Build More Medical Schools To Meet Demand?

[Futuredocplz531]

---

Members do not see this ad.

Yes, the research suggests that. My question is if we could selectively move fat from around the organs (invisible) to under the skin (visible) and eliminate a number of the morbidities associated with obesity, would you still regard obese and overweight people with the contempt you've shown in this thread?

People would use the surgery as a crutch, just look at liposuction. I’ve had 3 family members who had the surgery and thought it would solve their problems. 2 years later the weight was back on because they didn’t change their lifestyle

 

[emergentmd]

I didn't say anything about white privilege. I'm not white either, but I can recognize that I'm in a position where I've got the privilege to do things like change my diet, and blow money I don't have.

I also said nothing about drugs, but I mean if you want to start another thread lol yeah fully blame big pharma and policy-makers on the double-think that's been used to approach the heroin epidemic and pharmaceutical drug abusers differently throughout modern medical history.

I don't know what you tell you my friend, you seem to be lacking a lot of empathy towards people in positions unlike your own. I actually dare you to stretch a $50 food budget for a family of five lol, I mean I spent 5 months with a nutrition team trying to just that for a lot of families. But I bet you could do it better.

your $50 budget is the exception and not the norm. $50 budget also doesn't tell the whole story. i doubt a family only have $50 to buy food for the month/week.

We need to stop looking at headlines and hold to that as stead fast truth which is what you and many libs do instead of looking deeper into the numbers.

Ask that $50 family if they have a cell phone? nice car? Nails done? Flat screen? if the answer is no, I would be happy and empathetic to send them my tax money. But I have very little for the obese family that have a 60 inch flat screen at home, having difficulty with surfing on their iphone X b/c of their recent set of nails having difficulty stretching $50 of what is left b/c they spend it on the nonessentials.

I have great empathy and likely give more to charity than you when someone needs it and not because they make bad choices. If I were into wasting my money, I would just give it all to Uncle Sam b/c they are the biggest waster of money.

 

[TwoHighways]

First, I think you should probably read up on the pretty substantial issue of hunger in America. As someone who has done hunger work, I can tell you with my whole chest that it is a problem.

If you're going to be a physician, that's got to be something on your radar. Can't operate based on your privilege here.



nope not perhaps NAFLD, NAFLD is a metabolic syndrome and again. What i'm asking you isn't what you meant by metabolic syndrome, again- i get what you meant, that stat was for NAFLD and diabetes is now a big issue in western africa. I meant, what in the world was your point.

So I’m privileged because I had the wherewithal to connect the dots with what I choose to consume and its effects on my health and body composition?

My point is if factored out the obese and metabolically deranged in America versus other countries, our access, outcomes, and costs would be much more inline with other 1st world countries. Ignoring how grossly unhealthy we are in comparison to other countries is going to skew the results in favor of countries with better underlying health to begin with.

We can go on and on about social factors vs personal responsibility, but honestly that isn’t a debate I feel is productive in moving the needle the right way regarding our collective health. What are your solutions to the problem?

 

[emergentmd]

People would use the surgery as a crutch, just look at liposuction. I’ve had 3 family members who had the surgery and thought it would solve their problems. 2 years later the weight was back on because they didn’t change their lifestyle

So are you really trying to say that Quick fixes, expecting someone else to help you, and not taking the more difficult path/personal responsibility doesn't work?

I guess I am just privileged and don't understand what the less fortunate is going through. I guess when life throws me a curve ball, I try to figure out what I can do to fix it rather than letting someone else fix it. I guess I will never understand what others are going through or am not empathetic enough to ever understand. I guess I had everything given to me as a child and thus will never understand what growing up in poverty is like where parents work all the time.

I guess my life as a migrant who came over to the USA with my parents who didn't speak any English, Who always wore used clothes, Who never had money to go to restaurants/movies, Who never had a buck in my pocket, rarely had birthday/christmas gifts, who worked/took out loans to put myself through college puts me in the privilege status and will never understand how US born Americans with English as the primary language have it so difficult.

I Just have no empathy for socially/economically poor people eventhough I bet I was much more disadvantaged than they ever will be.

 

[electropartyogram]

Yes, the research suggests that. My question is if we could selectively move fat from around the organs (invisible) to under the skin (visible) and eliminate a number of the morbidities associated with obesity, would you still regard obese and overweight people with the contempt you've shown in this thread?

Theoretically, such an advance in medicine would change many things. I don't believe I have regarded obese and overweight people with contempt, or dehumanize them. I have tried to explain my beliefs on personal responsibility. My position is that being overweight and obese is unhealthy, and leads to the majority of preventable diseases. I have stated this before: my passion for wanting people to be healthier should not be taken as a lack of empathy. Obesity is bad because of morbidities. If it did not cause morbidities, then it would no longer be bad. In that case, it doesn't matter if someone was obese or not since at that point it becomes a cosmetic preference. Since I do not care about what other people prefer for their cosmetic choices, I would not care if someone was overweight or obese. Does that answer your question?

 

[emergentmd]

Theoretically, such an advance in medicine would change many things. I don't believe I have regarded obese and overweight people with contempt, or dehumanize them. I have tried to explain my beliefs on personal responsibility. My position is that being overweight and obese is unhealthy, and leads to the majority of preventable diseases. I have stated this before: my passion for wanting people to be healthier should not be taken as a lack of empathy. Obesity is bad because of morbidities. If it did not cause morbidities, then it would no longer be bad. In that case, it doesn't matter if someone was obese or not since at that point it becomes a cosmetic preference. Since I do not care about what other people prefer for their cosmetic choices, I would not care if someone was overweight or obese. Does that answer your question?

Only the myopic would think we rail against obesity due to appearance. I can care less if you smoke, eat whatever you want, jump off cliffs, ride a motorcycle without helmet, play russian roulette. I care when you don't take responsibility and expect other to fix your poor decisions.

