4 ms·

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,

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
    - deleted 6y ago
      [deleted]
    - renewiltord 6y ago
      What was the process you followed to get into medicine?
      - waxachasee 6y ago
        It was always on the radar for me so I just worked for a few years and applied. I do know people who were engineers for a decade plus, and they had to do a year of coursework (special medicine program) before applying to med school. If it's something you personally are interested in, happy to talk more.
        renewiltord 6y ago
        Yeah, I'm interested in chatting with you on this because I'm curious about the process. I looked in your profile but couldn't find an email. Would you mind sending me a message at renewiltord@protonmail.com
    - lotsofpulp 6y ago
      I think the last 40 years were golden years for doctors in the US. They made great money, but now the jig is up and there are 2 options for the next generation: 1) if US goes with taxpayer funded healthcare, expect pay to go down similar to other developed countries with taxpayer funded healthcare. Because there will be no negotiating power. 2) with the ACA framework, it’s a race for insurers, hospitals, and physicians groups to get as big as they can do they can gain as much negotiating power as they can. I can see it with all the M&A in the hospital and provider space, and the rule of thumb is “the closer you are to the money, the more you make”. In this case, insurers will hold the money, so it will be at their mercy that they approve or deny payments for certain procedures. The American people themselves don’t have enough money to continue paying for this gravy train, and the government was picking up the slack, but I think that’s going to be over soon. The CVS/Aetna vertical integration model is interesting too, as they are talking about adding doctors to their stores to make it a one stop shop. Insurance, provider, medicine all in one, similar to Kaiser. And then there’s doctor groups who are able to pump out more work from one doctor by using physician assistances and nurse practitioners to actually see patients “supervised” by one doctor, but the doctor never actually sees the patient.
- jac241 6y ago
  Because you want to help people and not hijack their reward systems to maximize ad revenue?
btgeekboy 6y ago
The theoretical person you’re describing sounds like a nurse practitioner.
jjoonathan 6y ago
The inflated requirements are a result of restricting the supply of seats, not a cause.
- qwerty456127 6y ago
  Makes sense but how can you be sure?
khyryk 6y ago
I think what'll happen eventually is that the doctor situation will be sidestepped and the role doing stuff like looking at patients coming in to check on a generic cough or headache will go to physician assistants and nurse practitioners. To some extent I'm already seeing it happen.
x86_64Ubuntu 6y ago
They're already kind of doing that with Nurse Practitioners. I used to have asthma, and for years I always saw a doctor. Towards the end, I rarely saw a doctor but saw a nurse practitioner instead. I strongly doubt the difference in pay was reflected in my bill.
chiph 6y ago
Depends on the specialty, I would think. Pediatricians, general practice, etc. can probably have lower standards than other specialties since they are where people typically enter the medical system for treatment. If they haven't seen a malady before, they refer the patient. However, for cardiologists, anesthesiologists, neurosurgeons, etc. you probably want a higher education standard.

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
  - deleted 6y ago
    [deleted]
  - renewiltord 6y ago
    What was the process you followed to get into medicine?
    - waxachasee 6y ago
      It was always on the radar for me so I just worked for a few years and applied. I do know people who were engineers for a decade plus, and they had to do a year of coursework (special medicine program) before applying to med school. If it's something you personally are interested in, happy to talk more.
      - renewiltord 6y ago
        Yeah, I'm interested in chatting with you on this because I'm curious about the process. I looked in your profile but couldn't find an email. Would you mind sending me a message at renewiltord@protonmail.com
  - lotsofpulp 6y ago
    I think the last 40 years were golden years for doctors in the US. They made great money, but now the jig is up and there are 2 options for the next generation: 1) if US goes with taxpayer funded healthcare, expect pay to go down similar to other developed countries with taxpayer funded healthcare. Because there will be no negotiating power. 2) with the ACA framework, it’s a race for insurers, hospitals, and physicians groups to get as big as they can do they can gain as much negotiating power as they can. I can see it with all the M&A in the hospital and provider space, and the rule of thumb is “the closer you are to the money, the more you make”. In this case, insurers will hold the money, so it will be at their mercy that they approve or deny payments for certain procedures. The American people themselves don’t have enough money to continue paying for this gravy train, and the government was picking up the slack, but I think that’s going to be over soon. The CVS/Aetna vertical integration model is interesting too, as they are talking about adding doctors to their stores to make it a one stop shop. Insurance, provider, medicine all in one, similar to Kaiser. And then there’s doctor groups who are able to pump out more work from one doctor by using physician assistances and nurse practitioners to actually see patients “supervised” by one doctor, but the doctor never actually sees the patient.
jac241 6y ago
Because you want to help people and not hijack their reward systems to maximize ad revenue?

btgeekboy 6y ago

The theoretical person you’re describing sounds like a nurse practitioner.

jjoonathan 6y ago

The inflated requirements are a result of restricting the supply of seats, not a cause.

qwerty456127 6y ago
Makes sense but how can you be sure?

khyryk 6y ago

I think what'll happen eventually is that the doctor situation will be sidestepped and the role doing stuff like looking at patients coming in to check on a generic cough or headache will go to physician assistants and nurse practitioners. To some extent I'm already seeing it happen.

x86_64Ubuntu 6y ago

They're already kind of doing that with Nurse Practitioners. I used to have asthma, and for years I always saw a doctor. Towards the end, I rarely saw a doctor but saw a nurse practitioner instead. I strongly doubt the difference in pay was reflected in my bill.

chiph 6y ago

Depends on the specialty, I would think. Pediatricians, general practice, etc. can probably have lower standards than other specialties since they are where people typically enter the medical system for treatment. If they haven't seen a malady before, they refer the patient. However, for cardiologists, anesthesiologists, neurosurgeons, etc. you probably want a higher education standard.