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'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

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Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#41

Post by soco »

jswelker wrote: post #6
jmclnx wrote: post #3

Simple, 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.

I think the issue is US _culture_, not education (although the two are intertwined). We had too many easy years where you could take a Jack Kerouac road trip for 5 years to find yourself and then settle down to the equivalent of a cushy 6 figure job just for being a man with a pulse. Now if you do that, you will come back to find all the cushy jobs filled, and you are unqualified for anything except bottom of barrel…

Getting into the medical school and staying there for so many years until you can support yourself means also a huge investment from the family. Now, what is the culture saying about this? Would you keep your kids on your paycheck until they're almost 30, or you throw them out to get a job as soon they're 16? And of course, can the kids already afford to be independent and support themselves when they're 16 (aah sweet liberty fuck those geezers)? These are I believe other major contributing factors in western societies.

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#42

Post by tastyface »

Philpax wrote: post #13
Ksknsbz wrote: post #11

[flagged]

> 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?

FYI, "blood and soil" is a white supremacist dog whistle. That would probably explain the why.

Ugh, we need hard IP bans on this site.

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#43

Post by deeg »

Ksknsbz wrote: post #24
eesmith wrote: post #17

Earlier quoted context omitted.

> I want a doctor who feels some blood and soil attachment to their patients. "Blood and soil (German: Blut und Boden) is a nationalist phrase and concept of a racially defined national body ("Blood") united with a settlement area ("Soil"). Originating in the German völkisch movement, it was used extensively by Nazi Germany, ... North American white supremacists, white nationalists, Neo-Nazis and members of the alt-r…

I’m not a nazi. There is nothing wrong with wanting to live and work with people of your culture.

There IS something wrong with doctors treating people differently due to race, country, religion, gender, etc.

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#44

Post by alistairSH »

paleotrope wrote: post #39
alistairSH wrote: post #12

Earlier quoted context omitted.

The 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 mor…

The residency system itself is a relic and represents a sort of trapped labor system.

That 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.

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#45

Post by archagon »

jswelker wrote: post #6
jmclnx wrote: post #3

Simple, 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.

I think the issue is US _culture_, not education (although the two are intertwined). We had too many easy years where you could take a Jack Kerouac road trip for 5 years to find yourself and then settle down to the equivalent of a cushy 6 figure job just for being a man with a pulse. Now if you do that, you will come back to find all the cushy jobs filled, and you are unqualified for anything except bottom of barrel…

At our current level of technological advancement, we should be able to get far more than a 5y Kerouac road trip before joining the grind. Where are all those supposed productivity gains going? Why are we becoming less free?

(This is sort of an aside. Yes, bring all the hardworking immigrants here, please. And maybe let them have those road trips, too.)

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#46

Post by bulbar »

Ksknsbz wrote: post #19
Philpax wrote: post #13

Earlier quoted context omitted.

> 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?

The same reason a parent cares for their child more than a random strangers? Cultures and people matter.

Doctors with proper training will do what they were trained for. Maybe personality traits play a role as well secondary, but stuff like culture is just noise compared to what really matters.

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#47

Post by deepfriedchokes »

If 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-c...

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#48

Post by array_key_first »

archagon wrote: post #45
jswelker wrote: post #6

Earlier quoted context omitted.

I think the issue is US _culture_, not education (although the two are intertwined). We had too many easy years where you could take a Jack Kerouac road trip for 5 years to find yourself and then settle down to the equivalent of a cushy 6 figure job just for being a man with a pulse. Now if you do that, you will come back to find all the cushy jobs filled, and you are unqualified for anything except bottom of barrel…

At our current level of technological advancement, we should be able to get far more than a 5y Kerouac road trip before joining the grind. Where are all those supposed productivity gains going? Why are we becoming less free? (This is sort of an aside. Yes, bring all the hardworking immigrants here, please. And maybe let them have those road trips, too.)

It's obvious to me the gains of our productivity is being siphoned up. The US economy is... very weird right now, and has been getting weird for a few decades. I wouldn't even consider the US a capitalist nation, what we have is something new.

Most companies don't do anything, most investors make money without putting in any labor, and money just... poof, appears. But not for us. Nothing really seems to make sense anymore.

Things that were trivial before, like having a receptionist to answer your phone, now seems economically impossible. And yet, our GDP continues to rise. We run companies with a tenth of the people we did before - everything is computerized, automated. But the wages are lower.

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#49

Post by tastyface »

Ksknsbz wrote: post #24
eesmith wrote: post #17

Earlier quoted context omitted.

> I want a doctor who feels some blood and soil attachment to their patients. "Blood and soil (German: Blut und Boden) is a nationalist phrase and concept of a racially defined national body ("Blood") united with a settlement area ("Soil"). Originating in the German völkisch movement, it was used extensively by Nazi Germany, ... North American white supremacists, white nationalists, Neo-Nazis and members of the alt-r…

I’m not a nazi. There is nothing wrong with wanting to live and work with people of your culture.

What is "your culture," exactly?

Re: 'Nobody wants to come': What if the U.S. can no longer attract immigrant doctors

#50

Post by robocat »

nxm wrote: post #5
jmclnx wrote: post #3

Simple, 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.

US 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.

> months long wait for procedures

The demand for healthcare procedures is unlimited.

Instead queues are used to limit access to expensive procedures, because waiting lists are the only solution that is palatable to voters.

Although in theory queues shouldn't actually reduce total costs (just delay the costs?)

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