If you like to rock climb without and didn't buy insurance, then you chose to do something risky that We collectively should not pay for
If you ride without a helmet, then I don't have sympathy nor should I pay for your longterm care
If you like to continually over consume food, then I should not pay for all of your comorbidities.

I would argue I have more sympathy and empathy b/c I willing to blame your lack of personal responsibility in hopes that you change rather than sugar coat it than labeling it a medical condition thus absolving you from any personal responsibility.

 

[Ho0v-man]

It’s pretty clear who in this thread has seen a type 2 diabetic who weighs 300+ lbs despite only having one leg present with a blood glucose over 600 present to the ER with “sleepiness” eating a bucket of KFC vs. who has just reshared FB posts so they can label themselves as “woke.”

edit: typo

 

[Matthew9Thirtyfive]

Other countries have less fast food, and cook their own food more.

lol what? Maybe developing countries. There is crappy restaurant and fast food all over the place.

 

[electropartyogram]

Only the myopic would think we rail against obesity due to appearance. I can care less if you smoke, eat whatever you want, jump off cliffs, ride a motorcycle without helmet, play russian roulette. I care when you don't take responsibility and expect other to fix your poor decisions.

If you like to rock climb without and didn't buy insurance, then you chose to do something risky that We collectively should not pay for
If you ride without a helmet, then I don't have sympathy nor should I pay for your longterm care
If you like to continually over consume food, then I should not pay for all of your comorbidities.

I would argue I have more sympathy and empathy b/c I willing to blame your lack of personal responsibility in hopes that you change rather than sugar coat it than labeling it a medical condition thus absolving you from any personal responsibility.

I agree. My original response in this thread was about the consequences of personal responsibility and that a lack thereof leads to issues that eventually create a burden on the health care system. Since obesity was the topic that's what I responded to, but I am against behaviors where a lack of personal responsibility leads to someone else fronting the bill. The topic was health care and cost. Obesity, as I previously linked, is one of the most costly, preventable conditions, and I argued (maybe not entirely coherently) that personal responsibility is a large factor.

Part of this argument extends to the original topic, more medical schools will not help the rates of overweight and obesity in the population. There has already been movements in policy and the health care system to try to accommodate and change our culture regarding food, provide information and programs, and more should be done, but mainly, it is an issue of personal responsibility and compliance on the population level.

I do not hate overweight or obese people. I just wanted to point out that population's burden on the health care system, and that adding more physicians won't do anything to stop it. Interestingly, obesity rates have increased as have the number of physicians. Just food for thought.

 

[emergentmd]

I agree. My original response in this thread was about the consequences of personal responsibility and that a lack thereof leads to issues that eventually create a burden on the health care system. Since obesity was the topic that's what I responded to, but I am against behaviors where a lack of personal responsibility leads to someone else fronting the bill. The topic was health care and cost. Obesity, as I previously linked, is one of the most costly, preventable conditions, and I argued (maybe not entirely coherently) that personal responsibility is a large factor.

Part of this argument extends to the original topic, more medical schools will not help the rates of overweight and obesity in the population. There has already been movements in policy and the health care system to try to accommodate and change our culture regarding food, provide information and programs, and more should be done, but mainly, it is an issue of personal responsibility and compliance on the population level.

I do not hate overweight or obese people. I just wanted to point out that population's burden on the health care system, and that adding more physicians won't do anything to stop it. Interestingly, obesity rates have increased as have the number of physicians. Just food for thought.

You missed the agreement and my sarcasm directed to everyone who believes the majority of obesity is not a choice.

 

[electropartyogram]

lol what? Maybe developing countries. There is crappy restaurant and fast food all over the place.

I found the post:



Also, the first comment.

 

[electropartyogram]

You missed the agreement and my sarcasm directed to everyone who believes the majority of obesity is not a choice.

No, I know what you meant and I agree with you. I wanted to add more of my thoughts for those reading my posts.

 

[KeikoTanaka]

It’s pretty clear who in this thread has seen a type 2 diabetic who weighs 300+ lbs despite only having one leg present with a blood glucose over 600 present to the ER with “sleepiness” eating a bucket of KFC vs. who has just reshared FB posts so they can label themselves as “woke.”

edit: typo

Lol many of these pre-meds are still starry eyed and hopeful. Some just finished writing about all the ethical greatness they've done in their personal statements for the 100th time.

 

[emergentmd]

lol what? Maybe developing countries. There is crappy restaurant and fast food all over the place.

This is just ignorant and wrong. Most industrialized countries do not have the ubiquitous amount of Fast food places that the US has. They don't have the ubiquitous Gas stations that are mini supermarkets filled with crappy food. They do not have the huge portions in our restaurants. Drive by any highway in any reasonable sized city and the majority are restaurants.

Unless something has changed over the past 10 yrs since I been to Italy, France, Spain; I did alot of walking to get to a restaurants and their portions were 1/2 the size. Went to a sandwhich shop in Venice and the sandwhich order was essentially two slices of breath, 1 piece of meat, and a piece of cheeze.

In America, a Sandwhich is two slices of bread, stacks of meat, double cheese, potentially grilled with a side order of fries and coke.

 

[AMCASTuesdays]

your $50 budget is the exception and not the norm. $50 budget also doesn't tell the whole story. i doubt a family only have $50 to buy food for the month/week.

We need to stop looking at headlines and hold to that as stead fast truth which is what you and many libs do instead of looking deeper into the numbers.

Ask that $50 family if they have a cell phone? nice car? Nails done? Flat screen? if the answer is no, I would be happy and empathetic to send them my tax money. But I have very little for the obese family that have a 60 inch flat screen at home, having difficulty with surfing on their iphone X b/c of their recent set of nails having difficulty stretching $50 of what is left b/c they spend it on the nonessentials.

I have great empathy and likely give more to charity than you when someone needs it and not because they make bad choices. If I were into wasting my money, I would just give it all to Uncle Sam b/c they are the biggest waster of money.

