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"There are thousands of schools that certify medical doctors, but only one certification agency for medical devices." Somewhat amazingly, there are only 133 sc

by hexis 16y ago

"There are thousands of schools that certify medical doctors, but only one certification agency for medical devices." Somewhat amazingly, there are only 133 schools in the united states that award MDs - https://www.aamc.org/about/medicalschools/ https://www.aamc.org/about/medicalschools/

maxharris 16y ago
The fact that this is so tightly regulated is directly responsible for the well-known shortage of physicians (especially primary care) in the US. Here's some data about how the supply of doctors is constrained by law: http://4.bp.blogspot.com/_otfwl2zc6Qc/S8p3XotZRpI/AAAAAAAANQ4/9Bn63-6lmgs/s1600/medschool.jpg http://4.bp.blogspot.com/_otfwl2zc6Qc/S8p3XotZRpI/AAAAAAAANQ... (http://mjperry.blogspot.com/2010/04/medical-school-grads-have-been-flat.html http://mjperry.blogspot.com/2010/04/medical-school-grads-hav...) For the last 30 years, only 16,000 new doctors are let through each year, and this is very carefully regulated to keep guild members rich. There's nothing wrong with people getting rich, so long as they don't use the government to secure and maintain their monopoly. This is why state licensing should be abolished. Unfortunately, it's been this way since the Middle Ages. Does it have to be this way? Not if you decide that people should be free to choose for themselves which expert they should seek medical help from, and what qualifications they require. If you own your own body (and I say you do), this is your right to decide.
- nickpinkston 16y ago
  Certainly - I don't understand how the AMA gets to enforce a monopoly cartel without the FTC breaking them up... There should also not be one level of doctor. An MD does little to say if a doctor could perform brain surgery - that's already based on performance metrics (specialty, years working, etc,). You're telling me nurses can't diagnose most diseases a general physician does? The Nurse Prac movement is great - I wonder how that's been regulated / affecting pay, service costs, etc.
- deleted 16y ago
  [deleted]
- jbooth 16y ago
  There's probably a middle ground between the current exclusionary system and some guy with a mail-ordered Hard Knocks University degree on his wall being allowed to practice medicine on people.
  - maxharris 16y ago
    The solution is freedom. Freedom means freedom from fraud. So if the guy with a mail-ordered degree lies to someone and says he got a degree from Harvard, causing that person to get "treated" when they would otherwise have gone elsewhere, that's when the government should intervene. Saving people from themselves is foolhardy, and such efforts are invariably used as tools of repression.
    - jbooth 16y ago
      Is this tongue in cheek? The solution is "freedom"? Like get ahold of a whole bunch of powdered freedom and just sprinkle it over the medical industry? The solution is likely a series of detailed, technocratic tweaks to the accreditation process to allow more schools offer an MD while not allowing Clown College to offer one. I'm an educated guy and I have zero ability to rate a doctor aside from the fact that in order to get the MD there's a uniformly high bar. You're suggesting I should bring a copy of US News and World Report Med School rankings to the doctors' office with me to make sure they don't operate on the wrong knee or something? And if I'm not diligent enough to do that, I deserve whatever happens to me?
      - dpatru 16y ago
        When people are left free, they tend to work out effective solutions. In a free society, there would likely be a multiple authorities to judge physician competency. The consumer would get to pick. A big problem with doctor certification today is that doctors are graded on a boolean scale, pass/fail. So two physicians can both be certified, but one can be vastly better than the other, and you, as a uninformed patient, have little way of judging. A close relative of mine has had an opportunity to assist in many open-heart surgeries performed by several doctors. He tells me that there is a huge difference between surgeons. One surgeon regularly completes operations in 20 minutes with no mistakes and complications, another surgeon, at the same medical center, takes two or three times as long, is much "messier" (cutting things he shouldn't), and his patients have many more complications. It's obvious to everyone in the operating room who is the better doctor, but no one will tell patients. For patients, both doctors are "competent." In free market, presumably there would be at least one rating agency that would provide a more nuanced report on doctors. Also, to get an MD, there is not a "uniformly high bar," at least there hasn't been in the past. Medical schools discriminate in their entry requirements based on at least race, but possibly other non-competency factors like sexual orientation and parental alumni status. So entering medical students are not held to a uniformly high bar. Once in medical school, student performance diverges. Some students are at the top of their class, others are at the bottom. Some pass the certification exams with high scores, others barely pass after two or three attempts. Most of this information is not readily accessible to the average healthcare consumer. The primary aim of doctor certification seems to be to restrict the supply so as to keep wages high, not to help consumers choose. The best solution really is freedom, not mere "detailed technocratic tweaks" to a system designed from the bottom-up to protect the interests of the medical profession against competition.
teej 16y ago
> Somewhat amazingly, there are only 133 schools in the united states that award MDs As well as 26 schools that award DOs, a degree equivalent to MD in all 50 states - http://www.aacom.org/people/colleges/pages/default.aspx http://www.aacom.org/people/colleges/pages/default.aspx
ramanujan 16y ago
I was also thinking of foreign medical schools; graduates of those schools make up a considerable portion of doctors and dentists in the US. But granting that it's more accurate to say "hundreds" rather than "thousands", the substantive point is that total centralization is not necessary to ensure quality of medical care.

