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DOMb

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Hey all,

as most of you know there are going to be 2 new med schools in arizona (ATSU-mesa(DO) and U of A pheonix (MD)) How do you guys think rotations will be affected especially for AZCOM students?
 

Nickelpennykid

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Hey all,

as most of you know there are going to be 2 new med schools in arizona (ATSU-mesa(DO) and U of A pheonix (MD)) How do you guys think rotations will be affected especially for AZCOM students?

Great...another DO school opening with no mention of additional funding of AOA residency positions.:thumbdown:
 

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I don't get the bitching about "not enough residencies"...when a bunch of them went unfilled this year, and remain unfilled most years.
 
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Nickelpennykid

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I was under the impression that there were more DO grads than availible AOA residency positions? The bitching has to do with the fact that on the quest for equality that people bitch about, the AOA has not established a proportional number of specialty residencies.
 

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I was under the impression that there were more DO grads than availible AOA residency positions? The bitching has to do with the fact that on the quest for equality that people bitch about, the AOA has not established a proportional number of specialty residencies.

This is true, however, I believe most of the angst is over the lack of specialty residencies available, and the location of the residency programs in general.

A bunch of Primary Care residencies apparently go unfilled every year.
 

Nickelpennykid

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This is true, however, I believe most of the angst is over the lack of specialty residencies available, and the location of the residency programs in general.

A bunch of Primary Care residencies apparently go unfilled every year.

That is true, PC goes unfilled. In general I just think it is irresponsible to open new schools when in actuality you can't educate all of the students you currently have all the way through their residencies...not to mention the fact that they are going to cost an arm and a leg and draw in some pretty low numbers in terms of MCAT / GPA due to newness/price for a few years.

That being said, I am going to PCOM and couldn't be happier about it. Absolutely loved it there.
 

Buckeye4life

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I think it is a great idea to open new schools. I hope they open schools in every state that way D.O.'s can become as mainstream as M.D.'s. Yeah, the applicant pool may be slightly lower for a few years, but they still have to pass the boards to practice. Every area of medicine has to go through a rough adolescence phase, which osteopathic medicine seems to have gone through and is still maturing as a profession today. That aside, I just want the American public to recognize the D.O. degree as equivalent to the M.D. for what we offer. As for the residency spots, just work hard and getting a spot shouldn't be a problem. If in 4 and 1/2 years, I work hard and don't get a spot, then maybe I'll change my tune. As for now, I think it's the right move to try and expand the profession as much as possible.
 

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Every schools opti should have enough residencies to educate every single one of their students if they choose to go to the AOA. This is different from the not enough specialties debate that occurs.

As for the original question, if AZCOM has agreements set up with their hospitals it will not affect their rotations. The hospitals sign contracts to take so many students fromt he school a year. You may have students from the new school rotate through the same hospital
 

Nickelpennykid

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I think it is a great idea to open new schools. I hope they open schools in every state that way D.O.'s can become as mainstream as M.D.'s. Yeah, the applicant pool may be slightly lower for a few years, but they still have to pass the boards to practice. Every area of medicine has to go through a rough adolescence phase, which osteopathic medicine seems to have gone through and is still maturing as a profession today. That aside, I just want the American public to recognize the D.O. degree as equivalent to the M.D. for what we offer. As for the residency spots, just work hard and getting a spot shouldn't be a problem. If in 4 and 1/2 years, I work hard and don't get a spot, then maybe I'll change my tune. As for now, I think it's the right move to try and expand the profession as much as possible.

I agree they should open more schools, but at the same time you have to provide more residency spots. For DO to be as mainstream as MDs, as you claim, don't you think it is the responsibility of the Osteopathic governing bodies to make sure that they can train their doctors all the way through their residencies? You can't lean on MD programs for post-graduate training and then expect to be as mainstream. I am not saying that DO's are any better or worse than MD's in terms of their actual practice...but it is sad that nearly half of the training that 60% of graduating DO's receive is through allopathic programs.
 