Echo Jeremy in that I'm not sure how to make you care about people less fortunate about you, or to depend less on your google fueled confirmation bias. I mean you consider food insecurity, an actual USDA qualification for lack of reliable access to nutritional foods, that has nothing to do with obesity btw, a fictional thing so idk really where we go from there.

if the answer is no, I would be happy and empathetic to send them my tax money. But I have very little for the obese family that have a 60 inch flat screen at home,

A parting word, consider that empathy is not conditional. Your view of this issue is completely misguided for sure (no lol, the families on food stamps I was working didn't forget to budget for food when they were considering the merits of a 60in TV), but even if it wasn't, the point of empathy in medicine is that it extends to everyone you come into contact with as a physician.

With that, I'm out. Lord help us all

 

[emergentmd]

Echo Jeremy in that I'm not sure how to make you care about people less fortunate about you, or to depend less on your google fueled confirmation bias. I mean you consider food insecurity, an actual USDA qualification for lack of reliable access to nutritional foods, that has nothing to do with obesity btw, a fictional thing so idk really where we go from there.



A parting word, consider that empathy is not conditional. Your view of this issue is completely misguided for sure (no lol, the families on food stamps I was working didn't forget to budget for food when they were considering the merits of a 60in TV), but even if it wasn't, the point of empathy in medicine is that it extends to everyone you come into contact with as a physician.

With that, I'm out. Lord help us all

Anytime there is a societal problem and someone doesn't Kumbaya blaming everything/everyone but the person with the most control then becomes labeled as non-caring, mean spirited, not compassionate.

It is so much easier being in your position labeling yourself compassionate/caring when all you are doing is condemning these people to continued life of dependence. But if it makes you feel better about yourself, then that is the path you will continue to take. I prefer to lay some/most blame at the person's feet and allow them to pull themselves with some help with will lead them to a better path.

But go ahead, whatever helps you sleep at night grooming the next generation for a life of obesity and dependence.

 

[TwoHighways]

Absolving people from any consequences resulting from their actions is a failed social experiment. It breeds a culture of learned helplessness, anxiety, and dependence.

You cannot tackle obesity without acknowledging that there is some level of personal responsibility in the mix. I’m all for targeting the people that profit immensely based on the current agricultural practices that contribute to the abundance of cheap garbage we have on our grocery shelves, but there’s a demand side of the equation that needs to be addressed as well.

Let’s be honest, I’d rather eat a candy bar than celery and peanut butter, but I’ve seen the chronic effects of poor dietary choices every day in my line of work, and I simply don’t want that for myself.

 

[Zen Arcade]

This thread has become a cesspool of pointless gabbing, using personal anecdotes and hypothetical situations as examples. I think it's pretty clear that the problem of obesity in America isn't solely only either personal responsibility or environmental, socioeconomic, and societal factors. Obviously if a doctor tells an obese patient that they have to eat healthier, the obese patient has free will to attempt to improve their diet - there is personal responsibility in that regard. However, to dismiss the barriers to accessing healthy food (such as the prevalence of food deserts, difficulty for poor families to find time to cook healthy meals, etc.) requires ignoring a substantial amount of evidence that these barriers exist and make it more difficult for obese patients to make the right choices. Every piece of data that has been presented in this thread has shown that personal responsibility goes hand in hand with socioeconomic and environmental factors - they both play a part in determining choices.

Please keep the political idealism that anyone can reach their goals if they work hard enough out of the discussion on how to reach a solution. This idea makes a lot of incorrect assumptions about others and frankly relies on prejudice. Having come from a more conservative family, I've heard the '____insert race or other demographic here___ are just lazy. I had to work to get where I am' argument too many times. You might not be saying this outright, but it is seeping out of some of the comments in this thread. Seriously get over it. I don't mean this is a condescending way - I used to think this way. But I believe that this way of thinking is currently hurting medicine and will continue to hurt medicine in the future. If everyone thought this way, the obesity epidemic would never improve and we would be stuck in a rut of blaming obese patients for not eating healthier without considering what else might be contributing to the problem.

 

[Cornfed101]

This thread has become a cesspool of pointless gabbing, using personal anecdotes and hypothetical situations as examples. I think it's pretty clear that the problem of obesity in America isn't solely only either personal responsibility or environmental, socioeconomic, and societal factors. Obviously if a doctor tells an obese patient that they have to eat healthier, the obese patient has free will to attempt to improve their diet - there is personal responsibility in that regard. However, to dismiss the barriers to accessing healthy food (such as the prevalence of food deserts, difficulty for poor families to find time to cook healthy meals, etc.) requires ignoring a substantial amount of evidence that these barriers exist and make it more difficult for obese patients to make the right choices. Every piece of data that has been presented in this thread has shown that personal responsibility goes hand in hand with socioeconomic and environmental factors - they both play a part in determining choices.

Please keep the political idealism that anyone can reach their goals if they work hard enough out of the discussion on how to reach a solution. This idea makes a lot of incorrect assumptions about others and frankly relies on prejudice. Having come from a more conservative family, I've heard the '____insert race or other demographic here___ are just lazy. I had to work to get where I am' argument too many times. You might not be saying this outright, but it is seeping out of some of the comments in this thread. Seriously get over it. I don't mean this is a condescending way - I used to think this way. But I believe that this way of thinking is currently hurting medicine and will continue to hurt medicine in the future. If everyone thought this way, the obesity epidemic would never improve and we would be stuck in a rut of blaming obese patients for not eating healthier without considering what else might be contributing to the problem.

/thread

 

[emergentmd]

It have been proven time and time again that the best way to change your path is to take responsibility to change your path. It has been proven time and time again that even if society breaks down most barriers, people don't change their behavior.

Put a salad bar with the same access and cost as Mcdonalds throughout the country, you will not change most people's habits. Oh, I forgot that Mcdonalds and almost every fast food restaurant has healthy choices as similar prices as a BigMac.

It has been proven time and time again that social programs do not work for improved longterm outcome unless the person takes it upon themselves to be accountable which tends to be the more difficult path.

 

[Zen Arcade]

It have been proven time and time again that the best way to change your path is to take responsibility to change your path. It has been proven time and time again that even if society breaks down most barriers, people don't change their behavior.

