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'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors
- nis0s 11mo agoI suppose they could expand medical school admissions for Americans, why don’t they? It’s not for lack of talented people, the class size quotas are an archaic classist and partly racist way of thinking that have nothing to do with meritocracy, but instead are imposed to make sure that more undesirables don’t join the “elites” of society.
- cj 11mo agoSome quick Googling surfaces the number of residency slots as being another limiting factor to medical school admissions. Apparently, federal funding caps the maximum number of residency slots which creates a bottleneck in the system. It's most likely the case that there are multiple different bottlenecks. It's not just 1 person in a room somewhere saying "we need to make protect the elite!" - it's more likely just a lot of people continuing the status quo and few people fighting the change it.
- nis0s 11mo agoSee this from another comment by someone else > The AMA pushed for limited residency slots ~20 years ago, as they feared too many doctors would cut their own incomes.
- alistairSH 11mo agoThe AMA pushed for limited residency slots ~20 years ago, as they feared too many doctors would cut their own incomes. For some reason, residencies are paid by the federal government. Not sure of the history there - I find it hard to believe a resident doctor is a net-loss for the hospital system. Either way, I can't find any legal cap on number of residents - only a cap on funded slots (ie, a hospital could hire more residents and pay them out of pocket).
- paleotrope 11mo agoThe residency system itself is a relic and represents a sort of trapped labor system.
- alistairSH 11mo agoThat might be true, but at the same time, do we really want doctors who haven't completed some form of apprenticeship? The hours/shift were sliced in 2003 and again in 2011. Though they're still much higher than what's normal in the EU. What I can't quite figure out is patient outcomes... morbidity appears to have increased (very slightly) as resident working hours were reduced (possibly more risk from handoffs than tired MDs?) - how does the EU compare in this regard? Somebody must have done a study... Anyway, some form of on-the-job training seems reasonable here. But the current residency system in the US definitely appears broken, for several reasons.
- deleted 11mo ago[deleted]
- jmclnx 11mo agoSimple, US health care continues to fall behind other Industrial Countries. But the big ask here is, what is wrong with the US educational System that forces people to avoid becoming medical professionals ? Maybe when Trump is gone, this specific situation may revert back to pre-trump. But that does not mean education will be fixed.
- nxm 11mo agoUS health care continues to fall behind other Industrial Countries. Can you provide evidence of this? The services are top notch, and over 90% of people have health insurance. Moreover, in other single payer systems (Canada, Poland) I keep hearing about months long wait for procedures until you go private/out-of-pocket.
- emestifs 11mo agoSorry, but as an outsider from one of those other countries you mention, I don't get what you mean by top notch? Top notch for whom? The people who can afford to pay out of pocket? Or those willing to do into debt to just get treatment? Whenever I see news from places like PBS News Hour, it's about some low wage or senior person struggling to just care for their medical needs or prescriptions. I don't know my guy, your system isn't exactly top notch for most people - I don't think you need to look very hard to see that if you try. Random examples: - https://upload.wikimedia.org/wikipedia/commons/0/0b/OECD_health_expenditure_per_capita_by_country.svg https://upload.wikimedia.org/wikipedia/commons/0/0b/OECD_hea... - https://upload.wikimedia.org/wikipedia/commons/d/d6/Life_expectancy_vs_healthcare_spending.jpg https://upload.wikimedia.org/wikipedia/commons/d/d6/Life_exp... There's something very very wrong here when your paying that much per capita and a lot of people are still struggling.
- cosmotic 11mo agoThe unique thing about the US healthcare system is that care is directly proportional to how much money you can spend on it. So as a top spender, yes the care is great. Though realistically we should look at the system as a whole for all people it "covers". Looking at infant mortality rate, life expectancy, etc, for the average person, the picture is bleak; the US is shockingly bad.
- incomingpain 11mo agoGreat news for Canada. Thanks we'll keep our doctors. Bad news for New York, New Jersey, California, Maryland; or more aptly labelled democrat controlled states. Probably the only republican state impacted will be florida, but they often buck trends like this. they'll keep their immigrant doctors.
- alistairSH 11mo agoThe article states rural areas tend to be served by a higher proportion of immigrant doctors. The densely populated coasts will probably be fine - the higher salaries will continue to attract US-born and limited immigrant doctors.
- hakunin 11mo agoDoctors are paid more in rural areas than in big cities, a reverse of most other professions.
- alistairSH 11mo agoHuh, true enough. I linked one summary. $200k urban vs $205k rural median offers to new doctors overall. But, in surgical practices, that flips well in favor of urban offers. But, that's just for new MDs. Career numbers skew even more to rural doctors https://resources.nejmcareercenter.org/article/demystifying-urban-versus-rural-physician-compensation/ https://resources.nejmcareercenter.org/article/demystifying-...
- flag_fagger 11mo agoI spoke to a doctor at a bar a couple years back and he was telling me apparently out in North Dakota you can get a $400k salary as a family doctor.
- hakunin 11mo agoYes, Montana too.
- Ksknsbz 11mo ago[flagged]
- Philpax 11mo ago> I don’t want a doctor who has another country they call home. I want a doctor who feels some blood and soil attachment to their patients. But like... why? Why does that matter at all?
- deleted 11mo ago[deleted]
- alistairSH 11mo agoBecause jingoism.
- Ksknsbz 11mo agoThe same reason a parent cares for their child more than a random strangers? Cultures and people matter.
- Philpax 11mo agoNope, sorry, still not seeing it. You'll have to spell it out for me.
- deeg 11mo agoAre you saying that if you were a doctor you'd care less about patients from another country?
- taylodl 11mo agoYes, that is what they're saying. They're projecting and assuming everybody else is just like them. Thankfully, they're not.
- nis0s 11mo agoI think you fundamentally misunderstood any aspect of society, civility and community building if you adhere to such ideas. The issue at hand is bad governance and resource management, not that “immigrants should be kept out”. Immigration is needed at different parts of a country’s economic timeline, and the levels of immigration needed can vary depending on your needs to balance labor supply and demand. This isn’t about racism, or cultural differences. This is about good governance.
- antibull 11mo ago[dead]
- deepfriedchokes 11mo agoIf the residency restrictions were removed the labor market would work as intended. We’re doing this to ourselves to protect private profits at the expense of people’s lives. https://www.openhealthpolicy.com/p/medical-residency-slots-congress https://www.openhealthpolicy.com/p/medical-residency-slots-c...