JonnyG

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I think it is a great idea to open new schools. I hope they open schools in every state that way D.O.'s can become as mainstream as M.D.'s. Yeah, the applicant pool may be slightly lower for a few years, but they still have to pass the boards to practice. Every area of medicine has to go through a rough adolescence phase, which osteopathic medicine seems to have gone through and is still maturing as a profession today. That aside, I just want the American public to recognize the D.O. degree as equivalent to the M.D. for what we offer. As for the residency spots, just work hard and getting a spot shouldn't be a problem. If in 4 and 1/2 years, I work hard and don't get a spot, then maybe I'll change my tune. As for now, I think it's the right move to try and expand the profession as much as possible.

If you are going to be apart of the profession you should start reading up on this issue. particularlly the presidents blog on aoa online. The answer isn't more DOs, it never has been. The AOA also has a campaign going now to raise the awareness about more DOs and it does not involve opening more schools.

Dos are mainstream in places that they have worked over the years to build a solid reputation as doctors with their limited numbers. PA and MI for example. Yes some people still don't know what they are but must don't care. They just want to be treated.
 

Buckeye4life

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If you are going to be apart of the profession you should start reading up on this issue. particularlly the presidents blog on aoa online. The answer isn't more DOs, it never has been. The AOA also has a campaign going now to raise the awareness about more DOs and it does not involve opening more schools.

Dos are mainstream in places that they have worked over the years to build a solid reputation as doctors with their limited numbers. PA and MI for example. Yes some people still don't know what they are but must don't care. They just want to be treated.

Thanks, I work with D.O.s all the time in Ohio. People in Ohio still do not know the scope of services that D.O.s give. And there is definitely credibility in numbers. If the answer in your opinion is not more DO's, then what is it? This is a multifaceted answer, but having more DOs in the market will definitely help.
 

Buckeye4life

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Baby boomers and more pediatrics living with the advance of medical technology will also require many more physicians, and hopefully osteopathic physicians. With a surging influx of patients to treat will require more D.O.s than are currently being produced.
 
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builttorock

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Hey all,

as most of you know there are going to be 2 new med schools in arizona (ATSU-mesa(DO) and U of A pheonix (MD)) How do you guys think rotations will be affected especially for AZCOM students?

ATSU COM-Mesa will not actually effect AZCOM students' rotations, as all of the COM-Mesa students will be in other rotation locations throughout the country on their 2nd, 3rd and 4th years. That is, except for the 10 students that get assigned to a Phoenix Community Health Center.

Also, the U of A students will hardly effect AZCOM rotations for two reasons: U of A students have been doing rotations in Phoenix for decades already and the class size at the new school is going to be very very small.
 

Testy McAterson

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ATSU COM-Mesa will not actually effect AZCOM students' rotations, as all of the COM-Mesa students will be in other rotation locations throughout the country on their 2nd, 3rd and 4th years. That is, except for the 10 students that get assigned to a Phoenix Community Health Center.

Also, the U of A students will hardly effect AZCOM rotations for two reasons: U of A students have been doing rotations in Phoenix for decades already and the class size at the new school is going to be very very small.

you beat me to it. :thumbup:
 

DocBR

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That is true, PC goes unfilled. In general I just think it is irresponsible to open new schools when in actuality you can't educate all of the students you currently have all the way through their residencies...not to mention the fact that they are going to cost an arm and a leg and draw in some pretty low numbers in terms of MCAT / GPA due to newness/price for a few years.


I have lived in the Phoenix, Arizona area all my life and there are a few things I think you are overlooking.

First, UofA is a well established school that is filling an long over due need in the Phoenix area. Phoenix is the ONLY of the 10 largest cities in the country to not have a medical school. There was a proposed medical school that got side lined for a translational genomics research center about 6 years ago - so plenty of people have been waiting for U of A to expand. They will not have any trouble filling their spots with competitive students.

Second, hospitals are like starbucks here. They are popping up all over the place. Residency spots will be created (especially in this area) as the need increases. Just in the past 3 years, three full service hospitals have opened up in the East Valley (Mesa, Gilbert and Chandler)

Third, UofA is an instate only school and costs 18,000/year. That is not an arm and a leg. COM-Mesa students are applicable for the WICHE program (which pays 17,000-18,000$ of your tuition per year if you are in state or from another participating state - there are 15 of them).