Put a salad bar with the same access and cost as Mcdonalds throughout the country, you will not change most people's habits. Oh, I forgot that Mcdonalds and almost every fast food restaurant has healthy choices as similar prices as a BigMac.

It has been proven time and time again that social programs do not work for improved longterm outcome unless the person takes it upon themselves to be accountable which tends to be the more difficult path.

And, as proven time and time again in this thread, you make absolute claims without providing a single shred of scientific evidence to back them up. Every piece of data linked in this thread suggests that personal responsibility is much more nuanced than you make it out to be. A physician shouldn't be relying solely on anecdotes to back up their claims.

 

[Futuredocplz531]

And, as proven time and time again in this thread, you make absolute claims without providing a single shred of scientific evidence to back them up. Every piece of data suggests that personal responsibility is much more nuanced than you make it out to be. A physician shouldn't be relying solely on anecdotes to back up their claims.

What’s one thing successful people have in common? Personal responsibility and accountability

 

[AMCASTuesdays]

What’s one thing successful people have in common? Personal responsibility and accountability

They also more often have legacy and socioeconomic background in common

 

[Cornfed101]

I'm not sure why we are still going at this. It is both personal responsibility and environment, just like everything else (surprise!). Someone with a family history of alcoholism is more prone to being an alcoholic. If you have huge portions given to you at a restaurant, not everyone has the wherewithal to stop when they have finished 1/3 of it. Is there personal responsibility there? Sure. Is it also the fact that our portions are huge here? Absolutely.

The thread was about opening more schools. That's a dumb idea due to residency bottleneck, but we do need more physicians. Not because everyone is fat, but because you have to wait months to see a PCP. My daughter got an ear infection and they said they could see us in two weeks. That's stupid. An ear infection doesn't last that long.

 

[Futuredocplz531]

They also more often have legacy and socioeconomic background in common

You heard of Ben Carson? Also look at some pro atheletes who came from nothing

 

[TwoHighways]

You heard of Ben Carson? Also look at some pro atheletes who came from nothing

It doesn’t fit the narrative. The hypocrisy is astounding. How is writing off people who have pulled themselves up by the bootstraps any different than ignoring the sociological determinants of health? This is the real problem with politics. There’s no intellectual honesty. No one wants to concede anything that doesn’t align to their own worldview.

Meanwhile, hardly anyone has put forth any real solutions to the problem. I suggested a few. Anyone else have some ideas?

 

[Med Ed]

Okay. But wouldn't you also learn to manage those things by training in your actual field. It doesn't make much sense to me. You're either going to learn about things, you have no business managing or you're going to be doing things that you should be managing but getting less exposure to them because of the latter. So what does it do for you?

Oh, I don't know. Better understand the eye in the context of broader human physiology and pathology. Better understand and coordinate care with physicians in other specialties. Show up to ophtho residency having already had to make decisions and work with some measure of independence.

Look, nobody is forcing ophtho or any other specialty to require a year of whatever before starting dedicated training. If you really can't wrap your head around why it's desirable then I suggest you approach a PD or two.

 

[ChymeofPassion]

It doesn’t fit the narrative. The hypocrisy is astounding. How is writing off people who have pulled themselves up by the bootstraps any different than ignoring the sociological determinants of health? This is the real problem with politics. There’s no intellectual honesty. No one wants to concede anything that doesn’t align to their own worldview.

Meanwhile, hardly anyone has put forth any real solutions to the problem. I suggested a few. Anyone else have some ideas?

My freshman year sociology professor started off the course by saying "lots of people say sociologists just point out problems, complain, and offer no solutions".

Well...

 

[Matthew9Thirtyfive]

This is just ignorant and wrong. Most industrialized countries do not have the ubiquitous amount of Fast food places that the US has. They don't have the ubiquitous Gas stations that are mini supermarkets filled with crappy food. They do not have the huge portions in our restaurants. Drive by any highway in any reasonable sized city and the majority are restaurants.

Unless something has changed over the past 10 yrs since I been to Italy, France, Spain; I did alot of walking to get to a restaurants and their portions were 1/2 the size. Went to a sandwhich shop in Venice and the sandwhich order was essentially two slices of breath, 1 piece of meat, and a piece of cheeze.

In America, a Sandwhich is two slices of bread, stacks of meat, double cheese, potentially grilled with a side order of fries and coke.

I mean I dunno I’ve just been to a lot of countries during my time in the military and have seen plenty of fast food places in almost all of them.

But let’s take the UK for a start. There are 1,249 McDonald’s restaurants in the UK. California, which has enough square mileage to hold 1.74 UKs, has 1,276. And that is the state with the largest number. Population wise, there are 65 million people in the UK. California only has 39.5 million, so per capita there are more McDonald's per capita in California.

Let's look at all fast food places in the UK. There are apparently over 26,000 quick service restaurants (fast food places) in the UK out of a total of 86,630 restaurants. That's about 30%. There are 243,698 QSRs in the US out of a total of 660,775 restaurants. That's 36%. I don't consider that a significant difference.

Maybe Italy, France, and Spain are different, but there were plenty of places in Japan too. Japan is actually the number one country for most restaurants per capita.

 

[Angus Avagadro]

“I hate them! I HATE them!” @electropartyogram cried
With their upper lip curled in a grimace so snide
“I drink my chai smoothie at quarter to THREE,
and then jog 10k twice—why can’t they be like ME?
Surely there’s time between three different jobs
To make a nice pot roast—those poor, ugly SLOBS!
Why must they go on eating that horrid slime?
Because there’s no money? Because there’s no time?
Because they’re all stressed about bills yet in store?
Should’ve thought about THAT when they chose to be poor!"

"And now when I see patients they’re all fat, fat, FAT!
Well, now, I’ve got a great solution for THAT
If we take their healthcare—put them further in need,
Maybe THEN they’ll think twice! Maybe then they’ll take heed!
Who knew the solution was so simple, yet big?
Just make them all poorer, those fat, blubbery pigs!”
With that, then, they finished the rest of their shake
And set off to treat our country’s great mistake.

