I hear people say "we need more doctors" all the time. It would seem to me, the people deciding how many new doctors we train per year, are doctors. Their pay is proportionate to their scarcity, if we had 5x as many doctors, existing doctors would make far less.
Imagine if existing software engineers got to decide how many juniors entered our profession each year. I think things would look very, very different.
We have created a society in which the tail wags the dog. We have deferred so much control to institutions like the AMA that we have forgotten how to govern. Our politicians wring their hands and wax lyrical about the intractability of issues while they hold all the power to affect change.
I think it's time we stop allowing institutions to rule. We elect our leaders to lead. They need to start fucking leading, or people are going to start voting for some radical alternatives.
The AMA has no control over this. While they do advocate for training more doctors they don't have authority over medical school admissions or residency program funding or anything like that.
One area where we can perhaps legitimately criticize the AMA is for their lobbying state governments to limit the scope of practice for lower licensed PA/NP clinicians. While some of their concerns about care quality and patient safety might be legitimate, the reality is that we're not going to have enough primary care doctors to ensure adequate patient access. Some of that work has to be delegated down.
> The AMA has no control over this. While they do advocate for training more doctors they don't have authority over medical school admissions or residency program funding or anything like that.
I feel I made this distinction very clear in my comment, so I'm surprised to see you repeat it. I make it clear that it is our elected officials which hold the power, *but who have deferred that power to institutions like the AMA.* For example, the AMA and Association of American Medical Colleges jointly sponsor the Liaison Committee on Medical Education (LCME), which accredits US MD programmes. LCME accreditation is extremely consequential because most state licensing boards require graduation from an LCME-accredited US programme, and LCME accreditation establishes eligibility for the USMLE and ACGME residency programmes. This gives the accreditation system considerable influence over expansion. LCME standards require a school to admit only as many students as its resources can support, including faculty, facilities and clinical training capacity. Schools must also notify the LCME when class-size increases exceed specified thresholds, currently a cumulative increase of 10% or 15 students, whichever is smaller, relative to the class size at the previous full accreditation survey.
estearum · · focus · HN ↗
There's no solution other than training a lot, lot, lot, lot more doctors.
Their salaries need to be lower, training needs to be cheaper and faster, and we need a lot more of them.
ossicones · · focus · HN ↗
joenot443 · · focus · HN ↗
I hear people say "we need more doctors" all the time. It would seem to me, the people deciding how many new doctors we train per year, are doctors. Their pay is proportionate to their scarcity, if we had 5x as many doctors, existing doctors would make far less.
Imagine if existing software engineers got to decide how many juniors entered our profession each year. I think things would look very, very different.
Gareth321 · · focus · HN ↗
I think it's time we stop allowing institutions to rule. We elect our leaders to lead. They need to start fucking leading, or people are going to start voting for some radical alternatives.
nradov · · focus · HN ↗
<a href="https://savegme.org/" rel="nofollow">https://savegme.org/
One area where we can perhaps legitimately criticize the AMA is for their lobbying state governments to limit the scope of practice for lower licensed PA/NP clinicians. While some of their concerns about care quality and patient safety might be legitimate, the reality is that we're not going to have enough primary care doctors to ensure adequate patient access. Some of that work has to be delegated down.
Gareth321 · · focus · HN ↗
I feel I made this distinction very clear in my comment, so I'm surprised to see you repeat it. I make it clear that it is our elected officials which hold the power, *but who have deferred that power to institutions like the AMA.* For example, the AMA and Association of American Medical Colleges jointly sponsor the Liaison Committee on Medical Education (LCME), which accredits US MD programmes. LCME accreditation is extremely consequential because most state licensing boards require graduation from an LCME-accredited US programme, and LCME accreditation establishes eligibility for the USMLE and ACGME residency programmes. This gives the accreditation system considerable influence over expansion. LCME standards require a school to admit only as many students as its resources can support, including faculty, facilities and clinical training capacity. Schools must also notify the LCME when class-size increases exceed specified thresholds, currently a cumulative increase of 10% or 15 students, whichever is smaller, relative to the class size at the previous full accreditation survey.