3 ms·

I'm not sure how you made the jump from the AMA limiting med school enrollments to "youtube doctors". We could split the difference and expand existing med sch

I'm not sure how you made the jump from the AMA limiting med school enrollments to "youtube doctors". We could split the difference and expand existing med schools or start new ones with similar standards.

PaulDavisThe1st 6y ago
The issue is how you, as a (potential) patient, is going to interpret the fact that Doctor X graduated from a given med school. As a reader of libertarian stuff for 30 years, the usual answers are some combination of: 1) independent rating agency for med schools 2) independent rating agency for doctors (i.e. med school was irrelevant) 3) patient reviews for doctors 25 years of amzn have helped established serious questions about (3) (1) and (2) have the usual "who watches the watchers?" problems, which are fairly isomorphous to the problems with (3). And even without those issues, who wants to have do this level of research? Yeah, I know, libertarian nerds (meant with all possible respect). But almost nobody else. Part of the point (not all of it, to be sure) of things like the AMA, the FDA and other governmental regulation is to make people's lives simpler. Stop worrying about whether the doctor you're going to see has even met a basic level of medical qualification, and focus on whether you like their personality and approach, for example.
- chordalkeyboard 6y ago
  > (1) and (2) have the usual "who watches the watchers?" problems, Since we already deal with “who watches the watchers” problems in our current system, I see no problem here. > And even without those issues, who wants to have do this level of research? Yeah, I know, libertarian nerds (meant with all possible respect). But almost nobody else. Anyone who wants a good physician. > Part of the point (not all of it, to be sure) of things like the AMA, the FDA and other governmental regulation is to make people's lives simpler. Stop worrying about whether the doctor you're going to see has even met a basic level of medical qualification, and focus on whether you like their personality and approach, for example. If those things worked, this would be a point. Currently people can’t even afford to go to medical school, or afford to see a doctor, and when they get past the gatekeepers they are so desparate to get treatment that they can’t really even fathom rejecting a doctor because of a poor bedside manner.
  - PaulDavisThe1st 6y ago
    > If those things worked, this would be a point. Currently people can’t even afford to go to medical school, or afford to see a doctor, and when they get past the gatekeepers they are so desparate to get treatment that they can’t really even fathom rejecting a doctor because of a poor bedside manner. Other countries with socialized health care systems (i.e. doctor credential gatekeeping) do not have these issues (certainly not to anything like the extent that we do). I suspect therefore that changing the credentialling process is unlikely to have much impact on these issues and/or is not the most effective way to impact these issues. > Anyone who wants a good physician. I'm 57 years old. I've never, ever met anyone who isn't a libertarian nerd (I have friends ...) that checks to see what medical school a physician attended. If they are "checking" at something approximating that level, they do so via clinical affiliation (e.g. "anyone at the Mayo has to be great"). > Since we already deal with “who watches the watchers” problems in our current system, I see no problem here. Not really. The "watchers" in our current system are government agencies, not private (potentially for-profit, or at least for-big-salary) corporations. The incentives align in significantly different ways.
    - chordalkeyboard 6y ago
      > I suspect therefore that changing the credentialling process is unlikely to have much impact on these issues and/or is not the most effective way to impact these issues. The easiest way to expand medicine access would probably just be to remove government restrictions on the number of medical schools, the number of hospitals, and the number of physicians. I don’t think we need to dismantle the credential system. > I'm 57 years old. I've never, ever met anyone who isn't a libertarian nerd (I have friends ...) that checks to see what medical school a physician attended. This why we have to be careful about generalizing from our own experience conclusively :) > If they are "checking" at something approximating that level, they do so via clinical affiliation (e.g. "anyone at the Mayo has to be great"). There’s how things are, and how things should be. People ought to take more responsibility for their healthcare and that includes who provides it. > Not really. The "watchers" in our current system are government agencies, not private (potentially for-profit, or at least for-big-salary) corporations. The incentives align in significantly different ways. Perhaps you haven’t noticed but the watchers in government agencies and the for-profit, big salary corporations they are supposed to be watching are the same people. its called “regulatory capture” and “revolving door”.