With all this in mind, now, I really must pry
To all those on this forum—why medicine? Why?
Did your shadowing and rotations, in all of their wealth,
Not showcase the social determinants of health?
Who did all of you THINK you were going to treat?
The young and the fit? Come in, take a seat!
Should the ER have two lines there, on the way in—
This way for FAT! This way for THIN!

“I want to treat only when it’s NOT their fault!”
Should’ve chosen another career, bro, don’t salt
Don’t push your regret and your lack of due patience
On those you deem blobs—or as they’re called, “your patients”
Or maybe go do plastics up in LA
“Oh, you’d like a nose job? Come here, right this way!”
And if you can’t see it with at least some good humor,
I guess then I’ll shrug and I’ll say—
OK boomer

Impressive! Very right brained.

 

[tri99]

There are many individuals in poor health due to their own life choices just like their are many individuals in poor health due to lack of resources. I’m not sure how this is even an argument.

While this is a fact, whether not you’re willing to forgo 2.6% of your annual earnings (assuming highest tax bracket and the most recent change in taxation under new administration) to help those individuals is your opinion and nothing more.

 

[Med Ed]

At least in the case of eye-balling, it's because the AAO requires it. They don't cite any specific reason, and there's no strict requirements in terms of what type of postgraduate internship training is required. You can do surgery, internal medicine or pediatrics... I mean come on. One would think they would at least have a preference. I chose to mention ophthalmology because it's by far the most extreme example you could pick. I'm not the only one saying this, real doctors think so too. The point is there could be parts of residency training for certain specialties that take up a lot of time, for little benefit and could be cut to shorten residency training time. That's much easier than creating new residency programs and whatever to address any existing or coming doctor shortage.

Fascinating. Do go on.

 

[Cornfed101]

You can do surgery, internal medicine or pediatrics... I mean come on.

you do realize that you do surgery as an ophthalmologist, and you can do general or sub-specialize in pediatric ophtho (among other options)?

 

[meepdog]

I mean I dunno I’ve just been to a lot of countries during my time in the military and have seen plenty of fast food places in almost all of them.

But let’s take the UK for a start. There are 1,249 McDonald’s restaurants in the UK. California, which has enough square mileage to hold 1.74 UKs, has 1,276. And that is the state with the largest number. Population wise, there are 65 million people in the UK. California only has 39.5 million, so per capita there are more McDonald's per capita in California.

Let's look at all fast food places in the UK. There are apparently over 26,000 quick service restaurants (fast food places) in the UK out of a total of 86,630 restaurants. That's about 30%. There are 243,698 QSRs in the US out of a total of 660,775 restaurants. That's 36%. I don't consider that a significant difference.

Maybe Italy, France, and Spain are different, but there were plenty of places in Japan too. Japan is actually the number one country for most restaurants per capita.

THANK you. Literally live in a developing/undeveloped country right now. There is fast food anywhere people can afford it, and obesity is a problem among anyone without such a problem with nutritional access that their growth is stunted. Delivery services and all that jazz are absolutely booming. Even among the poorest of the poor, the staple food is calorie-dense and nutrient deficient. I don't know enough to comment on everything, but the way determinants of obesity has been framed as a strictly American phenomenon in this thread have been just objectively wrong.

 

[emergentmd]

I find it fascinating that only 1/9 are food insecure. If someone asked me if there was a time in the past year that I had concerns about getting food, I would definitely be in the 1/9. I remember many shifts that I was so busy that I had to skip lunch and couldn't go down to get my meal in the doctor's lounge. I went hungry and didn't know when I could grab a bite.

Add me to the food insecure group.
Financial insecure group = had to make alot of sacrifices to to be able to pay for my taxes
Housing insecure group = Had difficulty finding a place to stay b/c the resort was booked during the holidays
Transportation insecure group = My car was in the shop and had to share a care with the wife
Internet insecure group = Time warner have so much glitches
Electricity insecure group = Millions of Cali people have no clue when the rolling black out is going to happen.

 

[Med Ed]

you do realize that you do surgery as an ophthalmologist, and you can do general or sub-specialize in pediatric ophtho (among other options)?

And that the difference between a PGY-2 and PGY-1 in any field is immense.

 

[Zen Arcade]

I find it fascinating that only 1/9 are food insecure. If someone asked me if there was a time in the past year that I had concerns about getting food, I would definitely be in the 1/9. I remember many shifts that I was so busy that I had to skip lunch and couldn't go down to get my meal in the doctor's lounge. I went hungry and didn't know when I could grab a bite.

Add me to the food insecure group.
Financial insecure group = had to make alot of sacrifices to to be able to pay for my taxes
Housing insecure group = Had difficulty finding a place to stay b/c the resort was booked during the holidays
Transportation insecure group = My car was in the shop and had to share a care with the wife
Internet insecure group = Time warner have so much glitches
Electricity insecure group = Millions of Cali people have no clue when the rolling black out is going to happen.

Wow, we got a live one here guys! Not only is he solely using personal anecdotes to back up his claims, but everything he says points to him being the victim. Seems like the orange man in office is contagious. A classic example of Trumpfluenza. Time to quarantine the sub mods!

 

[electropartyogram]

Wow, we got a live one here guys! Not only is he solely using personal anecdotes to back up his claims, but everything he says points to him being the victim. Seems like the orange man in office is contagious. A classic example of Trumpfluenza. Time to quarantine the sub mods!

There was no reason for you to inject partisan politics into this thread.

 

[emergentmd]

Wow, we got a live one here guys! Not only is he solely using personal anecdotes to back up his claims, but everything he says points to him being the victim. Seems like the orange man in office is contagious. A classic example of Trumpfluenza. Time to quarantine the sub mods!

that was in jest but alot of truth in it. Read how this fascinating food insecurity poll was structured and how the questions were asked. Anyone who thinks this study/poll as any validity needs to rethink higher education.

