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The planning of U.S. physician shortages (2020)

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Re: The planning of U.S. physician shortages (2020)

#51

Post by the_d3f4ult »

SkyPuncher wrote: post #45
trustingtrust wrote: post #13

Earlier quoted context omitted.

I hope it’s not as easy to make a doctor as it is to make an engineer. I am an engineer dating a surgical resident who has to go through so much training that an engineer would never even come close to an engineer. The room for error is quite small. If it was as easy to make a doctor as an engineer I would lose faith in the medical system and would never want such a doctor opening me up.

I’m married to a doctor. My opinion is training level generally needs to correlate to the level of acuity. Surgeons will always need to be extremely highly trained because they do not have the ability to hesitate. Most of healthcare simply isn’t anywhere near the acuity level of surgery. By far, the biggest need is primary care. The exact opposite of acute. The rigor, effort, and expense of medical school simply does…

Physician lobbies are notorious for not actually aligning with physicians' interests and, rather, being in the pockets of the hospital industry. The AMA is the worst for this. Most physicians feel that they do not have a voice anymore.

Re: The planning of U.S. physician shortages (2020)

#52

Post by ch4s3 »

whitemary wrote: post #14
bruce511 wrote: post #6

Planning and predicting highly variable systems is hard. Long-range interventions are especially risky given the possibilities for unexpected consequences and also the long lead times in fixing the problems. Central planning on resources has been especially rife with failed examples (the USSR being the all-in poster child.) As the article points out, the concept of central planning is orthogonal to who is providing t…

"Communist" Cuba has 64 physicians per 10K population, which is 2nd in the entire world for physicians per capita. https://en.m.wikipedia.org/wiki/List_of_countries_and_depend... During the pandemic, they were sending droves of doctors to Europe. They offered to assist in NYC but Trump turned them away as our population dwindled. Famously, when a British cruise ship with ill passengers aboard was denied by ports in F…

I'm not sure how they could have assisted with anything, they basically have no medical supplies[1][2][3][4]. And before you bring it up, no medical supplies aren't covered by the embargo, they get a special exemption since the 90s.

[1] https://havanatimes.org/cuba/medicine-shortages-a-challenge-...

[2] https://www.reuters.com/world/americas/cuban-diaspora-sends-...

[3] https://www.sabcnews.com/sabcnews/south-african-medical-stud...

[4] https://cuba.miami.edu/business-economy/a-close-look-at-cuba...

Re: The planning of U.S. physician shortages (2020)

#53

Post by codersfocus »

whitemary wrote: post #14
bruce511 wrote: post #6

Planning and predicting highly variable systems is hard. Long-range interventions are especially risky given the possibilities for unexpected consequences and also the long lead times in fixing the problems. Central planning on resources has been especially rife with failed examples (the USSR being the all-in poster child.) As the article points out, the concept of central planning is orthogonal to who is providing t…

"Communist" Cuba has 64 physicians per 10K population, which is 2nd in the entire world for physicians per capita. https://en.m.wikipedia.org/wiki/List_of_countries_and_depend... During the pandemic, they were sending droves of doctors to Europe. They offered to assist in NYC but Trump turned them away as our population dwindled. Famously, when a British cruise ship with ill passengers aboard was denied by ports in F…

The thing is, not all of those doctors work in Cuba. The government rents them to neighboring countries to make money.

Re: The planning of U.S. physician shortages (2020)

#54

Post by ch4s3 »

bruce511 wrote: post #38
alehlopeh wrote: post #22

Earlier quoted context omitted.

What’s with the scare quotes around communist? Sure they have a lot of doctors. And how many of those doctors are allowed to do business as a private practice? Or how many would be allowed to change careers if they wanted to? How many are allowed to spend their income at fancy places, where the currency they get paid in isn’t even accepted? Hate to break it to you, but “your” worldview is incredibly, laughably, misin…

Again, it's best not to align planning to political methodologies. Cuba has success stories. That isn't a vote for communism. Equally, another "communist" state (China) is doing very well and while there is a lot of planning there, there is also a lot of free-market. Again, not a vote for communism. I use communist in quotes here because Chinese communism is different to communism as practiced in the USSR. Just like…

Cuba actually has a terrible health system that lacks even basic medical supplies like aspirin and antibiotics[1]. The state department and in the past MSF have called their medical missions modern day slavery[2][3]. There are also a lot of questions about the quality of Cuban medical training[4].

[1]https://cuba.miami.edu/business-economy/a-close-look-at-cuba...

[2]https://www.reuters.com/article/us-usa-cuba-trafficking/u-s-...

[3] https://www.hrw.org/news/2020/07/23/cuba-repressive-rules-do...

[4] https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909...

Re: The planning of U.S. physician shortages (2020)

#55

Post by fma »

carabiner wrote: post #19
trustingtrust wrote: post #13

Earlier quoted context omitted.

I hope it’s not as easy to make a doctor as it is to make an engineer. I am an engineer dating a surgical resident who has to go through so much training that an engineer would never even come close to an engineer. The room for error is quite small. If it was as easy to make a doctor as an engineer I would lose faith in the medical system and would never want such a doctor opening me up.

