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-   -   Let's put an end to the doctor shortage: (https://www.talkofthevillages.com/forums/medical-health-discussion-94/lets-put-end-doctor-shortage-132759/)

dbussone 11-10-2014 04:29 PM

Quote:

Originally Posted by Villages PL (Post 966340)
I'll repeat the quote from Wikipedia: "A student on a pre-med track is permitted to choose any undergraduate major in any field of study, so long as certain required courses are completed."



If they are allowed to choose any undergraduate major, then that would include art and music.


Perhaps, but I can tell you from personal experience that many (probably most) colleges with strong science schools have pre-med tracks that leave little time for anything but core science courses/pre-med requirements. The first year undergrad may have English, a language, etc. But by the second year students are trying to survive organic chemistry and other similar courses.

It is not uncommon, for those who know they will go the pre-med route, to take AP courses in high school to get extraneous courses out of the way.

applesoffh 11-10-2014 04:34 PM

My ex just retired from the medical profession. Young people may no longer be as motivated to go into medicine because of the cost of medical school being so prohibitive. In addition, I read in the NY Times a number of years ago how medical schools themselves keep the number of admissions artifically low to limit the number of doctors they graduate. Ditto the number of residencies given out. Just because someone graduates medical school doesn't guarantee a residency. Assuming a successful residency in a specialty, the doctor can now go out and earn a living, if they can find a practice. Can't afford to start one alone. Unless the doctor lives in a big city, she/he may not find a job. If you go where doctors are needed in this country, it's difficult to make a living. If you have a specialty, you have a begtter chance of earning a decent living than if you are a family physician, general practioner or internist. Specialists command more $$$. If you ask why there are so many foreign-born doctors in general practice, that's one of the reasons. They are sought out because they carry much less debt than an American-trained physician. I learned an awful lot putting my ex through school. (as an aside, he still carries debt; I'm retired!)

sunnyatlast 11-10-2014 04:36 PM

This whole thing is off track from the get-go, based on a faulty premise.

The dr. shortage is not due to their years of schooling or curriculum. It's due to fewer residency positions than there are graduates coming out of med school.

Required residency training is paid for in large part with Medicare funds, (supplying doctors in training at lower pay at teaching hospitals) and Medicare funding to the training programs is being cut by Congress, not increased:

New England Journal of Medicine -The Residency Mismatch
(The link works despite "error" inserted by forum):

MMS: Error

dbussone 11-10-2014 04:38 PM

Quote:

Originally Posted by Villages PL (Post 966369)
Two less years of schooling would help alleviate the above concern.



Yes, they would be valuable assets but we don't know how much more of those qualities they would have with 4 years of undergraduate study as opposed to 2 years.



Then how about giving people a choice? I think a doctor might be better adjusted and more "well rounded" if he/she got out of school sooner. Especially due to the fact that a lot of college work requires memorizing rather than creativity.



What basis do you have for saying it won't make a dent? More people will be able to afford becoming a doctor. That alone may be a big incentive. Not to mention the fact that they wouldn't have to put off living their lives for as long. And that in itself would make life less stressful.


There is a 6 year option for pre-med and med school. It is an extremely intensive education which involves going to school year round. Beyond med school most docs go for additional training for anywhere from 6 - 12 years. This additional training alone makes it near impossible to cut down the total length of training.

There's also a group called the AAMC (association of American medical colleges) that accredits medical schools based on scientifically based data.

dbussone 11-10-2014 04:41 PM

Quote:

Originally Posted by sunnyatlast (Post 966406)
This whole thing is off track from the get-go, based on a faulty premise.

The dr. shortage is not due to their years of schooling or curriculum. It's due to fewer residency positions than there are graduates coming out of med school.

Required residency training is paid for in large part with Medicare funds, (supplying doctors in training at lower pay at teaching hospitals) and Medicare funding to the training programs is being cut by Congress, not increased:

New England Journal of Medicine -The Residency Mismatch
(The link works despite "error" inserted by forum):

MMS: Error


Bingo. I was just getting ready to bring this up. In the late 90's the Feds capped the number of residency slots that are reimbursable in part by Medicare. This has become the bottle neck for more docs.

JoMar 11-10-2014 04:58 PM

And no mention of malpractice insurance, the impact lawyers have on the cost of medical care, the governments involvement through regulation, the patent practice. Seems we blame the doctors, which probably is the lowest cost factor in the equation. Of course we can do what others do, socialize medicine, have the government pay for their education and then tax the heck of the citizens to support it.

dbussone 11-10-2014 07:36 PM

Quote:

Originally Posted by JoMar (Post 966417)
And no mention of malpractice insurance, the impact lawyers have on the cost of medical care, the governments involvement through regulation, the patent practice. Seems we blame the doctors, which probably is the lowest cost factor in the equation. Of course we can do what others do, socialize medicine, have the government pay for their education and then tax the heck of the citizens to support it.

We are on the path you describe unless something drastic happens. I've been an inside observer for more than 40 years. I am the first to admit that there are things that need to be done differently. However, I've studied other countries' systems, and consulted in Canada and Germany for their governments wishing to make some pro market changes. Having said that, we are in the process of destroying the best health system in the world. And I hate to see that happen...for my kids, and their kids sake.

Barefoot 11-10-2014 07:54 PM

Quote:

Originally Posted by BarryRX (Post 966305)
If you're saying we should let people apply to med school after only 2 years of university, then we would see a whole bunch of folks that don't have the building blocks needed to pass the first year of medical school. Take a look at a typical pre med curriculum. I think the problem here is that you don't have a very good idea of what a pre med and medical education entail.