"The federal government annually measures household food security – defined as all people in a household having enough food for an active healthy life at all times – and distinguishes four levels of food security from high to very low.4 Households classified as having low or very low food security are combined into the category of food insecure. In 2012, more than one in seven (17.6 million) U.S. households experienced food insecurity at some time during the year.5 All of these households experienced limited or uncertain access to adequate food including reports of reduced quality, variety, or desirability of diet. About 7 million of these households had members who went hungry or skipped meals, an indication of very low food security. "

Let me break down this study for you.
1. They clump all severity into one group and Label them Food insecure
2. If you had one instant in the past year where you felt like you did not have enough to eat then you are labeled as Food insecure
3. 7 Million of this group went hungry or skipped meals = Low food security.

Ask almost anyone and they will fit into the food insecure group in the past year.

I skip meals all the time b/c I am too busy or didn't have enough to eat b/c I am too busy or come last to the table and most of the food was gone.
I go hungry all the time after a meal b/c I chose not to overstuff myself and happy to be alittle light = DIET
I grew up where we had basic foods to eat, still hungry after the food was gone but I would never say I was food insecure.

I would love to see the BMI of the respondents and would be the study flag bearer if all these pts were under Avg BMI. I suspect the majority of these people are OBESE/higher than avg BMI. These people need to be selected out.


Per your political twist, this is more Fake news from the Left.

 

[Zen Arcade]

that was in jest but alot of truth in it. Read how this fascinating food insecurity poll was structured and how the questions were asked. Anyone who thinks this study/poll as any validity needs to rethink higher education.

"The federal government annually measures household food security – defined as all people in a household having enough food for an active healthy life at all times – and distinguishes four levels of food security from high to very low.4 Households classified as having low or very low food security are combined into the category of food insecure. In 2012, more than one in seven (17.6 million) U.S. households experienced food insecurity at some time during the year.5 All of these households experienced limited or uncertain access to adequate food including reports of reduced quality, variety, or desirability of diet. About 7 million of these households had members who went hungry or skipped meals, an indication of very low food security. "

Let me break down this study for you.
1. They clump all severity into one group and Label them Food insecure
2. If you had one instant in the past year where you felt like you did not have enough to eat then you are labeled as Food insecure
3. 7 Million of this group went hungry or skipped meals = Low food security.

Ask almost anyone and they will fit into the food insecure group in the past year.

I skip meals all the time b/c I am too busy or didn't have enough to eat b/c I am too busy or come last to the table and most of the food was gone.
I go hungry all the time after a meal b/c I chose not to overstuff myself and happy to be alittle light = DIET
I grew up where we had basic foods to eat, still hungry after the food was gone but I would never say I was food insecure.

I would love to see the BMI of the respondents and would be the study flag bearer if all these pts were under Avg BMI. I suspect the majority of these people are OBESE/higher than avg BMI. These people need to be selected out.


Per your political twist, this is more Fake news from the Left.

1) I don't even know where this source is coming from because you didn't provide a citation
2) You didn't even give any example of how the questions were asked, you just reported the findings... They could have asked much more nuanced questions and then grouped people into these categories before reporting the findings. If you want to criticize the methods, at least point out how a specific question makes the results misleading, how the statistical power could be better, etc.
3) All epidemiological and sociological studies are just that: they combine large groups of people together and identify vulnerable groups and those who are more likely to have a disease, have difficulty accessing food, etc. Of course not EVERYONE in the group that is deemed vulnerable will actually be a victim to the whatever the study is investigating, but the data is useful for identifying trends.
4) A response to so-called 'leftist fake news' usually looks like this: No citation, vague criticism of the findings without fully understanding and/or adressing the methodology of the research or problem at hand, an attempt to discredit an entire field of scientific study based on conjecture, and pinpointing any conflicting evidence as leftist political propaganda.

EDIT: I decided to do my own research on the measures of food insecurity, and using this CITATION (USDA ERS - Measurement), I think I know why you decided not to quote the actual questions asked.

"Placement on this continuum is determined by the household's responses to a series of questions about behaviors and experiences associated with difficulty in meeting food needs. The questions cover a wide range of severity of food insecurity.

Least severe:
Was this statement often, sometimes, or never true for you in the last 12 months? "We worried whether our food would run out before we got money to buy more."

Somewhat more severe:
Was this statement often, sometimes, or never true for you in the last 12 months? "We couldn't afford to eat balanced meals."

Midrange severity:
In the last 12 months, did you ever cut the size of your meals or skip meals because there wasn't enough money for food?

Most severe:
In the last 12 months, did you ever not eat for a whole day because there wasn't enough money for food?

In the last 12 months, did any of the children ever not eat for a whole day because there wasn't enough money for food?"

These questions CLEARLY are classifying food insecure people as those who couldn't afford food.

 

[Chad12]

God no can we please stop building MD/DO schools before we end up like law students. Building more schools to satisfy the people who can't get in to medical school is absurd because it disadvantages the medical students that worked their asses off to get in and have the luxury of knowing that once they are in they are almost guaranteed a residency and a job as long as they graduate. I sound like a pompous doushbag and maybe I am. I barely scraped an acceptance out of pure luck and may have had to reapply a couple times but I'd take that over having to reapply for residency while I'm 200k+ in debt.

 

[electropartyogram]

God no can we please stop building MD/DO schools before we end up like law students. Building more schools to satisfy the people who can't get in to medical school is absurd because it disadvantages the medical students that worked their asses off to get in and have the luxury of knowing that once they are in they are almost guaranteed a residency and a job as long as they graduate. I sound like a pompous doushbag and maybe I am. I barely scraped an acceptance out of pure luck and may have had to reapply a couple times but I'd take that over having to reapply for residency while I'm 200k+ in debt.

If they are going to build them anywhere just put them in the Carribean!

 

[Cornfed101]

If they are going to build them anywhere just put them in the Carribean!

I might open a few. I've heard it's pretty lucrative

 

[gyngyn]

This thread is not the place for polarized politics.

