3 ms·

> I think you’re giving way too much credit to medical associations to rig the game in their favor. They exert enough influence over all fifty states and the va

by shkkmo 3y ago

> I think you’re giving way too much credit to medical associations to rig the game in their favor. They exert enough influence over all fifty states and the various private institutions to systemically deny training to qualified candidates? The underlying fact that the AMA is directly responsible for the doctor shortage in the USA is historically accurate. 20 years ago the AMA believes we were heading towards a doctor surplus and heavily lobbied and for fewer medical schools, caps on federal funding for residencies and big cuts to the available residencies. The AMA has reversed course and no longer supports these positions but the damage has been done, both to our supply of doctors and to their own reputation. However, even today the AMA supports many policies that keep taks that other professionals could perform the sole purview of doctors (which excacerbates the suppoy problem they helped create.)

pc86 3y ago
I am wildly in favor of expanding the number of medical schools, expanding med school class sizes, expanding residency slots and funding per resident. None of this means I want decisions now made by someone who does 4 years of college, 4 years of med school, 3-7 years of residency and potentially fellowship on top of that to instead be made by a nurse "under the supervision" of a doctor. If you're a doctor of one specialty and you want to change specialties, you have to redo residency and maybe fellowship. If you're a nurse and you want to change specialties the training is either on-the-job or measured in days/weeks.
- shkkmo 3y ago
  > one of this means I want decisions now made by someone who does 4 years of college, 4 years of med school, 3-7 years of residency and potentially fellowship on top of that to instead be made by a nurse "under the supervision" of a doctor. That is indeed the AMA the talking point to justify their stance. However my problem with the AMA here isn't that they support some scope restrictions (clearly many decisions do require full training) but that they strongly support ALL scope restrictions without data to support such a rigid hardline stance. They do this even when the loosening scope restrictions would decrease cost and increase availability without any harm to patient outcomes. This absolutely exacerbates the physician supply problem that the AMA created. If the AMA actually care about the physician supply issues in the country, it would work with state and federal regulators to identify which scope restrictions can safely be loosened.
  - pc86 3y ago
    That it may be an AMA talking point doesn't make it wrong, and as far as I am aware the AMA is in favor of increasing physician at supply at the supply point - increasing medical school class sizes, increasing the number of medical schools, and increasing federal funding for residency programs (which can increase the number of slots, pay existing residents more, or both). The answer to a physician supply problem is increasing the supply of physicians, not having nurses do physicians' jobs.
    - shkkmo 3y ago
      > That it may be an AMA talking point doesn't make it wrong When an organization with a clear history of a specific agenda has a talking point, it is good to take the context of their agenda into account. I would point out that this particular agenda is one that has been largely achieved, which is why doctors in the USA make so much more than any other country and part of why our healthcare costs are so much higher. In this case, we have a problem that the AMA deliberately worked to create for 20 years. Now that their "oversupply of doctors" myth is no longer remotely tenable, the AMA argues that the ONLY way to solve the supply problem they created is a solution that takes 10+ years to take effect. We absolutely need to increase the number of doctors we have, but we also need to look at other ways we can safely increase patient access and decrease patient costs while we wait for new doctors to be trained. The problem with increasing the supply of physicians it takes 10+ years for policy changes to have effects.
- deleted 3y ago
  [deleted]

by shkkmo 3y ago

pc86 3y ago

I am wildly in favor of expanding the number of medical schools, expanding med school class sizes, expanding residency slots and funding per resident. None of this means I want decisions now made by someone who does 4 years of college, 4 years of med school, 3-7 years of residency and potentially fellowship on top of that to instead be made by a nurse "under the supervision" of a doctor. If you're a doctor of one specialty and you want to change specialties, you have to redo residency and maybe fellowship. If you're a nurse and you want to change specialties the training is either on-the-job or measured in days/weeks.

shkkmo 3y ago
> one of this means I want decisions now made by someone who does 4 years of college, 4 years of med school, 3-7 years of residency and potentially fellowship on top of that to instead be made by a nurse "under the supervision" of a doctor. That is indeed the AMA the talking point to justify their stance. However my problem with the AMA here isn't that they support some scope restrictions (clearly many decisions do require full training) but that they strongly support ALL scope restrictions without data to support such a rigid hardline stance. They do this even when the loosening scope restrictions would decrease cost and increase availability without any harm to patient outcomes. This absolutely exacerbates the physician supply problem that the AMA created. If the AMA actually care about the physician supply issues in the country, it would work with state and federal regulators to identify which scope restrictions can safely be loosened.
- pc86 3y ago
  That it may be an AMA talking point doesn't make it wrong, and as far as I am aware the AMA is in favor of increasing physician at supply at the supply point - increasing medical school class sizes, increasing the number of medical schools, and increasing federal funding for residency programs (which can increase the number of slots, pay existing residents more, or both). The answer to a physician supply problem is increasing the supply of physicians, not having nurses do physicians' jobs.
  - shkkmo 3y ago
    > That it may be an AMA talking point doesn't make it wrong When an organization with a clear history of a specific agenda has a talking point, it is good to take the context of their agenda into account. I would point out that this particular agenda is one that has been largely achieved, which is why doctors in the USA make so much more than any other country and part of why our healthcare costs are so much higher. In this case, we have a problem that the AMA deliberately worked to create for 20 years. Now that their "oversupply of doctors" myth is no longer remotely tenable, the AMA argues that the ONLY way to solve the supply problem they created is a solution that takes 10+ years to take effect. We absolutely need to increase the number of doctors we have, but we also need to look at other ways we can safely increase patient access and decrease patient costs while we wait for new doctors to be trained. The problem with increasing the supply of physicians it takes 10+ years for policy changes to have effects.
deleted 3y ago
[deleted]