Fourth, Arizona is in need of more doctors, specialists and PC.

I say bring on the med schools!
 

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I am a 4th year at AZCOM right now and I can tell you that these new schools will most definitly effect AZCOM rotations!! First of all, even though Phoenix is the 5th largest city in the country, there are not enough residency programs here to accomodate the 3rd/4th year rotations that will be needed with more students. The preceptor model is hit or miss. AZCOM right now does have good rotations at most of the major hospitals and has worked hard to get just enough of these rotations for there students. AZCOM now plans on increasing their class size from 150 to 250 over the next couple of years. Many of the department chairs at AZCOM have PERSONALLY told me that they have no idea where they are going to have these students rotate. I guess they are hoping that a lot of students do away rotations like many of us have in the past.

U of A is planning on having 100 students and the rumor is that they will take all the rotations for Good Sam Med Center and get priority for the phoenix hospitals (more so than they already do).

A.T. Still is going to have at least 100 students per class. There new dean came from AZCOM and was involved in getting AZCOM many of their good rotations. I can see him getting a lot of these switched over for his students. Some students will probably go out of state, but most will want to stay here.

So in 2-3 years, there will be >450 students needing rotations in the valley. I could be wrong about all this but, I'm glad that I am almost finished.
 

DocBR

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A.T. Still is going to have at least 100 students per class. There new dean came from AZCOM and was involved in getting AZCOM many of their good rotations. I can see him getting a lot of these switched over for his students. Some students will probably go out of state, but most will want to stay here.

So in 2-3 years, there will be >450 students needing rotations in the valley. I could be wrong about all this but, I'm glad that I am almost finished.


Don't you think the ATSU students will either stay near their CHCs (where they spent 3 years of their education) or go somewhere else? There are only going to be 10 that remain in the Phoenix area for their entire education.

I cannot imagine that many of the ATSU students will specifically try to return to Arizona unless they currently live here now.
 

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This is true, however, I believe most of the angst is over the lack of specialty residencies available, and the location of the residency programs in general.

A bunch of Primary Care residencies apparently go unfilled every year.

Just because we wish to attend a DO school does not mean we wish to do PC 100%, there are quite a few that wish to specialize, and the AOA should make accomodations for this.
 

MJB

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Just because we wish to attend a DO school does not mean we wish to do PC 100%, there are quite a few that wish to specialize, and the AOA should make accomodations for this.

I tend to agree, but one also has to realize that the AOA still defines osteopathic medicine with primary care as a foundation. You go into the profession knowing this, so maybe I can see their side of things. If you want to specialize, perhaps MD is better for you.

I'm not decided on what I want to do for sure, but I'm guessing some form of primary care is in my future. I took that into consideration when deciding to apply to DO schools.

All that being said, I do think it's a little "curious" that there aren't even enough residencies for all Osteopathic students.

That's something that needs fixed.
 

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I tend to agree, but one also has to realize that the AOA still defines osteopathic medicine with primary care as a foundation. You go into the profession knowing this, so maybe I can see their side of things. If you want to specialize, perhaps MD is better for you.

I'm not decided on what I want to do for sure, but I'm guessing some form of primary care is in my future. I took that into consideration when deciding to apply to DO schools.

All that being said, I do think it's a little "curious" that there aren't even enough residencies for all Osteopathic students.

That's something that needs fixed.

Does this throw out the idea of DO=MD then? Of course not, just pointing this little tid-bit out. If the AOA wishes to maintain it's "ancient" idea that all DOs should pursue PC and nothing else, then that in itself is encouraging the fallacy. The AOA should understand that DO students are just as likely to wish to pursue a specialty-based residency program as an MD student and accomodate accordingly. It is unfair to keep holding us back from pursuing our dreams, beyond the fact of being a physician.
 

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Does this throw out the idea of DO=MD then? Of course not, just pointing this little tid-bit out. If the AOA wishes to maintain it's "ancient" idea that all DOs should pursue PC and nothing else, then that in itself is encouraging the fallacy. The AOA should understand that DO students are just as likely to wish to pursue a specialty-based residency program as an MD student and accomodate accordingly. It is unfair to keep holding us back from pursuing our dreams, beyond the fact of being a physician.

