3 ms·

we also could just stop having the federal government limit the number of residency slots so we could have enough doctors trained in the US.

yablak 1y ago
And by not limit you mean fund. And I agree.
ZYbCRq22HbJ2y7 1y ago
https://www.beckershospitalreview.com/quality/hospital-physician-relationships/residency-programs-4-things-to-know/ https://www.beckershospitalreview.com/quality/hospital-physi... https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/
jmye 1y ago
Not just residency. Fix the cost (and capacity) of the education system as a whole, especially for mid-levels. There’s no reason this country should have such a chronic NP shortage, and you don’t need MD/DOs for most of the healthcare gaps we have. You also make rural care viable when you don’t have folks who need to pay off astronomical loans.
- kgwgk 1y ago
  > you don’t need MD/DOs for most of the healthcare gaps we have Or maybe you do! It’s for your own good. https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten https://www.ama-assn.org/practice-management/scope-practice/...
- mindslight 1y ago
  How are NPs not just the trend of enshittification? Most doctors already aren't very engaged in the tiny 15 minute slices of appointments, and now we're supposed to be happy that they'll be even less educated? The most straightforward way to address the doctor shortage is to make it so doctors are spending most of their time on healthcare, rather than appeasing "insurance" company bureaucrats with onerous paperwork.
  - jmye 1y ago
    What a weird comment. What do you think you need an MD for, in your primary care visit, that an NP can’t do? What do you actually know about their education? What do you actually know about licensing? How much time, in a day, do you think doctors are spending on “insurance”, and what specific experience leads you to believe that? (Because the actual answer is “near zero for literally any provider who isn’t completely independent, and almost none of them are, anymore”.) Or was this just a way to memetically add “enshittification” to a conversation it doesn’t even slightly apply to, but you think that’s currently trendy?
    - FireBeyond 1y ago
      You can be an NP in as few as 4-5 years out of high school with some courses. That’s to me the definition of not knowing what you don’t know. I’m a critical care paramedic who has corrected many NPs on fairly fundamental learning. I’ve found that nurses with significant field experience do very well, but there are plenty of courses who will “zero to hero” you fresh out of high school. Meanwhile, PAs go through a program near as rigorous as medical school and have to have physician supervision while NPs are not subject to oversight.
      - tptacek 1y ago
        Doctors begin delivering clinical care in year 3 of med school. You're doing a sleight of hand with this "out of high school" thing; doctors are also educated "out of high school", the difference between the two roles is 1-2 years before clinical practice, and NPs tend to practice supervised for longer periods of time than doctors. And, obviously, NPs cover a smaller range of conditions than doctors.
        FireBeyond 1y ago
        No, I’m really not. You can do an accelerated RN program in 12 months - though 18 months is more common. Many colleges offer RN to BSN courses. Some of them can be 12 months (and some less reputable places offer nine months). Add in a one year graduate nursing degree with some electives and in some states you are now eligible to practice as an ARNP or CRNP. I’ve personally met several NPs who are 24 years old and are practicing. The issue is that at that point you are ignorant or often cocky about your knowledge. Versus premed 4 year degree, med student practice in years 2 and 3 and continued hand holding through residency…? There’s just a little difference.
kgwgk 1y ago
Good luck getting the federal government to stop doing what the unio..., I mean, what the American Medical Association and representatives of the nation's medical schools ask for. https://web.archive.org/web/20200501175120/https://www.baltimoresun.com/news/bs-xpm-1997-03-01-1997060012-story.html https://web.archive.org/web/20200501175120/https://www.balti...

yablak 1y ago

And by not limit you mean fund. And I agree.

ZYbCRq22HbJ2y7 1y ago

https://www.beckershospitalreview.com/quality/hospital-physician-relationships/residency-programs-4-things-to-know/ https://www.beckershospitalreview.com/quality/hospital-physi... https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/

jmye 1y ago

Not just residency. Fix the cost (and capacity) of the education system as a whole, especially for mid-levels. There’s no reason this country should have such a chronic NP shortage, and you don’t need MD/DOs for most of the healthcare gaps we have. You also make rural care viable when you don’t have folks who need to pay off astronomical loans.

kgwgk 1y ago
> you don’t need MD/DOs for most of the healthcare gaps we have Or maybe you do! It’s for your own good. https://www.ama-assn.org/practice-management/scope-practice/ama-successfully-fights-scope-practice-expansions-threaten https://www.ama-assn.org/practice-management/scope-practice/...
mindslight 1y ago
How are NPs not just the trend of enshittification? Most doctors already aren't very engaged in the tiny 15 minute slices of appointments, and now we're supposed to be happy that they'll be even less educated? The most straightforward way to address the doctor shortage is to make it so doctors are spending most of their time on healthcare, rather than appeasing "insurance" company bureaucrats with onerous paperwork.
- jmye 1y ago
  What a weird comment. What do you think you need an MD for, in your primary care visit, that an NP can’t do? What do you actually know about their education? What do you actually know about licensing? How much time, in a day, do you think doctors are spending on “insurance”, and what specific experience leads you to believe that? (Because the actual answer is “near zero for literally any provider who isn’t completely independent, and almost none of them are, anymore”.) Or was this just a way to memetically add “enshittification” to a conversation it doesn’t even slightly apply to, but you think that’s currently trendy?
  - FireBeyond 1y ago
    You can be an NP in as few as 4-5 years out of high school with some courses. That’s to me the definition of not knowing what you don’t know. I’m a critical care paramedic who has corrected many NPs on fairly fundamental learning. I’ve found that nurses with significant field experience do very well, but there are plenty of courses who will “zero to hero” you fresh out of high school. Meanwhile, PAs go through a program near as rigorous as medical school and have to have physician supervision while NPs are not subject to oversight.
    - tptacek 1y ago
      Doctors begin delivering clinical care in year 3 of med school. You're doing a sleight of hand with this "out of high school" thing; doctors are also educated "out of high school", the difference between the two roles is 1-2 years before clinical practice, and NPs tend to practice supervised for longer periods of time than doctors. And, obviously, NPs cover a smaller range of conditions than doctors.
      - FireBeyond 1y ago
        No, I’m really not. You can do an accelerated RN program in 12 months - though 18 months is more common. Many colleges offer RN to BSN courses. Some of them can be 12 months (and some less reputable places offer nine months). Add in a one year graduate nursing degree with some electives and in some states you are now eligible to practice as an ARNP or CRNP. I’ve personally met several NPs who are 24 years old and are practicing. The issue is that at that point you are ignorant or often cocky about your knowledge. Versus premed 4 year degree, med student practice in years 2 and 3 and continued hand holding through residency…? There’s just a little difference.

kgwgk 1y ago

Good luck getting the federal government to stop doing what the unio..., I mean, what the American Medical Association and representatives of the nation's medical schools ask for. https://web.archive.org/web/20200501175120/https://www.baltimoresun.com/news/bs-xpm-1997-03-01-1997060012-story.html https://web.archive.org/web/20200501175120/https://www.balti...