Quote:
Originally Posted by blueash
Lots of opinions and a couple of "facts" upon which those opinions were formed.
Easiest to fact check, how many applicants were there for medical schools in 1978? was is 129000 US applicants? Not even close. In 1978 there were under 30,000 applicants. The last year reported in 2014 had the highest number of applicants in history.
Medical School Applicants, Enrollment Reach All-time Highs - News Releases - Newsroom - AAMC
Medical School Applicants, Enrollees Reach New Highs - News Releases - Newsroom - AAMC
Long term trends are here up to 2002 Medical Schools And Their Applicants: An Analysis
So that fact is in error by a huge amount.
Primary care providers no longer means physicians. An increase of 10% in the number of insured lives means that all else being equal, you need 10% more primary providers. This requirement is likely to be met by advanced practice nurses and PA's in large part, freeing the more highly trained MD's and DO's to handle the non-routine patient care.
In 1965 23% of residency positions were filled by foreign medical graduates
Foreign Medical Graduates in the United States - Harold Margulies, Lucille Stephenson Bloch - Google Books
and it is 21% now
Medscape: Medscape Access
When you start with non-factual facts, you might end up with non-reasonable conclusions, or not
As to what we Americans will stand for, that is for the political forum but to suggest that there is some secret conspiracy of people attempting to collapse the health care industry is .... |
Thank you for the update---my info is about 10-12 years old.
The 129,000 number was just what we were told in 1978, it may have included non-US citizens, or been inflated to emphasize the competitiveness of the process, so my apologies
According to your own citation, medical school applicants dropped from 47,000 to 32,000 from 1996 to 2003--but yes, those numbers have since rebounded
It did not state whether "residency programs" also included fellowship programs. Since many fellowships went from 2 to 3 years, the number finishing each year declined by 33%. In addition, about 50% of medical school graduates are now women, and that is great---however, women physicians tend to work less hours and have career interruptions for maternity leave, numbers alone don't tell the whole story
I still question the qualifications of new applicants. MCAT scores have declined. The pass rate on NBME pat I is now down to 85%---a test that my dog could pass( yes, that's a hyperbole). I sat on the admissions committee at SUNY and we had applicants with 2.3 GPAs and 35 on the MCATs---so not all "applicants" are created equal
Now, that takes care of new physicians, and your numbers are accepted. It does not include the accelerated attrition of existing physicians. The AMA estimated that as many as 250,000 current clinical MDs out of 900,000 will be lost to alternative careers and early retirement over the next 5 years. And the demand will only go up. In addition, more physician time is spent on documentation and regulation, so the number of hours in direct patient care has declined, per physician
I love nurse practitioners, but there is a pitfall there also. NPs, on average , will order far more lab tests and imaging procedures for the same condition than an experienced MD would. This drives up cost. They do spend more time with each patient, but therefore see less numbers, so you cannot substitute them for MDs 1 for 1.
So regardless of some of my inaccurate or out of date numbers, I stand by my opinion that the quality of medical in the US is going to go down, not up.