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Why It Takes Forever to Get a Doctor's Appointment (2023)
- NavinF 2y agoThe article whines about doctors having to read patient's charts and use crappy software while ignoring the elephant in the room. The average doctor makes $350k and specialists make even more. As salaries increase, the number of doctors does not increase (the way it would in any other industry) because there is a fixed number of doctors in the US each year. It's capped by law: https://www.advisory.com/daily-briefing/2022/02/16/physician-shortage https://www.advisory.com/daily-briefing/2022/02/16/physician... Note that other healthcare (generic drugs, telehealth, DEXA scans, etc) is dirt cheap in the US and has no waitlists. There is no cap on the number of Nurse Practitioners or DEXA techs.
- dataflow 2y agoI glanced at your article and didn't see where it says the number of doctors each year is capped by law. What law is it that does this?
- genocidicbunny 2y agoIn a roundabout way, the law that allow you to practice medicine only if you're a licensed doctor. The organizations that run the MD and DO programs in the US limit the number of students and residents added to the system every year, and unless you go through the whole program, you can't practice medicine legally.
- dataflow 2y ago> The organizations that run the MD and DO programs in the US limit the number of students and residents added to the system every year. The argument that a licensing requirement constitutes a legal cap is silly, otherwise you have to say every licensed profession is capped. It sounds like those organizations are capping it, not the law. And they could presumably change that decision without any change to the law.
- genocidicbunny 2y agoI was being a bit reductionist since it's really the interaction of multiple laws and policies, but largely they all boil down to money and licensing requirements for practicing medicine. Other responses to your parent comment explain it in a bit more detail, so you should take a look at those. The residency bottleneck is a real thing that I've had the mispleasure of hearing about from multiple friends and family members pursuing a medical degree.
- NavinF 2y agoDoctors must do three years of residency. More for specialists. The number of resident slots is limited because the gov't must pay a fixed amount to the hospital for each resident and that funding is capped. This is an intentional construction. More on that here: https://www.openhealthpolicy.com/p/medical-residency-slots-congress https://www.openhealthpolicy.com/p/medical-residency-slots-c...
- dataflow 2y agoIf that's what you mean then "there is a fixed number of doctors in the US each year. It's capped by law" seems like an incredibly misleading description of it. Why not just say "the US government underfunds residency programs"? Couldn't some other entity ostensibly fund these programs?
- NavinF 2y agoThe gov't forces itself to pay for residency programs. The intent of the law is to cap the number of new doctors each year. Other replies have answered your question in more detail
- dataflow 2y agoI've read the answers and I still don't see what legally prevents (for example) state governments from funding these. Is there a law that prohibits them from taking money from anybody other than the federal government?
- vsskanth 2y agoThe number of residency slots (a legal requirement to be a doctor) is limited because it's funded by Medicare and only Congress can increase it. AMA (American Medical Association) has lobbied to keep it that way.
- dataflow 2y agoIs there some legal obstacle to some entity other than Medicare funding it?
- 972811 2y agonot really, but private funding is generally pretty controversial with weird incentives (e.g. a company may only fund for positions that will create demand for their products--like a skincare company only funding dermatologists) [1] don't think many other entities besides the federal government have a ton of incentive to fund residency. and the federal government does have caps on residency slots [1] https://slate.com/technology/2005/06/private-funding-for-residency-slots.html https://slate.com/technology/2005/06/private-funding-for-res...
- dataflow 2y agoWhat about state governments?
- NavinF 2y agoStates do fund residency. This site says that state matching of federal Medicaid funds is ~12% of the total funding: https://mostpolicyinitiative.org/science-note/state-supported-physician-residency-programs/#:~:text=Federal%20funds%20support%20most%20medical,can%20increase%20rural%20healthcare%20supply https://mostpolicyinitiative.org/science-note/state-supporte.... Interesting related thread: https://www.reddit.com/r/Residency/comments/a01cfr/funding_your_own_residency_spot/ https://www.reddit.com/r/Residency/comments/a01cfr/funding_y...
- 972811 2y ago
- guywithahat 2y agoMy understanding is the balanced budget act of 1997 limits how many residency slots there can be, and then medical schools can also prevent new schools from being created through the LCME and ACGME. So schools will only graduate enough students for federal funding, and existing schools will keep other schools from being formed which might compete against them in new ways. Edit: this comment must have made a lot of people mad, because three other people responded within 5 minutes lol
- rakkhi 2y agoAustralia has many GP's now using apps. Very easy to get even a same day appointment. But we have single payer healthcare, with 2% of gross income taxed for Medicare. We also have a system that encourages high income earners to pay for additional private health. Seems like a good system to me.
- deleted 2y ago[deleted]
- Terr_ 2y ago> Ordering something as simple as Tylenol requires doctors to click between fourteen and sixty-two times, While number-of-clicks is relatively easy to tally, it can be a misleading metric. Better to have four clicks that are each really fast simple decisions as opposed to one click that takes you 30 seconds of squint-hunting through a giant grid, etc.
- pintxo 2y agoI guess we can all agree that 62-clicks is still a tiny bit (about 50 clicks or so) too much?