(10-22-2014 08:46 AM)Owl 69/70/75 Wrote: (10-22-2014 08:37 AM)VA49er Wrote: (10-21-2014 10:44 PM)UM2001GRAD Wrote: The AAMC says medical school enrollments are on track to reach a 30% increase in the 15 year period from 2002 to 2017. It doesn't appear there is much disincentivizing going on. Let's move on the next right-wing talking point.
What about quality? Not disagreeing with you, just playing devil's advocate. I can see young people realizing there maybe a doctor shortage and deciding to apply to medical school. However, given other factors, there are still more lucrative careers to choose.
Remember too that a significant number of med school graduates do something other than practice medicine. I think Hambone has some stats on this, I don't. If the practice of medicine is financially unrewarding, more of them will choose to do something else.
That statistic (and I have no idea how valid it is) spans a period that's split about equally between before Obamacare and after Obamacare. Would be interesting to look at the before and after splits.
Yep.. Being an MD doesn't make you a physician...
If I have time I'll pull the stats, but they aren't easy to find from public sources. As we run a residency program at my hospitals, I have access to some private data I'm not comfortable reproducing.
You're mixing your arguments, GRAD.
First you argue that enrollment is up 30% at med schools, but then argue that despite being frozen since 1997, we still can't fill those slots. So which is it? Candidate Obama is on the record saying we don't have enough primary care physicians because we don't have enough residency slots... but I guess we should listen to UMGRAD as opposed to the AMA and the past and current President.
Yes, there are a few isolated residency slots that go unfilled every year... usually at some remote rural location (where they are often funded hoping the doctors stay as PCPs because they don't have any)... where a candidate accepted and then backed out too late to convince someone else to move to the country... but the 'fill' rate is and has been in the high 90's for a very long time.... OFTEN with foreign candidates... so to the extent that ANY of these additional candidates become physicians, many of these new US med school candidates will merely take the slots of foreign candidates from similarly accredited medical schools.
Private Residency funding typically comes from pharmaceutical companies for specialists... i.e. Ortho-Neutrogena funds people to become dermatologists... but it isn't much of a plan for them because they can't be sure to capture the future revenue...
So where is this money going to come for to fund primary care physicians, most of whom treat simple infections with generic prescriptions that have been off patent for decades?
Remember that the average cost of a residency is about 100k per resident per year... and some specialties can require up to 10 years of residency. How many Enbrel prescriptions would have to be filled by just one dermatologist to make that a good investment for a company? Much less Erythromyacin (produced by the right manufacturer)
SOME business models just don't work, and this is one of them.
That's also what makes the comment that NPs or PAs are 'just as good' as MDs. While many of them are quite talented and skilled etc etc etc... it makes a mockery out of our residency programs. If we aren't by definition (on average) getting FAR superior quality by spending half a million dollars to fund a resident, then why are we doing it?
*, and is reducing the incentive for many to enter the medical practitioner field in the first place- money. It has signed up a relatively tiny percentage of those it claimed to be aimed at, and when this trillion(s) dollar debacle is "fully implemented" there will still be approx the same number of people uninsured *this is what success looks like?*. Better care cannot be delivered, by definition, to millions more people if there is greater strain on those delivering that care. The care will suffer, it simply must.