The darker side of being a doctor (2017)

When an organization with a clear history of a specific agenda has a talking point, it is good to take the context of their agenda into account. I would point out that this particular agenda is one that has been largely achieved, which is why doctors in the USA make so much more than any other country and part of why our healthcare costs are so much higher.

In this case, we have a problem that the AMA deliberately worked to create for 20 years. Now that their "oversupply of doctors" myth is no longer remotely tenable, the AMA argues that the ONLY way to solve the supply problem they created is a solution that takes 10+ years to take effect.

We absolutely need to increase the number of doctors we have, but we also need to look at other ways we can safely increase patient access and decrease patient costs while we wait for new doctors to be trained.

The problem with increasing the supply of physicians it takes 10+ years for policy changes to have effects.

According to 'studentdoctor.net' from 2017 - there is a cap because there are not enough residencies for graduating med students. The government is the primary payer for residencies: "It was because of the cost of GME funding that this program came under the fire of budget-minded politicians in Congress. This resulted in curbing of funding for residencies under the Balanced Budget Act (BBA) of both 1997 and 1999:" [1]

> The limitation in funding has essentially put a cap on the number of residencies that can take place in the United States – and since a doctor cannot go into practice without a residency, this is essentially a cap on the number of new, American-trained physicians who are allowed to practice in this country. The American Medical Association, in its AMA wire, blames this cap for the record number of students in 2015 who were not matched with a residency program at the end of their four years in medical school: of the 18,025 allopathic seniors and 3,000 osteopathic seniors who participated in the Main Residency Match, the two groups matched at rates of 93.9% and 79.3% respectively, leaving the highest percentage ever unmatched – and also unable to practice on their own.

> There are proponents for keeping the current cap in place, however. This is mostly among budget-minded members of Congress who are wanting to cut spending, but even the Obama administration proposed reducing Medicare expenditure on GME, even halving support for children’s hospitals, which have their own separate sources of funding. People on this side of this issue tend to decry the seriousness of the physician shortage, pointing out that the increase of physician’s assistants and advanced nurse practitioners has helped to mitigate this problem, even with the cap still in place.

The resource [1] is a bit dated. "Congress recently took steps to support several programs supporting GME funding by fixing technical issues that left some rural programs with an inadvertently low cap, expanding eligibility for rural training track funding, and adding 1000 new Medicare-funded positions for the first time since 1997. " [2]

[1] https://www.studentdoctor.net/2017/01/24/medical-students-kn...

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8370355/

I don’t even know what argument you’re trying to make here? It’ll take time to solve? Yeah, obviously. That’s why we should start ASAP and given that we don’t have a time machine, that’d mean right now.

This one hanging under the current top comment as an example:

"It's the same in the US, Italy, etc Doctors are a cartel receiving a monopoly from the State. That's all there is to it, really"

Forgetting the reasons (sure - it's all some grand program by the AMA et al to keep up current Physician pay) for a second thinking that if you can just churn them out like you do 'coders' with some quick program that doesn't require many many years of training and residency programs as well as hospitals and other infrastructure. And of course the cost to do all of this.

In almost typical HN fashion it's always a scam. Everyone else is getting away with being overpaid and undertaxed except top software engineers who of course deserve the pay they are getting.

The particular Physician in question is in Australia and is a surgeon. So you want to just be able to pluck people at random and give them a chance to be a surgeon as if there isn't something special that is required for that specialty.

Also, that Surgeon details some of his bad experiences but not how often that has happened. And doesn't even detail what he has done in terms of fixing it with the hospital administrators just continues to be a martyr getting beaten up by the system. Not claiming it's his job to try and get change at his hospital. But by the same token this idea that he has to do what he does or 'people will die' does not fly. Your own health and sanity is more important than that (as is your families).

If it's indeed the case that most hospitals can't cover their overhead then by default it must be limited to the high end, if it ever does happen.