You're only referring to SWE, right? I've noticed that there are no bootcamps for becoming an aerospace engineer and getting a job at Boeing.

And actual engineering disciplines you can't do jack squat unless someone w/ a PE license signs off on it and becomes legally liable. Meanwhile Tesla deploys OTA at will... Oh yeah - and why be a medical doctor, or a Professional Engineer when you can make more money with less debt without the legal liable...

Re: The planning of U.S. physician shortages (2020)

#56

Post by MauroIksem »

w10-1 wrote: post #46
trashface wrote: post #27

The health care industry seems to be profiting off this by having more care provided by nurse practitioners and physician assistants but billing the insurers same as they would charge for M.D./D.Os.

Medicare and most insurance strictly control this. But the industry benefits from a constrained supply of doctors because it means less competition; laws ultimately require doctors to be in charge of a practice. Some laws are now even restricting the number of PA/NP's that can be supervised, but it's not a strong effect. Some states permit NP's to practice without a physician, but PA's all require a supervising physi…

PA's no longer require a supervising physician. Also why do people seem to think PAs and NPs are equivalent? PA's have 4x the clinical experience/ training that NPs have. 2000 hours vs 500 and MDs at 4000.

Re: The planning of U.S. physician shortages (2020)

#57

Post by codersfocus »

ch4s3 wrote: post #52
whitemary wrote: post #14

Earlier quoted context omitted.

"Communist" Cuba has 64 physicians per 10K population, which is 2nd in the entire world for physicians per capita. https://en.m.wikipedia.org/wiki/List_of_countries_and_depend... During the pandemic, they were sending droves of doctors to Europe. They offered to assist in NYC but Trump turned them away as our population dwindled. Famously, when a British cruise ship with ill passengers aboard was denied by ports in F…

I'm not sure how they could have assisted with anything, they basically have no medical supplies[1][2][3][4]. And before you bring it up, no medical supplies aren't covered by the embargo, they get a special exemption since the 90s. [1] https://havanatimes.org/cuba/medicine-shortages-a-challenge-... [2] https://www.reuters.com/world/americas/cuban-diaspora-sends-... [3] https://www.sabcnews.com/sabcnews/south-african…

There's a US law that says any ship that docks with Cuba can't dock with the US. Considering that modern shipping relies on big ships making many port calls, this law restricts Cuba's access to stuff like medical supplies.

Re: The planning of U.S. physician shortages (2020)

#58

Post by MauroIksem »

lotsofpulp wrote: post #26
nemonemo wrote: post #23

I doubt US would be able to see a level of medical accessibility on par with many European countries. The medical education system has a perverse incentive to reduce the yearly graduates -- the less graduates there are, the more profits and prestiges each of the current members can garner (with arguably better trained graduates) -- and as shown in the article, they seem to have monopolistic capability for the throttl…

There already has been. The solution was to pump out physician assistants (PAs) and nurse practitioners (NPs) that require a fraction of the training of a doctor to get licensed, and then have them practice medicine under the “supervision” of a doctor. Some states even went as far as giving people with no medical training the right to prescribe, such as naturopaths, whatever that means. So it is up to each person now…

You're being disingenuous. PAs are required to have 2000 hours of clinical experience before they can sit for their licensing exam. NPs however only require 500 hours. MDs require 4000 hours.

Re: The planning of U.S. physician shortages (2020)

#59

Post by [deleted] »

ch4s3 wrote: post #54
bruce511 wrote: post #38

Earlier quoted context omitted.

Again, it's best not to align planning to political methodologies. Cuba has success stories. That isn't a vote for communism. Equally, another "communist" state (China) is doing very well and while there is a lot of planning there, there is also a lot of free-market. Again, not a vote for communism. I use communist in quotes here because Chinese communism is different to communism as practiced in the USSR. Just like…

Cuba actually has a terrible health system that lacks even basic medical supplies like aspirin and antibiotics[1]. The state department and in the past MSF have called their medical missions modern day slavery[2][3]. There are also a lot of questions about the quality of Cuban medical training[4]. [1] https://cuba.miami.edu/business-economy/a-close-look-at-cuba... [2] https://www.reuters.com/article/us-usa-cuba-traff…

[deleted]

Re: The planning of U.S. physician shortages (2020)

#60

Post by feraloink »

DieBruderBauer wrote: post #5

discriminatory MCATs, brutal STEPS, insane Pre-Med curriculum, and more nonsense designed to cater to white elites who gamed the educational system and less to those who are genuinely trying to help the disenfranchised, unremembered, diverse and more. Hopefully one day, we'll make it as easy to become a doctor as it is to -- say -- become an Engineer.

>... less to those who are genuinely trying to help the disenfranchised, unremembered, diverse and more.

There are many government and philanthropic institution-sponsored programs in the U.S. that repay 100% of medical school, dental school, or medical specialty tuition and expenses, in return for committing to five to 10 years of medical service, on site, to remote or under-served communities.

'Remote' can be rural communities in Appalachia. They can be 'under-served' and very remote, e.g. for American indigenous people who live on their sovereign nation's land.

Under-served communities can also be in economically devastated cities (usually due to offshoring of manufacturing) in the Midwest or East Coast where people of color and white people lack access to medical care that is within walking distance or public transport.

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