4 ms·

Do you have evidence of this lobbying? It does not stand to reason, since care provided by residents is quite cheap to hospitals from the perspective of labor.

Do you have evidence of this lobbying? It does not stand to reason, since care provided by residents is quite cheap to hospitals from the perspective of labor. Hospitals have no obligation to hire the residents they produce, so an optimal behavior would seem to be training many residents and not hiring them.

renewiltord 3y ago
It's interesting how truth can disappear over time. They were out and proud about it back then. Here: https://www.washingtonpost.com/archive/politics/1997/03/09/rx-for-physician-glut-pay-hospitals-not-to-train-new-ones/f0514eed-3e43-4a19-8f09-6264acafd9a5/ https://www.washingtonpost.com/archive/politics/1997/03/09/r... > Last week a powerful coalition of medical groups, including the American Medical Association and the Association of American Medical Colleges -- the umbrella group for medical schools -- proposed their own plan. Their idea is to limit residency slots financed by Medicare to the number needed for the 17,000 annual graduates of U.S. medical schools. There's other things like this that folks say "Well, where's the evidence?" and the truth is that the evidence was all around us back then. Now that people have changed their minds on this stuff, it's harder to find as the perpetrators go quiet about it. And you have to search the past which isn't that easy. I'm sure the pandemic response will be similarly rewritten, especially the business about telling people masks don't work because they wanted to make sure that average people won't take masks that they wanted to keep for healthcare people. That's being rewritten in front of me to say "Oh there's no evidence that masks ever worked and that's why they said that". Where's the evidence? Well, in many cases, it was everywhere. Truth casts a small shadow on time. The motivated sceptic stands purely in the light.
- ejstronge 3y ago
  This is a difficult issue - if we accept the statements on their face (and I don't have enough information to accept or reject the statements), it seems that there was waste by hospitals that were doing just what I mentioned, soliciting residents that were not needed. From the article: "But why should hospitals be interested in this when, under current law, they automatically get sizable government subsidies for training residents who as part of their education take care of many of the hospitals' patients, work long hours and collect meager salaries?" If this issue were to arise again in today's political climate, I imagine there would be a redistribution of seats away from in-demand specialties to primary care.
  - renewiltord 3y ago
    Yeah, this is one of those things you had to be there for. When you're just reading a picture from history, and that's the only insight you have into it, you're going to get a particular view of it. It can't be helped, especially if one is searching for evidence to support one's own beliefs.
s1artibartfast 3y ago
>It does not stand to reason, since care provided by residents is quite cheap to hospitals from the perspective of labor. The AMA represents doctors, not hospitals, and doctors benefit from scarcity. Hospitals benefit from residency grants, existing doctors do not. >Do you have evidence of this lobbying? Here is a source [1] >Hospitals have no obligation to hire the residents they produce, so an optimal behavior would seem to be training many residents and not hiring them. Optimal only if they can make money from the residents. Due to the bizarre natures of US medical reimbursement, resident physicians do not bill for their services [2]. While they may provide value in other ways, they are viewed as cost on the balance sheet. This is further complicated by the fact that hospitals dont want to bear this cost if they can get a grant, or simply hire a doctor away from another hospital. Getting rid of the grants would be a step in the right direction. 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... https://thesheriffofsodium.com/2022/02/04/how-much-are-resident-physicians-worth/#:~:text=Governmental%20subsidies,additional%20revenue%20stream%3A%20governmental%20subsidies https://thesheriffofsodium.com/2022/02/04/how-much-are-resid....
- ejstronge 3y ago
  Residents are not fully qualified physicians, so it does make sense that they cannot bill for their work. Further, residents, by and large, are paid for by Medicare. > While they may provide value in other ways, they are viewed as cost on the balance sheet. Are you saying that replacing residents with physicians would be more advantageous to hospitals? I don't have a sense of the numbers or billing processes involved
  - s1artibartfast 3y ago
    no, Im saying if it costs 200k to train a physician, They should include that in the cost of their in what they charge for their licensed physicians. It is basically how it works in every other job in the world that requires on the job training or licensing.
    - 3y ago
RALaBarge 3y ago
I find myself reading comments like this in disbelief (or assuming the author is not in good faith responding), as if there can be any doubt where political lobbying is possible that there doesnt exist a tremendous apparatus to exploit it.
light_hue_1 3y ago
Yes, here it is. With citations: https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/#:~:text=The%20American%20Medical%20Association%20(AMA,quarter%20of%20all%20residency%20positions https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope....
asdfman123 3y ago
You can look up things for yourself, you know

