6 ms·

As the other poster mentioned, med schools aren't actually the barrier to increasing the physician workforce. In order to be a practicing physician you need to

As the other poster mentioned, med schools aren't actually the barrier to increasing the physician workforce. In order to be a practicing physician you need to go through residency training. However the number of residency spots has stayed fixed for the last 3 decades and is controlled by government funding. If you want more doctors, lobby your government to increase residency training funding.

vsskanth 6y ago
Maybe drop the requirement that only governments fund residency slots?
- nathanvanfleet 6y ago
  "Let private corporations do it." - America
  - vsskanth 6y ago
    In case this wasn't clear - Maybe drop the requirement that "only" governments fund residency slots?
- wl 6y ago
  Such a requirement doesn't exist. 77% of residency slots are funded by the federal government. But there are slots that aren't funded by the federal government. And this makes sense because residents make residency programs money.
deleted 6y ago
[deleted]
mc32 6y ago
So propublica isn’t being pro pubic and letting us know what the real issue is, but would rather present it as their own perceived issue? They could say this is the quick fix but the long term solution is different.
anonunivgrad 6y ago
The number of residencies is set by a board which the AMA controls a majority of the seats on. They blame the lack of Medicare funding for additional residency spots, but that is such a preposterous excuse. American medicine is one of the most lucrative industries in the world, and American doctors some of the highest paid people in the world. They don't need the public to subsidize their training. The AMA is a guild and the doctor shortage is their fault.
- koheripbal 6y ago
  The doctor shortage is their intentional strategy. The fewer new doctors, the higher their pay. They are a labor organization that's intentionally limiting supply.
  - jjoonathan 6y ago
    Yes. One time I was (politely) arguing this with a MD acquaintance and I let him convince me it was an unfortunate, unintentional outcome rather than a successful hustle. A few weeks later I read an article about a new cuneiform tablet that had just been translated. The oldest translated writing in the world, at the time. Evidently the brick-making guild hadn't been training enough young apprentices and the price of construction was becoming excessive. They wanted the king to step in. It was the same trick! This was literally the oldest trick in all of recorded history! I am still somewhat adjacent to the biomedical scene and I've heard that the AMA has reversed course recently -- but I don't know the degree to which the new words correspond to actual actions. In any case, the sentiment is correct: if they don't become part of the solution, they will be seen as part of the problem when the eye of Sauron turns in their direction, and the terms imposed on them will be much worse than the terms that could otherwise have been arranged.
    - renewiltord 6y ago
      In the AMA’s case, physician pay was explicitly their objective. They said so.
    - nicodjimenez 6y ago
qwerty456127 6y ago
Or to lower the requirements. Doctors with no experience but a medical school are still much better than no doctors. I don't need a doctor with a fancy license, I need a doctor who has a scientifically adequate (and up-to-date) idea of how does a human body work and what has a good chance to be a reasonable way to cure my sickness.
- lotsofpulp 6y ago
  I agree with this comment. US medicine has setup a long and tortuous road, which might result in extremely well qualified people (or might not), but other developed countries seem to do just fine without the hazing ritual the US required doctors to go through. Why would you ever choose to be a doctor over an employee at a FAANG? It would be worse for your mental and physical health, and now the pay isn’t even much higher for doctors.
  - asdfasgasdgasdg 6y ago
    I would guess the average pay is not higher at all. Even if you don't account for opportunity cost and the time value of money, I think it may be that top tech cos pay better for someone with similar levels of experience. Certainly I don't think many of my doctor friends my age are making as much as I do, and I was also earning for almost a decade before most of them were able to become attending physicians. And many of them went into family practice or other solidly middle class specialties, which certainly pay a good deal less. This is not even accounting for the fact I work like 36h a week with zero on call time (at least on the current project), and few doctors can swing that.
    - waxachasee 6y ago
      I left FANG for medicine. I think this is not a good argument for 2 main reasons. 1) People tend to compare FANG to family medicine. It wouldn't be more apt to compare the average tech worker making 100-200k to family medicine, or compare to some of the more competitive specialties. 2) Salaries are underestimated by many people. The best source is the MGMA is is often used to negotiate salaries by the hiring side. Unfortunately the data is expensive to access so few have it - there's an older screenshot someone took [1]. Further, these are biased lower since academic medicine and part time researchers tend to make less. You can also tailor you're career with more flexibility. Want to make $1M? Go for it. Want to work 2 weeks a year and still bring in 2-300k? Go for it. Now if you want to live in NY or SF tech will pay more as medicine pays more as you get more rural. [1] : https://imgur.com/gallery/ZQo6aKo https://imgur.com/gallery/ZQo6aKo
refurb 6y ago
The way Medicare funds residencies is also odd. What they do is add a pay bump to all reimbursement for a teaching hospital. For example, for an appendectomy, a non-teaching hospital might be reimbursed $4,500. If you’re a teaching hospital you get an extra 1.3% (too lazy to look up exact number, but it’s quite small), so $4,559. And that’s for every procedure at the hospital, whether the resident was involved or not. Seems like a more direct, “here is $80,000 for each residency spot” would make things a bit more transparent?
yangikan 6y ago
What do students who pass med school, but can't get a residency do? If the numbers are right, then there should a large pool of them.

