3 ms·

All countries control rather strictly who can practice medicine. Yes, there is some amount of protectionism, but that happens almost everywhere. The reason is n

by rscho 2y ago

All countries control rather strictly who can practice medicine. Yes, there is some amount of protectionism, but that happens almost everywhere. The reason is not only money, but also cultural issues. So yes, I expect that to be a valid criticism, but I don't think opening the floodgates would have the result you expect either. Access to care is a complex problem, and IMO not primarily limited by doc counts in the US. Young docs would absolutely work less for less if possible, I think. Old docs wouldn't. IMO, that's reflected in the rise of big network providers such as Kaiser and friends. In Europe, access to care is better IMO mainly because both patients and docs are far less aggressive, and often quite happy just doing nothing. Which is in fact the true problem about US healthcare: the culture of absolutism.

whimsicalism 2y ago
> All countries control rather strictly who can practice medicine To pretend that the restrictions in other countries like Germany are at all comparable to the restrictions in the US is laughable. Just look at the work involved for a German doctor to legally practice in the US vs the reverse if the controls are so similarly strict (they're obviously not). You are very clearly engaging in motivated reasoning in this thread.
- rscho 2y ago
  I agree the US is especially restrictive. But that's just the US doing its usual thing: treating everywhere else as a 3rd world country. Docs from developing countries also have a hard time in Europe. You clearly have an axe to grind with MDs.
throwaway2037 2y ago
> cultural issues Can you explain this part a bit more? Can you provide some concrete examples?
- rscho 2y ago
  There is always a strong sense of national pride in medicine. Many people both inside and outside healthcare believe their nation has the best care, and make it an institution of sorts. It really seems stupid and insignificant, but the fact that foreigners are not feeling welcome has consequences. For example, US people often compare to german docs. Except I'm from Europe and having worked in the US, I can tell you I wouldn't go back to the US even for a million bucks. Why go somewhere you do 1.5x the hours, have a miserable quality of life and be treated like s##t, just to earn a little more ? So, if the US was to open the floodgates to foreign grads, I don't think the 'brain drain' would go the way people expect. Within the US, the limitation of admission of US students into med school is another matter. And I think people are probably right to call out protectionism in this case. But I have no first hand experience, being a foreign graduate myself. I'm just a random bloke having worked in Boston, though. So YMMV.

by rscho 2y ago

whimsicalism 2y ago

> All countries control rather strictly who can practice medicine To pretend that the restrictions in other countries like Germany are at all comparable to the restrictions in the US is laughable. Just look at the work involved for a German doctor to legally practice in the US vs the reverse if the controls are so similarly strict (they're obviously not). You are very clearly engaging in motivated reasoning in this thread.

rscho 2y ago
I agree the US is especially restrictive. But that's just the US doing its usual thing: treating everywhere else as a 3rd world country. Docs from developing countries also have a hard time in Europe. You clearly have an axe to grind with MDs.

throwaway2037 2y ago

> cultural issues Can you explain this part a bit more? Can you provide some concrete examples?

rscho 2y ago
There is always a strong sense of national pride in medicine. Many people both inside and outside healthcare believe their nation has the best care, and make it an institution of sorts. It really seems stupid and insignificant, but the fact that foreigners are not feeling welcome has consequences. For example, US people often compare to german docs. Except I'm from Europe and having worked in the US, I can tell you I wouldn't go back to the US even for a million bucks. Why go somewhere you do 1.5x the hours, have a miserable quality of life and be treated like s##t, just to earn a little more ? So, if the US was to open the floodgates to foreign grads, I don't think the 'brain drain' would go the way people expect. Within the US, the limitation of admission of US students into med school is another matter. And I think people are probably right to call out protectionism in this case. But I have no first hand experience, being a foreign graduate myself. I'm just a random bloke having worked in Boston, though. So YMMV.