DO students are progressive. It's the DO "old guard" that seems to be holding things back.

"Seperate but equal" is a foolish doctrine and does not work.

Joint Match TODAY, Joint Match Tommorrow, Joint Match FOREVER!:thumbup:
 
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Dr.Inviz

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DO students are progressive. it's the DO "old guard" that seems to be holding things back.

"Seperate but equal" is a foolish doctrine and does not work.

Joint Match TODAY, Joint Match Tommorrow, Joint Match FOREVER!:thumbup:

That was my point when I mentioned the "ancient" beliefs of DO students being encouraged to pursue PC and only PC ...
 

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DO students are progressive. it's the DO "old guard" that seems to be holding things back.

"Seperate but equal" is a foolish doctrine and does not work.

Joint Match TODAY, Joint Match Tommorrow, Joint Match FOREVER!:thumbup:

It sure didn't work for US history, I wonder why it'd work in the medical field ...

The AOA should just die ... :smuggrin:
 

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Could someone give me more info on the UoA phx medical program?? Is there a separate application process...or are students choosing which place that they would like to attend??? I havent looked into it much...but am curious.

Also, it does seem that hospitals are going up like starbucks around here...but eventhough new hospitals are going up quickly, I was under an impression that it takes them time for them to start "teaching."
 

DocBR

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Could someone give me more info on the UoA phx medical program?? Is there a separate application process...or are students choosing which place that they would like to attend??? I havent looked into it much...but am curious.

Also, it does seem that hospitals are going up like starbucks around here...but eventhough new hospitals are going up quickly, I was under an impression that it takes them time for them to start "teaching."


I think so, I honestly do not know much about the way things work with residency teaching. I was just commenting that the need is here in Arizona for more physicians and I think the opportunities to educate them will follow. It would be foolish of the state/hospitals/board of reagents to not provide those opportunities in a timely manner. Although, it probably will not help those of us applying now.

UofA Phx is the same process as Tucson. When you apply to UofA you have a Tucson interview/tour then a Phx interview/tour, and a community physician interview. After you complete all the interviews you rank which campus you would like to attend and why. They choose the class first, then assign students to each campus.
 

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The U of A medical school in phoenix may actually help develop more residency programs in the phoenix area. There will probably be more state funding and willingness to invest in GME than what is seen with the ostoepathic programs. Osteopathic GME has been largely on the decline in Arizona (except for a handful of spots in the metropolis of Kingman, AZ) with the closure of Mesa General and a program in Tucson.

I agree that rotations are going to get "tight" and more DO students may get pushed into preceptor-type rotations rather than the traditional hospital-based ones, but this is not the end of the world. I trained in the preceptor-model with some electives at outside facilities and as long as you read you will be fine. Later in life you will discover that 3rd year and 4th year of medical school make up an incredibly small part of your education as a physician.

With that being said, I do agree that it is irresponsible of the AOA to allow the proliferation of DO schools (big money!!) without the opening of new residency positions (especially the specialties and subspecialties). Fortunately right now the data shows a doctor shortage so we aren't getting killed in the court of public opinion, but I bet that the schools would be opening even if there was a surplus predicted. The money is just too hard for them to pass up.
 

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Isn't the residency situation Congress's responsibility? They allocate money that pays for residency slots. Why don't people write to their congress critters and request they increase this budget, which actually was cut a few years ago? But if people are arguing that AOA needs to be lobbying for this action, then I would agree. Though this does not address the issue that the lower demand slots, i.e. primary care, fill last if at all.

Regarding Phoenix--it seems to me that increasing the number of medical schools is a good thing. As I understand it, Arizona is growing fast, they have a large and active geriatric population, and they have a tremendous shortage of medical personnel. This all argues for making it more of a medical city. They will bring more faculty, more research, more respect for the region as a medical science center. Thus, AZCOM grads will benefit from the heightened prestige and available resources.

Maybe this will also convince AZCOM to reverse their new policy on keeping 3rd year rotations in-state.
 

