5 ms·

Given that the AMA cartel sets artificial quotas on med school admissions per school, it's not that simple lol

verteu 3y ago
I don't think that's accurate. From my research, the bottleneck is residencies, whose funding is determined by Congress [1]. The AMA has supported laws to increase residencies, such as "H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act" [2]. The paper "Physician workforce in the United States of America: forecasting nationwide shortages" [3] mainly blames an aging population and too-slow growth in the number of "residents and fellows". edit: Found a dissenting view here [4], its main reference seems to be [5]. [1] https://www.washingtonian.com/2020/04/13/were-short-on-healthcare-workers-why-doesnt-the-u-s-just-make-more-doctors/ https://www.washingtonian.com/2020/04/13/were-short-on-healt... [2] https://www.ama-assn.org/system/files/2024-nac-action-kit-gme-physician-workforce.pdf https://www.ama-assn.org/system/files/2024-nac-action-kit-gm... [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006215/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006215/ [4] https://www.motherjones.com/kevin-drum/2013/11/its-doctors-who-control-number-doctors-america-not-government/ https://www.motherjones.com/kevin-drum/2013/11/its-doctors-w... [5] https://washingtonmonthly.com/2013/06/19/first-teach-no-harm/ https://washingtonmonthly.com/2013/06/19/first-teach-no-harm...
- bradleyjg 3y ago
  > whose funding is determined by Congress There’s no law forbidding you, a state government, a local government, an insurance company, the AARP, or anyone else from funding a residency.
  - verteu 3y ago
    Good point - I don't see why they're subsidized by the federal gvt at all, rather than the resident, the hospital, the AMA, etc.
    - whatshisface 3y ago
      Med students don't have a lot of money, and hospitals are actually there (from their perspective, at least) to make money. The AMA doesn't have a lot of extra money either.
      - bradleyjg 3y ago
        They don’t have a lot of money yet. They have a very high amount of lifetime earning potential compared to their peers in other countries (yes, even after debt service and malpractice insurance.)
        esoleyman 3y ago
        Are you seriously asking residents to subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services? If that were the case, then the only ones who would put up with such a system would be those who have rich families to back them up. I came from a blue collar background and my family could not help subsidize my training and I could not afford to live, make rent, or afford food if I had to pay for my training as well. There are so many other things that you are completely glossing over including annual income between generalists vs specialists, pediatricians vs non-pediatricians, reimbursement inequality from Medicare (has not kept up with inflation and is ~40% below inflation), Medicaid pays at best 10-15% on the dollar, and so on. American physicians also work almost teice as many hours as their European counterparts which would increase their incomes. [1] it’s considerably more because if you report it then the program can be in danger and lose its credentialing
        tastyfreeze 3y ago
        > subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services That sounds like an apprenticeship. Many other industries do exactly that. Why should doctors be different?

I don't think that's accurate. From my research, the bottleneck is residencies, whose funding is determined by Congress [1]. The AMA has supported laws to increase residencies, such as "H.R. 2389/S. 1302, the Resident Physician Shortage Reduction Act" [2]. The paper "Physician workforce in the United States of America: forecasting nationwide shortages" [3] mainly blames an aging population and too-slow growth in the number of "residents and fellows". edit: Found a dissenting view here [4], its main reference seems to be [5]. [1] https://www.washingtonian.com/2020/04/13/were-short-on-healthcare-workers-why-doesnt-the-u-s-just-make-more-doctors/ https://www.washingtonian.com/2020/04/13/were-short-on-healt... [2] https://www.ama-assn.org/system/files/2024-nac-action-kit-gme-physician-workforce.pdf https://www.ama-assn.org/system/files/2024-nac-action-kit-gm... [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006215/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006215/ [4] https://www.motherjones.com/kevin-drum/2013/11/its-doctors-who-control-number-doctors-america-not-government/ https://www.motherjones.com/kevin-drum/2013/11/its-doctors-w... [5] https://washingtonmonthly.com/2013/06/19/first-teach-no-harm/ https://washingtonmonthly.com/2013/06/19/first-teach-no-harm...

bradleyjg 3y ago
> whose funding is determined by Congress There’s no law forbidding you, a state government, a local government, an insurance company, the AARP, or anyone else from funding a residency.
- verteu 3y ago
  Good point - I don't see why they're subsidized by the federal gvt at all, rather than the resident, the hospital, the AMA, etc.
  - whatshisface 3y ago
    Med students don't have a lot of money, and hospitals are actually there (from their perspective, at least) to make money. The AMA doesn't have a lot of extra money either.
    - bradleyjg 3y ago
      They don’t have a lot of money yet. They have a very high amount of lifetime earning potential compared to their peers in other countries (yes, even after debt service and malpractice insurance.)
      - esoleyman 3y ago
        Are you seriously asking residents to subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services? If that were the case, then the only ones who would put up with such a system would be those who have rich families to back them up. I came from a blue collar background and my family could not help subsidize my training and I could not afford to live, make rent, or afford food if I had to pay for my training as well. There are so many other things that you are completely glossing over including annual income between generalists vs specialists, pediatricians vs non-pediatricians, reimbursement inequality from Medicare (has not kept up with inflation and is ~40% below inflation), Medicaid pays at best 10-15% on the dollar, and so on. American physicians also work almost teice as many hours as their European counterparts which would increase their incomes. [1] it’s considerably more because if you report it then the program can be in danger and lose its credentialing
        tastyfreeze 3y ago
        > subsidize their own training working 60-80 hours a week [1] and being paid maybe $20-25/hr for 3-7 years while the hospitals make money from their services That sounds like an apprenticeship. Many other industries do exactly that. Why should doctors be different?