 

[Princeton Medical Student]

I always have wondered how hellish the entire medical school landscape would be if the competition wasn't to get into med school but rather into any single residency program (kinda like law school).

 

[sunshinefl]

You are misunderstanding and let me clarify.

In other countries, fast food is not as available as it is in the United States. Foreigners who travel to the U.S. all remark about how large the portions are. We as Americans know this and somehow are proud of it.

In Europe for example, the culture is completely different. Fast food is not predominant. People cook their food on their own, or they need to travel to obtain fast food.

In the U.S., we have freaking food delivery for when you are too lazy. We have grocery pickup. We all have cars. We are much less active. We snack a lot. We snack way too much. People snack when they are bored, or sad, or to supplement their entertainment. And it’s not healthy snacks.

The U.S. just has too much access to calories, and nothing to really counter the excess. The “slimmest” stateI believe is Colorado. I wonder why? They have mountains, skiing, outdoor activities. Around the world, people make an effort to go out to eat; they walk, use public transit, bike. We drive our cars, sit in the drive-thru.

Despite these differences people still choose to eat their entire plate at The Cheesecake Factory.

We have a culture centered around food. Every day, people make a rational choice to stop by McDonald’s or get the sugary soda from the lounge. We make these choices without thinking now. While there is fault with the fast food industry, there’s a point where people need accountability and to take responsibility for their daily choices. While not the same, but for thought: are alcohol companies responsible for when people get intoxicated and drive? I do not believe they are. Are fast food companies responsible for obesity? Not necessarily. Even with transparent calorie counts on food, obesity rates have increased!

Sounds like a personal responsibility problem to me.

Okay... I’ve accepted responsibility. Does that mean you will stop chastising me or....

I apologize for using "blob". It was not intended to marginalize obesity.

If as a country we continue to make obesity a disease and not a personal responsibility, then we are just going to make the issue worse. This can be debated but to me Obesity along with drinking/smoking/poor health choices/ not exercising is a personal responsibility. If you choose to do something that clearly has been demonstrated to benefit you (eat right/exercise) and you chose not to do it then it is your personal choice.

I am no better than anyone else. I love ice cream, I love good food, I really do not enjoy running 3 times a week, I rather eat whatever I want. But that is the CHOICE I make to be healthier. Just as I Never smoke, only socially drink, and stop eating when I feel full. Just as I take a shower every day, brush my teeth everyday, keep my house clean, take care of my car, wash my clothes. Its a choice I make to have better health.

If I ignore regular maintenance on my car, and it breaks down all the time then it is my fault. No one will argue with this.
If you don't take care of your body and it breaks down prematurely, then how can some say that it is not their fault???? I will never understand this.

You would not put bad gas in your car but people can put Bad food in their body every day.

And please, don't tell me that some are too busy to cook. You can go to any fast food joint and order healthy options like a salad. Even if you order unhealthy food, it doesn't mean you have to eat the whole meal and wash it down with a coke and shake. I go to cheesecake factory all the time and I order unhealthy items all the time. But instead of eating the 2K calorie meal, I eat 1/3 of it and bring the rest home. The Obese guy all around me (Yes, look around you at a cheesecake factory) just packed in Bread/butter service, fried calamari, Burger/fries, Coke, and topped it off with a whole slice of cheescake faster than I could finish my bread service. I swear these people don't even stop to talk or finish chewing before the next glob gets shoved in. I am not even sure they even tasted the food.

I don't care what another person does with their body eventhough that Cheesecake guy's eating habit is quite disgusting but blame yourself for your poor health and not someone else b/c you don't feel you have adequate healthcare access.

Okay great anecdote about Cheesecake Factory so I’ll share my experience eating there as one of your “blobs”: I drink water, I get vegetarian food, I take half my meal home, I take home a slice of cheesecake without even eating a bite there, I eat a couple bites here and there over several days and usually throw the rest out once it’s been a week and it’s not fresh anymore.

 

[Obnoxious Dad]

God no can we please stop building MD/DO schools before we end up like law students. Building more schools to satisfy the people who can't get in to medical school is absurd because it disadvantages the medical students that worked their asses off to get in and have the luxury of knowing that once they are in they are almost guaranteed a residency and a job as long as they graduate. I sound like a pompous doushbag and maybe I am. I barely scraped an acceptance out of pure luck and may have had to reapply a couple times but I'd take that over having to reapply for residency while I'm 200k+ in debt.

Currently, growth in the number of medical school seats in the U.S. would be irrelevant to the physician job market. It's the number of residency slots that affect the supply and compensation of physicians. In the 2019 match about 3,600 categorical slots were taken by non U.S. IMGs. 2,760 categorical slots were taken by U.S. IMGs. I suspect another 300 or so U.S. IMGs and non U.S. IMGs took slots in programs that do not participate in the match and a few more U.S. IMGs may have successfully soaped.

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2019/04/NRMP-Results-and-Data-2019_04112019_final.pdf

Let's assume residency programs stopped growing. There would still be room for another 6,600 Americans per year with domestic medical degrees if Americans stopped attending Caribbean schools and non U.S. IMGs stopped getting visas for residency. More schools won't affect physician salaries for the foreseeable future.

The quoted post assumes that people who didn't get into medical school were necessarily less worthy of admission than people who got in. That's not always true. The allopathic medical school admissions process is not perfectly rational and it is not conducted on a level playing field. If you are from Michigan, West Virginia, North Dakota and have reasonable stats, you will get in to an allopathic med school. If you are from New Hampshire, California, Rhode Island, you could get end up in a DO school or the Caribbean.

Finally, the lousy job market for law school graduates is not the product of law school growth. It is the result of legal simplification and automation. The number of law students in the U.S. today equals the number of U.S. law students in 1975.

