3 ms·

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

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
    I’m less optimistic. It’s just too easy for the AMA to say “hey we are saving lives and we need to make sure we have the best of the best!”. I think a parallel system needs to happen which won’t be controlled by AMA. It will happen eventually but it will probably take a long time.
    - horsawlarway 6y ago
      I think it's happening right now. There's a reason CVS and Walgreens are both trying to position themselves less as drugstores and more as walk-in clinics. There's a huge opportunity in the market for providing low cost care that has fewer regulations and restrictions. Honestly, I don't know if it will work or not, but I think it's interesting they're trying to take advantage of the (frankly ridiculous) medical situation in the US right now.

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
  I’m less optimistic. It’s just too easy for the AMA to say “hey we are saving lives and we need to make sure we have the best of the best!”. I think a parallel system needs to happen which won’t be controlled by AMA. It will happen eventually but it will probably take a long time.
  - horsawlarway 6y ago
    I think it's happening right now. There's a reason CVS and Walgreens are both trying to position themselves less as drugstores and more as walk-in clinics. There's a huge opportunity in the market for providing low cost care that has fewer regulations and restrictions. Honestly, I don't know if it will work or not, but I think it's interesting they're trying to take advantage of the (frankly ridiculous) medical situation in the US right now.