3 ms·

The AMA has been pushing congress to increase the number of residency slots for the last 20 years.

by sarchertech 3y ago

bequanna 3y ago
Big if true. Do you have a source you can point to? This is the opposite of everything I’ve heard or read.
- Calavar 3y ago
  You are both correct. Back in the 80s and 90s, it was projected that there would be a physician surplus about 10 to 20 years down the road, so the AMA advocated cutting the number of residency positions [1, 2]. But those predictions didn't bear out, and in recent years (about the past 10 years), they have advocated increasing the number of positions [1, 3] In my opinion, a lot of the talk about artificial physician scarcity is BS. We have more physicians per capita than the UK, Australia, or New Zealand, but fewer than most EU countries. So we are roughly in the middle of the pack for developed nations. The problem is not a lack of physicians, but the fact that the US has a much larger rural area than most other nations and that you need a certain density of physicians in those areas. But you can't fix that simply by training more physicians -- you train more, and they'll predominately move to the cities too for the same factors. [1] https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/ https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope... [2] https://www.openhealthpolicy.com/p/medical-residency-slots-congress https://www.openhealthpolicy.com/p/medical-residency-slots-c... [3] https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...
FireBeyond 3y ago
The AMA shot itself in the foot, and doctors are suffering burnout. It also does a very good job of publicizing how much it wants more doctors, while not doing anything (or actively opposing attempts) to make this happen.
- sarchertech 3y ago
  There are more physicians per capital now than were in 1980. The population is older now, but it’s also now far more common to see a midlevel practitioner than it was in 1980. What has changed is most physicians no longer work for themselves or for physician owned groups. Working for private equity will burn anyone out. Physicians also spend more time overseeing cheaper midlevel practitioners. That itself could be a source of increased burnout (got into the job to treat patients not manage midlevels), but the second order effect is that their direct care patient mix has shifted higher acuity (potentially more stressful to handle) patients.

The AMA has been pushing congress to increase the number of residency slots for the last 20 years.

bequanna 3y ago

Big if true. Do you have a source you can point to? This is the opposite of everything I’ve heard or read.

Calavar 3y ago
You are both correct. Back in the 80s and 90s, it was projected that there would be a physician surplus about 10 to 20 years down the road, so the AMA advocated cutting the number of residency positions [1, 2]. But those predictions didn't bear out, and in recent years (about the past 10 years), they have advocated increasing the number of positions [1, 3] In my opinion, a lot of the talk about artificial physician scarcity is BS. We have more physicians per capita than the UK, Australia, or New Zealand, but fewer than most EU countries. So we are roughly in the middle of the pack for developed nations. The problem is not a lack of physicians, but the fact that the US has a much larger rural area than most other nations and that you need a certain density of physicians in those areas. But you can't fix that simply by training more physicians -- you train more, and they'll predominately move to the cities too for the same factors. [1] https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/ https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope... [2] https://www.openhealthpolicy.com/p/medical-residency-slots-congress https://www.openhealthpolicy.com/p/medical-residency-slots-c... [3] https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...

FireBeyond 3y ago

The AMA shot itself in the foot, and doctors are suffering burnout. It also does a very good job of publicizing how much it wants more doctors, while not doing anything (or actively opposing attempts) to make this happen.

sarchertech 3y ago
There are more physicians per capital now than were in 1980. The population is older now, but it’s also now far more common to see a midlevel practitioner than it was in 1980. What has changed is most physicians no longer work for themselves or for physician owned groups. Working for private equity will burn anyone out. Physicians also spend more time overseeing cheaper midlevel practitioners. That itself could be a source of increased burnout (got into the job to treat patients not manage midlevels), but the second order effect is that their direct care patient mix has shifted higher acuity (potentially more stressful to handle) patients.