by hexis 16y ago

maxharris 16y ago

The fact that this is so tightly regulated is directly responsible for the well-known shortage of physicians (especially primary care) in the US. Here's some data about how the supply of doctors is constrained by law: http://4.bp.blogspot.com/_otfwl2zc6Qc/S8p3XotZRpI/AAAAAAAANQ4/9Bn63-6lmgs/s1600/medschool.jpg http://4.bp.blogspot.com/_otfwl2zc6Qc/S8p3XotZRpI/AAAAAAAANQ... (http://mjperry.blogspot.com/2010/04/medical-school-grads-have-been-flat.html http://mjperry.blogspot.com/2010/04/medical-school-grads-hav...) For the last 30 years, only 16,000 new doctors are let through each year, and this is very carefully regulated to keep guild members rich. There's nothing wrong with people getting rich, so long as they don't use the government to secure and maintain their monopoly. This is why state licensing should be abolished. Unfortunately, it's been this way since the Middle Ages. Does it have to be this way? Not if you decide that people should be free to choose for themselves which expert they should seek medical help from, and what qualifications they require. If you own your own body (and I say you do), this is your right to decide.

nickpinkston 16y ago
Certainly - I don't understand how the AMA gets to enforce a monopoly cartel without the FTC breaking them up... There should also not be one level of doctor. An MD does little to say if a doctor could perform brain surgery - that's already based on performance metrics (specialty, years working, etc,). You're telling me nurses can't diagnose most diseases a general physician does? The Nurse Prac movement is great - I wonder how that's been regulated / affecting pay, service costs, etc.
deleted 16y ago
[deleted]
jbooth 16y ago
There's probably a middle ground between the current exclusionary system and some guy with a mail-ordered Hard Knocks University degree on his wall being allowed to practice medicine on people.
- maxharris 16y ago
  The solution is freedom. Freedom means freedom from fraud. So if the guy with a mail-ordered degree lies to someone and says he got a degree from Harvard, causing that person to get "treated" when they would otherwise have gone elsewhere, that's when the government should intervene. Saving people from themselves is foolhardy, and such efforts are invariably used as tools of repression.
  - jbooth 16y ago
    Is this tongue in cheek? The solution is "freedom"? Like get ahold of a whole bunch of powdered freedom and just sprinkle it over the medical industry? The solution is likely a series of detailed, technocratic tweaks to the accreditation process to allow more schools offer an MD while not allowing Clown College to offer one. I'm an educated guy and I have zero ability to rate a doctor aside from the fact that in order to get the MD there's a uniformly high bar. You're suggesting I should bring a copy of US News and World Report Med School rankings to the doctors' office with me to make sure they don't operate on the wrong knee or something? And if I'm not diligent enough to do that, I deserve whatever happens to me?
    - dpatru 16y ago
      When people are left free, they tend to work out effective solutions. In a free society, there would likely be a multiple authorities to judge physician competency. The consumer would get to pick. A big problem with doctor certification today is that doctors are graded on a boolean scale, pass/fail. So two physicians can both be certified, but one can be vastly better than the other, and you, as a uninformed patient, have little way of judging. A close relative of mine has had an opportunity to assist in many open-heart surgeries performed by several doctors. He tells me that there is a huge difference between surgeons. One surgeon regularly completes operations in 20 minutes with no mistakes and complications, another surgeon, at the same medical center, takes two or three times as long, is much "messier" (cutting things he shouldn't), and his patients have many more complications. It's obvious to everyone in the operating room who is the better doctor, but no one will tell patients. For patients, both doctors are "competent." In free market, presumably there would be at least one rating agency that would provide a more nuanced report on doctors. Also, to get an MD, there is not a "uniformly high bar," at least there hasn't been in the past. Medical schools discriminate in their entry requirements based on at least race, but possibly other non-competency factors like sexual orientation and parental alumni status. So entering medical students are not held to a uniformly high bar. Once in medical school, student performance diverges. Some students are at the top of their class, others are at the bottom. Some pass the certification exams with high scores, others barely pass after two or three attempts. Most of this information is not readily accessible to the average healthcare consumer. The primary aim of doctor certification seems to be to restrict the supply so as to keep wages high, not to help consumers choose. The best solution really is freedom, not mere "detailed technocratic tweaks" to a system designed from the bottom-up to protect the interests of the medical profession against competition.

teej 16y ago

> Somewhat amazingly, there are only 133 schools in the united states that award MDs As well as 26 schools that award DOs, a degree equivalent to MD in all 50 states - http://www.aacom.org/people/colleges/pages/default.aspx http://www.aacom.org/people/colleges/pages/default.aspx

ramanujan 16y ago

I was also thinking of foreign medical schools; graduates of those schools make up a considerable portion of doctors and dentists in the US. But granting that it's more accurate to say "hundreds" rather than "thousands", the substantive point is that total centralization is not necessary to ensure quality of medical care.