vsskanth 6y ago

Maybe drop the requirement that only governments fund residency slots?

nathanvanfleet 6y ago
"Let private corporations do it." - America
- vsskanth 6y ago
  In case this wasn't clear - Maybe drop the requirement that "only" governments fund residency slots?
wl 6y ago
Such a requirement doesn't exist. 77% of residency slots are funded by the federal government. But there are slots that aren't funded by the federal government. And this makes sense because residents make residency programs money.

deleted 6y ago

[deleted]

mc32 6y ago

So propublica isn’t being pro pubic and letting us know what the real issue is, but would rather present it as their own perceived issue? They could say this is the quick fix but the long term solution is different.

anonunivgrad 6y ago

The number of residencies is set by a board which the AMA controls a majority of the seats on. They blame the lack of Medicare funding for additional residency spots, but that is such a preposterous excuse. American medicine is one of the most lucrative industries in the world, and American doctors some of the highest paid people in the world. They don't need the public to subsidize their training. The AMA is a guild and the doctor shortage is their fault.

koheripbal 6y ago
The doctor shortage is their intentional strategy. The fewer new doctors, the higher their pay. They are a labor organization that's intentionally limiting supply.
- jjoonathan 6y ago
  Yes. One time I was (politely) arguing this with a MD acquaintance and I let him convince me it was an unfortunate, unintentional outcome rather than a successful hustle. A few weeks later I read an article about a new cuneiform tablet that had just been translated. The oldest translated writing in the world, at the time. Evidently the brick-making guild hadn't been training enough young apprentices and the price of construction was becoming excessive. They wanted the king to step in. It was the same trick! This was literally the oldest trick in all of recorded history! I am still somewhat adjacent to the biomedical scene and I've heard that the AMA has reversed course recently -- but I don't know the degree to which the new words correspond to actual actions. In any case, the sentiment is correct: if they don't become part of the solution, they will be seen as part of the problem when the eye of Sauron turns in their direction, and the terms imposed on them will be much worse than the terms that could otherwise have been arranged.
  - renewiltord 6y ago
    In the AMA’s case, physician pay was explicitly their objective. They said so.
  - nicodjimenez 6y ago

qwerty456127 6y ago

Or to lower the requirements. Doctors with no experience but a medical school are still much better than no doctors. I don't need a doctor with a fancy license, I need a doctor who has a scientifically adequate (and up-to-date) idea of how does a human body work and what has a good chance to be a reasonable way to cure my sickness.

lotsofpulp 6y ago
I agree with this comment. US medicine has setup a long and tortuous road, which might result in extremely well qualified people (or might not), but other developed countries seem to do just fine without the hazing ritual the US required doctors to go through. Why would you ever choose to be a doctor over an employee at a FAANG? It would be worse for your mental and physical health, and now the pay isn’t even much higher for doctors.
- asdfasgasdgasdg 6y ago
  I would guess the average pay is not higher at all. Even if you don't account for opportunity cost and the time value of money, I think it may be that top tech cos pay better for someone with similar levels of experience. Certainly I don't think many of my doctor friends my age are making as much as I do, and I was also earning for almost a decade before most of them were able to become attending physicians. And many of them went into family practice or other solidly middle class specialties, which certainly pay a good deal less. This is not even accounting for the fact I work like 36h a week with zero on call time (at least on the current project), and few doctors can swing that.
  - waxachasee 6y ago
    I left FANG for medicine. I think this is not a good argument for 2 main reasons. 1) People tend to compare FANG to family medicine. It wouldn't be more apt to compare the average tech worker making 100-200k to family medicine, or compare to some of the more competitive specialties. 2) Salaries are underestimated by many people. The best source is the MGMA is is often used to negotiate salaries by the hiring side. Unfortunately the data is expensive to access so few have it - there's an older screenshot someone took [1]. Further, these are biased lower since academic medicine and part time researchers tend to make less. You can also tailor you're career with more flexibility. Want to make $1M? Go for it. Want to work 2 weeks a year and still bring in 2-300k? Go for it. Now if you want to live in NY or SF tech will pay more as medicine pays more as you get more rural. [1] : https://imgur.com/gallery/ZQo6aKo https://imgur.com/gallery/ZQo6aKo

refurb 6y ago

The way Medicare funds residencies is also odd. What they do is add a pay bump to all reimbursement for a teaching hospital. For example, for an appendectomy, a non-teaching hospital might be reimbursed $4,500. If you’re a teaching hospital you get an extra 1.3% (too lazy to look up exact number, but it’s quite small), so $4,559. And that’s for every procedure at the hospital, whether the resident was involved or not. Seems like a more direct, “here is $80,000 for each residency spot” would make things a bit more transparent?

yangikan 6y ago

What do students who pass med school, but can't get a residency do? If the numbers are right, then there should a large pool of them.