Quote:

Originally Posted by Bogie Shooter (Post 966322)
I want to be on BarryRX's team.

Quote:

Originally Posted by Villages PL (Post 966376)
It seems that U.S. physicians don't live as long, on average, as the rest of the population. I believe the average lifespan in the U.S. is about 78.

White physicians only live to 73 on average
Black doctors................68.7
Surgeons................68

And we entrust our health to them because they are better educated and well rounded.

I don't think that VPL is serious about doctors having "too much education".
I think he is just being controversial. But if he is serious, Barry, I want to be on your team too.

SALYBOW 11-10-2014 10:06 PM

My son is a doctor so we have some insight on this
 
He would contend that the lack of good, plentiful docotrs in mostly due to the low number of spots available in Medical schools. We have an affirmative action system in this country which makes the Medical schools accept many applicants from other countries and other ethnicities. Some of these docs return to their native countries and the rest come to FL. LOL
The reason there are so few opppening in the Med Schools is that the AMA does not want an overabundance of docs splitting the pie. Since an doctor can get a huge amount of student loans money should not be the problem there. The place where money becomes a problem is that with the huge cuts in pay that doctors are being forced to take is making all that hard work less attractive. Medical school is really a tough row to hoe.

perrjojo 11-10-2014 10:09 PM

There are fewer physicians because medical school is expensive and the student is going into the workforce 4 years later than other college graduates. After going into practice the physician is not his / her own boss. Their practice is run by insurance companies and the government. Medicare, Medicaid and insurance reinbursemets are decreasing each year. Expensive equipment, large number of staff needed to process all of the paper work are causing the physicians overhead to go through the roof. That is why we are having fewer doctors. Who would what to go through all of that? Oh, and then patients are non compliant and call them incompetent.

blueash 11-10-2014 10:29 PM

Quote:

Originally Posted by SALYBOW (Post 966584)
He would contend that the lack of good, plentiful docotrs in mostly due to the low number of spots available in Medical schools. We have an affirmative action system in this country which makes the Medical schools accept many applicants from other countries and other ethnicities. Some of these docs return to their native countries and the rest come to FL. LOL
The reason there are so few opppening in the Med Schools is that the AMA does not want an overabundance of docs splitting the pie. Since an doctor can get a huge amount of student loans money should not be the problem there. The place where money becomes a problem is that with the huge cuts in pay that doctors are being forced to take is making all that hard work less attractive. Medical school is really a tough row to hoe.

Do you have any references to support your contention that there is a system forcing medical schools to accept foreign applicants and other "ethnicities" whatever that might mean? What are the huge pay cuts you believe primary care or any doctors have taken? Do you have data? By what mechanism does the AMA, in your research, manage to keep new medical schools from opening?

blueash 11-10-2014 10:48 PM

In 2013 there were 20,055 students accepted in US medical schools. Of that number, 115 are residents outside the US. An additional small number are unclassified.

Of those 20,055 students, 1826 are Hispanic or Spanish surname, 1234 are Black, 3713 are Asian, 10,374 are White, the remainders are mixed or unknown or other.

blueash 11-10-2014 11:13 PM

Quote:

Originally Posted by Villages PL (Post 966376)
It seems that U.S. physicians don't live as long, on average, as the rest of the population. I believe the average lifespan in the U.S. is about 78.

White physicians only live to 73 on average

Black doctors................68.7

Surgeons................68

And we entrust our health to them because they are better educated and well rounded.

Where did you get your statistic? Here is the last published data I could locate for your claim, and it is the opposite of your conclusion:

Mortality rates and causes among U.S. physicians. - PubMed - NCBI

"Among both U.S. white and black men, physicians were, on average, older when they died, than were lawyers, all examined professionals, and all men."

CFrance 11-10-2014 11:24 PM

According to FoxNews Politics,
Congress passes bill to stop cut in payments to Medicare doctors | Fox News
there has not been a cut to the payments made to doctors by Medicare since 1997, except for one in 2002. Every year it comes up, and every year congress passes a last-minute patch to the proposed cuts. Would someone who thinks Medicare keeps cutting payments to doctors correct me with facts if I am wrong? (Not trying to be a wiseacre; just trying to understand the situation.)

sunnyatlast 11-11-2014 12:08 AM

Quote:

Originally Posted by CFrance (Post 966613)
According to FoxNews Politics,
Congress passes bill to stop cut in payments to Medicare doctors | Fox News
there has not been a cut to the payments made to doctors by Medicare since 1997, except for one in 2002. Every year it comes up, and every year congress passes a last-minute patch to the proposed cuts. Would someone who thinks Medicare keeps cutting payments to doctors correct me with facts if I am wrong? (Not trying to be a wiseacre; just trying to understand the situation.)

"Cuts to teaching hospitals and graduate medical education (residency training) payments.

The budget proposes reducing Medicare add-on payments to teaching hospitals by 10 percent. Typically, hospitals receive those add-on payments to cover the indirect costs of teaching new physicians. In addition, HHS would encourage teaching hospitals to train more primary care residents through new GME payment standards.

Teaching hospitals would lose $960 million in Medicare payments in this upcoming year alone and more than $14.6 billion during the next decade."

Obama's Budget for 2015: 10 Points for Hospitals Know


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