, it may be better to create an independent organization for certification. However, would we be willing to subsequently dismantle these organizations? Good question. I'd air on the side of not dismantling the program if for no other reason than it seems to me we're already having trouble getting medical practitioners out of schools and into the field doing good with our current system. (Limited rotation slots for entrants per year, the securitization of the debts of hopefuls being made worse by getting unlucky with being delayed multiple-cycles from entry into the industry). The primary concern I have is that I think that the college/board systems may be too fragile to the point they represent more of an economic gatekeeper (by artificially constraining supply) rather than a balloon holding up the standard of care. Then again, I have no numbers whatsoever with regards to how many "bad practitioners" are weeded out of the system by virtue of licensing authorities with which to back that up; merely a vague personal hunch probably fuelled by a dislike for needlessly rigorous licensure systems. Plus I have no idea the social/career advancement issues such an organization would create. Would long enough service in this context translate to full licensure after a time? How long should that take? Does it make sense to maybe integrate the two disparate systems as one at some point and maybe formulate a way where highly restrictive entry-level licensure has a proof of experience based and continuing education process by which further advancement toward unsupervised, independent practice is slowly developed toward? What would that look like? Is it feasible? Is it worse than we have now? I don't know. I do know that in our current predicament though, we may be literally killing off our societal immune system through overwork; and the only way to overcome that, is through more hands.