renewiltord 3y ago

It's interesting how truth can disappear over time. They were out and proud about it back then. Here: https://www.washingtonpost.com/archive/politics/1997/03/09/rx-for-physician-glut-pay-hospitals-not-to-train-new-ones/f0514eed-3e43-4a19-8f09-6264acafd9a5/ https://www.washingtonpost.com/archive/politics/1997/03/09/r... > Last week a powerful coalition of medical groups, including the American Medical Association and the Association of American Medical Colleges -- the umbrella group for medical schools -- proposed their own plan. Their idea is to limit residency slots financed by Medicare to the number needed for the 17,000 annual graduates of U.S. medical schools. There's other things like this that folks say "Well, where's the evidence?" and the truth is that the evidence was all around us back then. Now that people have changed their minds on this stuff, it's harder to find as the perpetrators go quiet about it. And you have to search the past which isn't that easy. I'm sure the pandemic response will be similarly rewritten, especially the business about telling people masks don't work because they wanted to make sure that average people won't take masks that they wanted to keep for healthcare people. That's being rewritten in front of me to say "Oh there's no evidence that masks ever worked and that's why they said that". Where's the evidence? Well, in many cases, it was everywhere. Truth casts a small shadow on time. The motivated sceptic stands purely in the light.

ejstronge 3y ago
This is a difficult issue - if we accept the statements on their face (and I don't have enough information to accept or reject the statements), it seems that there was waste by hospitals that were doing just what I mentioned, soliciting residents that were not needed. From the article: "But why should hospitals be interested in this when, under current law, they automatically get sizable government subsidies for training residents who as part of their education take care of many of the hospitals' patients, work long hours and collect meager salaries?" If this issue were to arise again in today's political climate, I imagine there would be a redistribution of seats away from in-demand specialties to primary care.
- renewiltord 3y ago
  Yeah, this is one of those things you had to be there for. When you're just reading a picture from history, and that's the only insight you have into it, you're going to get a particular view of it. It can't be helped, especially if one is searching for evidence to support one's own beliefs.

s1artibartfast 3y ago

>It does not stand to reason, since care provided by residents is quite cheap to hospitals from the perspective of labor. The AMA represents doctors, not hospitals, and doctors benefit from scarcity. Hospitals benefit from residency grants, existing doctors do not. >Do you have evidence of this lobbying? Here is a source [1] >Hospitals have no obligation to hire the residents they produce, so an optimal behavior would seem to be training many residents and not hiring them. Optimal only if they can make money from the residents. Due to the bizarre natures of US medical reimbursement, resident physicians do not bill for their services [2]. While they may provide value in other ways, they are viewed as cost on the balance sheet. This is further complicated by the fact that hospitals dont want to bear this cost if they can get a grant, or simply hire a doctor away from another hospital. Getting rid of the grants would be a step in the right direction. 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... https://thesheriffofsodium.com/2022/02/04/how-much-are-resident-physicians-worth/#:~:text=Governmental%20subsidies,additional%20revenue%20stream%3A%20governmental%20subsidies https://thesheriffofsodium.com/2022/02/04/how-much-are-resid....

ejstronge 3y ago
Residents are not fully qualified physicians, so it does make sense that they cannot bill for their work. Further, residents, by and large, are paid for by Medicare. > While they may provide value in other ways, they are viewed as cost on the balance sheet. Are you saying that replacing residents with physicians would be more advantageous to hospitals? I don't have a sense of the numbers or billing processes involved
- s1artibartfast 3y ago
  no, Im saying if it costs 200k to train a physician, They should include that in the cost of their in what they charge for their licensed physicians. It is basically how it works in every other job in the world that requires on the job training or licensing.
  - 3y ago

RALaBarge 3y ago

I find myself reading comments like this in disbelief (or assuming the author is not in good faith responding), as if there can be any doubt where political lobbying is possible that there doesnt exist a tremendous apparatus to exploit it.

light_hue_1 3y ago

Yes, here it is. With citations: https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/#:~:text=The%20American%20Medical%20Association%20(AMA,quarter%20of%20all%20residency%20positions https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope....

asdfman123 3y ago

You can look up things for yourself, you know