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Just to reclarify so rumors don't get spread (gotta love SDN): ATSU-Mesa students are only in Phoenix their first year. After that they move to community health centers across the US. Only one community health center group will be here in Phoenix and it's emphasis is on American Indian health (which would be an awesome opportunity but won't "compete" with U of A and AZCOM) read here.

Phoenix needs a public medical school and I think it's great that UofA is expanding. Their first class (next year) will have only 24 students. At my interview, they said they expect their second class to have around 40 students. By 2015, they're expecting to reach their 150 students size. I'm really writing this just so I can tell you that at my UofA-Phx interview the director and faculty used "rotating with D.O. students" as one of the selling points for their campus (as opposed to the Tucson campus) -- I wanted to high-5 the guy :thumbup:
 

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That ATSU-Mesa system sounds like alot offun if I was single. Also, It looks like you would got to see alot of interesting pathology from traveling all over.
 

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ATSU mesa is definitely going to be interesting, and no, it won't affect the rotations at all in AZ. I actually have a really tough decision to make regarding that school or another.... :confused:
 

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Just to reclarify so rumors don't get spread (gotta love SDN): ATSU-Mesa students are only in Phoenix their first year. After that they move to community health centers across the US. Only one community health center group will be here in Phoenix and it's emphasis is on American Indian health (which would be an awesome opportunity but won't "compete" with U of A and AZCOM) read here.


What are the chances, do you think, of students still specializing in a first year school like ATSU mesa??? Are they going to be pushing these students toward primary care then????
 

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What are the chances, do you think, of students still specializing in a first year school like ATSU mesa??? Are they going to be pushing these students toward primary care then????


They place a LOT of emphasis on primary care. I Interviewed there and loved it, but ultimately decided to turn down their acceptance because I am not ready to commit to primary care.

In fact, one of their selling points was their progressive education which focuses on what you need to know as a doctor, not everything there is to know. For instance, instead of dissecting a cadaver, you view prosections of already dissected body parts, accompanied with slice of life material.

I felt like their basic message was that you learn the stuff that is going to make you an awesome primary care doc, at the expense of the less important aspects of non-primary care medicine.
 

Halligan

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They place a LOT of emphasis on primary care. I Interviewed there and loved it, but ultimately decided to turn down their acceptance because I am not ready to commit to primary care.

In fact, one of their selling points was their progressive education which focuses on what you need to know as a doctor, not everything there is to know. For instance, instead of dissecting a cadaver, you view prosections of already dissected body parts, accompanied with slice of life material.

I felt like their basic message was that you learn the stuff that is going to make you an awesome primary care doc, at the expense of the less important aspects of non-primary care medicine.

You know, that is a total bummer. I'm not ready to commit to primary care either, and I dont know about you, but I'm one of those people that really looks forward to becoming a doctor the same way everyone else did (traditionally, so to speak). Sure, studying hard, but also going through the notorious anatomy lab, dissecting the cadaver, etc. I think it's great that they want to make people into doctors by being very progressive, but I think that experience of dissecting a real cadaver is essential for future docs - especially in emotionally speaking. It's a reality check for many people that they'll be dealing with lives, and that these people they're working on were speaking, working, functioning humans. Just my two cents... agree or disagree? The idea that they have the parts already dissected for them seems so impersonal - like they're making robot doctors to just be able to memorize the body parts - instead of really understanding the whole idea.

Anyone else have an experience similar with ATSU mesa????
 

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1. I think with all of the online resources and journals available, it will be completely possible to know a lot of things in depth, Who doesn't study what interests them most? We are not robots, and we as medical students need to be learning on our own anyway, so I think it would be completely plausible.

2. I DID cadaver dissection for a year, (prepped them for med students, so actually they were prosected), and while I DO agree that there is an element of humanity, learning from a prosected cadaver and slice of life will be just as effective and possibly moreso.... I think it will also be reinforced through other modalities as you study cases and possible problems throughout year 1 and 2.
 

