3 ms·

Why can’t we have more doctors?

dessimus 3mo ago
The issue for doctors isn't medical school but the bottleneck is residency slots available post graduation. https://pmc.ncbi.nlm.nih.gov/articles/PMC12256077/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12256077/
- EvanAnderson 3mo ago
  That's an excellent link for getting down into the details. Thanks for posting it. > This editorial argues that the long-standing cap on residency slots, originating with the 1997 Balanced Budget Act, is the key structural constraint throttling the U.S. physician workforce. > In the 1990s, influential groups like the American Medical Association (AMA) and Association of American Medical Colleges (AAMC) had become convinced the U.S. faced an impending “physician oversupply.” In March 1997, just months before the BBA’s passage, a consortium of medical organizations, including the AMA, went so far as to recommend reducing the number of residency positions by 25% (from ~25,000 slots down to 19,000) to stave off a surplus [4]. “The United States is on the verge of a serious oversupply of physicians,” the AMA and others warned at the time. (Not sure how I feel about the ideas the editorial poses about using ML in a supervisory capacity for residents, though...)
  - antisthenes 3mo ago
    tl;dr educational nimby-ism. And we all pay the bill for the shortage.
EvanAnderson 3mo ago
The number of Medicare funded residency slots are limited by law. Medical schools won't graduate more doctors because residency can't be guaranteed. Who wants to be the med school who graduates doctors with >$100K debt and no path to licensure? In the 1990s the AMA lobbied congress to get the number of Medicare-funded slots limited. This was done in response to a projected "oversupply" of doctors (preventing a deflationary effect on doctors' compensation). That limit has stuck and now, even though the AMA is lobbying for the removal of the limit, the damage to the supply of doctors has been done and it's a process with a long pipeline.
- mishellaneous 3mo ago
  > The number of Medicare funded residency slots are limited by law. why don't hospitals fund residencies themselves? from what i hear, residents are poorly paid (they make less than nurses) and work long hours (almost like they "reside" in the hospital). i bet they even make money to the hospital. what's more, when you look at what people pay for healthcare in the USA, money to train residents is peanuts. it'd even make economic sense for people themselves to pool money together and fund residents which would then take care of them as an "alternative" to insurance.
kishkash 3mo ago
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The issue for doctors isn't medical school but the bottleneck is residency slots available post graduation. https://pmc.ncbi.nlm.nih.gov/articles/PMC12256077/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12256077/

EvanAnderson 3mo ago
That's an excellent link for getting down into the details. Thanks for posting it. > This editorial argues that the long-standing cap on residency slots, originating with the 1997 Balanced Budget Act, is the key structural constraint throttling the U.S. physician workforce. > In the 1990s, influential groups like the American Medical Association (AMA) and Association of American Medical Colleges (AAMC) had become convinced the U.S. faced an impending “physician oversupply.” In March 1997, just months before the BBA’s passage, a consortium of medical organizations, including the AMA, went so far as to recommend reducing the number of residency positions by 25% (from ~25,000 slots down to 19,000) to stave off a surplus [4]. “The United States is on the verge of a serious oversupply of physicians,” the AMA and others warned at the time. (Not sure how I feel about the ideas the editorial poses about using ML in a supervisory capacity for residents, though...)
- antisthenes 3mo ago
  tl;dr educational nimby-ism. And we all pay the bill for the shortage.

EvanAnderson 3mo ago

The number of Medicare funded residency slots are limited by law. Medical schools won't graduate more doctors because residency can't be guaranteed. Who wants to be the med school who graduates doctors with >$100K debt and no path to licensure? In the 1990s the AMA lobbied congress to get the number of Medicare-funded slots limited. This was done in response to a projected "oversupply" of doctors (preventing a deflationary effect on doctors' compensation). That limit has stuck and now, even though the AMA is lobbying for the removal of the limit, the damage to the supply of doctors has been done and it's a process with a long pipeline.

mishellaneous 3mo ago
> The number of Medicare funded residency slots are limited by law. why don't hospitals fund residencies themselves? from what i hear, residents are poorly paid (they make less than nurses) and work long hours (almost like they "reside" in the hospital). i bet they even make money to the hospital. what's more, when you look at what people pay for healthcare in the USA, money to train residents is peanuts. it'd even make economic sense for people themselves to pool money together and fund residents which would then take care of them as an "alternative" to insurance.

kishkash 3mo ago

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