Law School Enrollment Trends, 1963-2024 | LawHub

Compare 1L enrollment, JD enrollment, non-JD enrollment, 1L attrition, ABA Standard 501 compliance, admissions standards, demand for law school as measured by LSAT takers, applicants, and the national acceptance rate.

data.lawschooltransparency.com

 

[emergentmd]

Okay great anecdote about Cheesecake Factory so I’ll share my experience eating there as one of your “blobs”: I drink water, I get vegetarian food, I take half my meal home, I take home a slice of cheesecake without even eating a bite there, I eat a couple bites here and there over several days and usually throw the rest out once it’s been a week and it’s not fresh anymore.

Unless you have a medical condition that slows down your metabolism, which is a small percentage, most obese people overeat. Define overeating how you want, but you take in more calories than your body burns. Its simple math. If you are obese, then over your lifetime you have taken in more than you burn, thus your body has told you that you are overeating which results in gaining weight. Just because you don't feel full or leave half the food on the plate, if you gain weight then you have eaten too much.

My weight fluctuates around 5 lbs either way. When I am 5lb above my norm, I work out more/eat less.

I have friends/family who always complain that they can't lose weight and they barely eat much. Everyone's frame of reference to food is different but almost everyone who gains weight has consumed more than 1800 -2000 calories a day.

 

[emergentmd]

Currently, growth in the number of medical school seats in the U.S. would be irrelevant to the physician job market. It's the number of residency slots that affect the supply and compensation of physicians. In the 2019 match about 3,600 categorical slots were taken by non U.S. IMGs. 2,760 categorical slots were taken by U.S. IMGs. I suspect another 300 or so U.S. IMGs and non U.S. IMGs took slots in programs that do not participate in the match and a few more U.S. IMGs may have successfully soaped.

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2019/04/NRMP-Results-and-Data-2019_04112019_final.pdf

Let's assume residency programs stopped growing. There would still be room for another 6,600 Americans per year with domestic medical degrees if Americans stopped attending Caribbean schools and non U.S. IMGs stopped getting visas for residency. More schools won't affect physician salaries for the foreseeable future.

The quoted post assumes that people who didn't get into medical school were necessarily less worthy of admission than people who got in. That's not always true. The allopathic medical school admissions process is not perfectly rational and it is not conducted on a level playing field. If you are from Michigan, West Virginia, North Dakota and have reasonable stats, you will get in to an allopathic med school. If you are from New Hampshire, California, Rhode Island, you could get end up in a DO school or the Caribbean.

Finally, the lousy job market for law school graduates is not the product of law school growth. It is the result of legal simplification and automation. The number of law students in the U.S. today equals the number of U.S. law students in 1975.

Law School Enrollment Trends, 1963-2024 | LawHub

Compare 1L enrollment, JD enrollment, non-JD enrollment, 1L attrition, ABA Standard 501 compliance, admissions standards, demand for law school as measured by LSAT takers, applicants, and the national acceptance rate.

data.lawschooltransparency.com

Your premises may be correct initially, but you don't look at the ramification down the road which is what politicians always do. Put a bandaid on now but don't look at the consequences down the road.

Lets assume your above data and rounded for simplicity, currently 6K residency spots. 3000 to IMGs, 3000 US grads. Currently most US grads gets to the field they want and the rest (mostly Primary care) is left for IMGs

We double the med schools and now produce 6K US grads. Now you have 3K IMG, 6K US.
Lets assume 5K US grads get residency spots, 1K IMG.

What do you think is going to happen? There would be an uproar from med schools with 15-20% Grads with useless degrees and no residency spots. The 5K US grads who gets residency spots would have a good percentage that are stuck in Primary care in the middle of nowhere.

What would be your solution to fix this problem now that the Genie is out of the box? Thats right, you have to double residency spots to give the med students their residency choices.

 

[Chad12]

Currently, growth in the number of medical school seats in the U.S. would be irrelevant to the physician job market. It's the number of residency slots that affect the supply and compensation of physicians. In the 2019 match about 3,600 categorical slots were taken by non U.S. IMGs. 2,760 categorical slots were taken by U.S. IMGs. I suspect another 300 or so U.S. IMGs and non U.S. IMGs took slots in programs that do not participate in the match and a few more U.S. IMGs may have successfully soaped.

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2019/04/NRMP-Results-and-Data-2019_04112019_final.pdf

Let's assume residency programs stopped growing. There would still be room for another 6,600 Americans per year with domestic medical degrees if Americans stopped attending Caribbean schools and non U.S. IMGs stopped getting visas for residency. More schools won't affect physician salaries for the foreseeable future.

The quoted post assumes that people who didn't get into medical school were necessarily less worthy of admission than people who got in. That's not always true. The allopathic medical school admissions process is not perfectly rational and it is not conducted on a level playing field. If you are from Michigan, West Virginia, North Dakota and have reasonable stats, you will get in to an allopathic med school. If you are from New Hampshire, California, Rhode Island, you could get end up in a DO school or the Caribbean.

Finally, the lousy job market for law school graduates is not the product of law school growth. It is the result of legal simplification and automation. The number of law students in the U.S. today equals the number of U.S. law students in 1975.

Law School Enrollment Trends, 1963-2024 | LawHub

Compare 1L enrollment, JD enrollment, non-JD enrollment, 1L attrition, ABA Standard 501 compliance, admissions standards, demand for law school as measured by LSAT takers, applicants, and the national acceptance rate.

data.lawschooltransparency.com

I don't think they are less worthy but not everyone gets to go to medical school and thats a fact of life just like the way not everyone gets to be a professional sportsperson even though a large majority of people dream of it. The solution is not to dilute the quality of athletes to fulfill everyone's wishes right? So why do that in medicine? If you can't get into an existing allopathic or osteopathic school even after reapplication, there's probably something extremely gaping in your application and maybe medicine isn't the best path for you. Also if you read my post I'm against expanding both MD and DO schools because doing so disadvantages both MD and DO students(both of which produce fine physicians). I have a lots of friends in osteopathic schools who are so sick of new schools popping up in stripmalls every year and diluting the quality of their degree. While allopathic schools have a bit more stringent conditions to open a school, I can see us going down the same route in the future.