Quote:
Originally Posted by Kevin
What part in the cost of health care does the scarcity of M.D.'s play?
It seems that the extremely restrictive enrollment criteria from med schools has really limited the number of doctors.
Could some serious public investment in new med schools or larger med schools help to alleviate some of our cost problems?
|
Kevin, VERY AWESOME QUESTION!!! Given I just got back from my State Legislature and some info on healthcare...
Physicians who have limited training cannot best treat their patients. It is different from other countries like China, where what they call MD's there are really PA-C here... They KNOW some aspects of medicine, but not all the aspects that are expected to pass the USMLE--all parts.
The enrollment is restrictive because there are so many people who want to be MDs. The other issue is there is something like ~300 med schools in the US--the one's that are accredited. Moreover, it is very expensive to fund certain specialties--like surgical wings-- pricey--and NO ONE will pay for students to screw up that on anyone... So most med students take on the "higher paying, easier (loosely used) pass" specialties, like family med, internal med, pediatrics, a few others. The hard ones, like cardiothoracic surgery... Wow, the school I worked for, cannot find many students interested... I'd do it if I could tie knots, but I cannot do it.
There is only one med school in my state. And it serves 4 other states with the pre-requisite of those students going back to their home states... That rarely occurs. Reasons are after one finishes med school, they go to do residency elsewhere in another location, that includes clinic duty. And if they like research, well they do that, too.
Who does the healthcare, ER surgeons do... But most of those doctors are triage folks. Many of ex-military or currently serve... A JAMA article just came out about their duties in Iraq and how to train for triage. But EVERYONE KNOWS that ER healthcare is NOT preventative--especially for chronic conditions... Good for blown limbs, BAD for chronic conditions du jour--unless there is a heart problem, priaprism or huristism...
And the sad part is, most of the American public uses ER care as their primary health care due to anger toward their primary care physicians. One has to be dead in their butts to get optimal care from an HMO, non-specialist... Even I had to do that. What's interesting about my HMO, is I write them emails and that crap gets into my medical record... So, if they deny me treatment, they might get put up under AMA board review... (hint, hint)