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You know, that is a total bummer. I'm not ready to commit to primary care either, and I dont know about you, but I'm one of those people that really looks forward to becoming a doctor the same way everyone else did (traditionally, so to speak). Sure, studying hard, but also going through the notorious anatomy lab, dissecting the cadaver, etc. I think it's great that they want to make people into doctors by being very progressive, but I think that experience of dissecting a real cadaver is essential for future docs - especially in emotionally speaking. It's a reality check for many people that they'll be dealing with lives, and that these people they're working on were speaking, working, functioning humans. Just my two cents... agree or disagree? The idea that they have the parts already dissected for them seems so impersonal - like they're making robot doctors to just be able to memorize the body parts - instead of really understanding the whole idea.

Anyone else have an experience similar with ATSU mesa????

I completely agree. I want the entire traditional medical school experience - not just what I will need in a future practice.

I believe that COM-Mesa will train some wonderful physicians who have a lot of experience that most doctors will not have (for instance learning the ins and outs of community health care), but for me, I want to open up the body and dig through it, not just see it. Another thing that worried me about the school was that in years 2-4 many of the CHCs will be using video conferencing for the OMT labs. I mean, if I am going to go through the trouble of learning OMT for the boards, I want to really learn it - I just don't know if you can do that with a video conferencing set up.

The school seemed awesome, just not for me.
 

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Isn't the residency situation Congress's responsibility? They allocate money that pays for residency slots. Why don't people write to their congress critters and request they increase this budget, which actually was cut a few years ago? But if people are arguing that AOA needs to be lobbying for this action, then I would agree. Though this does not address the issue that the lower demand slots, i.e. primary care, fill last if at all.

The Balanced Budget Act of 1997 limited the expansion of existing residency programs, however, programs can still be started/funded at hospitals that do not already have programs. I believe there a handful of examples of new programs in Nevada and Kingman, AZ for example, but these increases are tiny in proportion to the number of new students being trained.

Next, regarding the "empty" primary care slots. This problem is due to primary care having terrible reimbursement. Many medical students now faced with student loan debt in excess of $100,000 are realizing that subspecialty training will give them an extra income advantage which will allow them to dig out of debt while still living comfortably.

Perhaps if primary care were an "easy" lifestyle people would still pursue it, even with low pay, but primary care is NOT easy. These guys are seeing 30-60 patients a day for $120,000 a year. Imagine billing over $100 for an office visit and getting reimbursed $28. Patients will pay their plumbers and air conditioning technicians more than that. The students who are pursuing primary care are probably doing so because of a true passion for that kind of practice and probably the only way to fill those spots is to incentivize students by increasing reimbursement for primary care.

However, with the growing use of mid-level providers at these new Nurse-In-A-Box practices, such as those at Walmart, I feel even less numbers will pursue primary care. The "easy" (sore throat, UTI, etc.) office visits that added income to PCPs, will be sucked up by those $45 cash only NP practices. Kind of a gloomy picture but my 2 cents.
 

theraball

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Perhaps if primary care were an "easy" lifestyle people would still pursue it, even with low pay, but primary care is NOT easy. These guys are seeing 30-60 patients a day for $120,000 a year. Imagine billing over $100 for an office visit and getting reimbursed $28. Patients will pay their plumbers and air conditioning technicians more than that. The students who are pursuing primary care are probably doing so because of a true passion for that kind of practice and probably the only way to fill those spots is to incentivize students by increasing reimbursement for primary care.

Stimulate,

Your numbers are a bit suspect. If you assume 30 patients a day at $28 net reimbursement, that's $200,000 per year (assuming 5 days a week, 48 work weeks/year). However this is obviously not a real world situation. Different procedures bill out at different amounts. A 15-minute epidural for sciatica is going to bill out at $800-$1200 depending on the insurance co.; a few of of those per week is going to dramatically affect the bottom line.

There are a lot of such procedures that go beyond a simple annual checkup. Annuals probably are best done by a mid-level for $45 cash at a Walmart--why not? It will help to get more people in for annual checkups, and increase the overall health of the population. I can't think of a better trend right now. I would only caution that a physician should be in the loop because a mid level isn't necessarily going to have the same perspective and breadth and depth of training.

Also keep in mind that the nationwide average first year pay for primary care is higher than $120K, more like $140K for FP and $150K for IM. Probably these numbers vary by region.

But I agree with you that tuition reimbursement is a good first step to incentivizing more people into the primary care field.
 
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