PaulDavisThe1st 6y ago

The issue is how you, as a (potential) patient, is going to interpret the fact that Doctor X graduated from a given med school. As a reader of libertarian stuff for 30 years, the usual answers are some combination of: 1) independent rating agency for med schools 2) independent rating agency for doctors (i.e. med school was irrelevant) 3) patient reviews for doctors 25 years of amzn have helped established serious questions about (3) (1) and (2) have the usual "who watches the watchers?" problems, which are fairly isomorphous to the problems with (3). And even without those issues, who wants to have do this level of research? Yeah, I know, libertarian nerds (meant with all possible respect). But almost nobody else. Part of the point (not all of it, to be sure) of things like the AMA, the FDA and other governmental regulation is to make people's lives simpler. Stop worrying about whether the doctor you're going to see has even met a basic level of medical qualification, and focus on whether you like their personality and approach, for example.

chordalkeyboard 6y ago
> (1) and (2) have the usual "who watches the watchers?" problems, Since we already deal with “who watches the watchers” problems in our current system, I see no problem here. > And even without those issues, who wants to have do this level of research? Yeah, I know, libertarian nerds (meant with all possible respect). But almost nobody else. Anyone who wants a good physician. > Part of the point (not all of it, to be sure) of things like the AMA, the FDA and other governmental regulation is to make people's lives simpler. Stop worrying about whether the doctor you're going to see has even met a basic level of medical qualification, and focus on whether you like their personality and approach, for example. If those things worked, this would be a point. Currently people can’t even afford to go to medical school, or afford to see a doctor, and when they get past the gatekeepers they are so desparate to get treatment that they can’t really even fathom rejecting a doctor because of a poor bedside manner.
- PaulDavisThe1st 6y ago
  > If those things worked, this would be a point. Currently people can’t even afford to go to medical school, or afford to see a doctor, and when they get past the gatekeepers they are so desparate to get treatment that they can’t really even fathom rejecting a doctor because of a poor bedside manner. Other countries with socialized health care systems (i.e. doctor credential gatekeeping) do not have these issues (certainly not to anything like the extent that we do). I suspect therefore that changing the credentialling process is unlikely to have much impact on these issues and/or is not the most effective way to impact these issues. > Anyone who wants a good physician. I'm 57 years old. I've never, ever met anyone who isn't a libertarian nerd (I have friends ...) that checks to see what medical school a physician attended. If they are "checking" at something approximating that level, they do so via clinical affiliation (e.g. "anyone at the Mayo has to be great"). > Since we already deal with “who watches the watchers” problems in our current system, I see no problem here. Not really. The "watchers" in our current system are government agencies, not private (potentially for-profit, or at least for-big-salary) corporations. The incentives align in significantly different ways.
  - chordalkeyboard 6y ago
    > I suspect therefore that changing the credentialling process is unlikely to have much impact on these issues and/or is not the most effective way to impact these issues. The easiest way to expand medicine access would probably just be to remove government restrictions on the number of medical schools, the number of hospitals, and the number of physicians. I don’t think we need to dismantle the credential system. > I'm 57 years old. I've never, ever met anyone who isn't a libertarian nerd (I have friends ...) that checks to see what medical school a physician attended. This why we have to be careful about generalizing from our own experience conclusively :) > If they are "checking" at something approximating that level, they do so via clinical affiliation (e.g. "anyone at the Mayo has to be great"). There’s how things are, and how things should be. People ought to take more responsibility for their healthcare and that includes who provides it. > Not really. The "watchers" in our current system are government agencies, not private (potentially for-profit, or at least for-big-salary) corporations. The incentives align in significantly different ways. Perhaps you haven’t noticed but the watchers in government agencies and the for-profit, big salary corporations they are supposed to be watching are the same people. its called “regulatory capture” and “revolving door”.