Don't Believe The Feds!

Discussion in 'Clinical Rotations' started by Goofy, Jan 31, 2002.

  1. Goofy

    Goofy Senior Member

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    I don't have the source at the moment, but a recent study (reputable) delineated a very big shortage in medical specialists in general and physicians in particular.

    I have debated this issue with my colleagues for years, and it seems that the powers that be were either dead wrong, or simply lying to us. I will let you decide. In any case, with an aging population, MORE docotors in all fields will be needed. A shortage of thousands already exists ballooning to 50,000 by 2010. I think the numbers in the article are conservative. The bottom line: We all win! The population continues to age, and virtually every discipline stands to benefit, from nurses and PA's to seasoned specialists.

    I have dubbed this the great health care conspiracy. I believe PA's and nurse practitioners in particular stand to gain the most, as they will have to pick up the slack. There simply isn't enough physicians around to handle the patient load NOW! And it is getting much much worse without a meaningful increase in slots. These numbers include the influx of foreign grads as well.

    Thoughts?
     
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  3. Voxel

    Moderator Emeritus

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    I've stated this in a previous post about how the Pew Commission report on the oversupply of specialists was just smoke-screen to get more people into primary care.

    The top 4 areas of growth in the medical field will be in order of higher to lower # of cases.
    1) Cardiovascular disease 2) Oncology, 3) Cerebrovascular disease+Peripheral Vascular Disease and 4) Orthopaedic/Rheumatologic disease. In addition there will be an overall increase in diseases of the elderly across every specialty (except pediatrics of course).

    Actually there are several new DO schools opening up. So there will be more US physicians and if there will not be enough US trained physicians, the US will turn to other countries and get their FMGs and increase Medicare Funding of residency slots just like they did in the 1960s when there was a huge in-flux of FMGs, especially from India, England, Canada, Australia.
     
  4. Goofy

    Goofy Senior Member

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  5. MacGyver

    MacGyver Banned
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    Is the number of DO schools tightly regulated (like MD schools) or can any university start one up if they want to?
     
  6. brownman

    brownman Member

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    Great points all,

    Well, healthcare has three possible roads:

    1) Continued Employer driven healthcare:

    Employers continue to fit the bill, and just eat rising costs. Good thought, but only a few companies will do this. Most will do part 2.

    2) Employees bear a larger part of the burden:

    Right now, the employee doesn't feel it. The view medical care as being a co-pay if an when used, and a percentage of coverage if necessary. The future...will be very different. Plan management for employers is now COSTING MORE than the tax incentive from benefit referral. It is a huge infrastructure burden for them, not to mention a cost burden. THEY WILL DEFRAY THAT ON THE EMPLOYEE. Employee's will pick up the slack, covering remaining premiums out of thier pay check.

    3) The government takes over healthcare: now this is a possibility that will NEVER HAPPEN. But never say never I suppose. The last few years has basically been nationalized health care, especially primary care. The theory is burden gets so huge for the private sector and costs become so high for the employed...that people demand the government step in. Well...people are stupid...but not that stupid! The government is notorious for mismanagement, and the tax burden on the common man would be enormous.

    Now..which is going to win. A mixture of 1 and 2 known as market driven health care. WHICH MEANS...DOCTORS WILL MAKE OUT LIKE BANDITS. Remember how everyone kept saying fee for service is a thing of the past...managed care is here to stay, etc., etc. Ok...the beauty of fee for service was that ANYBODY...whether you lived in NY city where there were a hundred other internists or the middle of nowhere....COULD GET PAID!!! Period. Now...the dollars are fixed...so the practices that are the best businesses...will make the most money. A PHYSICIAN SHORTAGE IS A BOON FOR PHYSICIANS. Large insurance companies are thinking of implementing fixed cost plans (we give the employee a fixed amount, it gets rolled over, etc.); if they want to use a physician..they pick one AT COST. If you get into a good group...you can get competitive prices, great volume and good remediation. EVEN IF you had to reduce your prices because of competition, why do you care....you will still make more than you do now...BECAUSE YOU WILL ACTUALLY GET REIMBURSED. It's what the future will be. Even the government will eventually get in on the act...they are already debating doing a similar system with social security. The bottom of the physician salary crisis is done. Salaries will continue to go up, and in certain fields more so....THE STATE TO WATCH THE BLOODY CARNAGE IS CALIFORNIA. In a few years...we are going to see market driven medicine in action...when there aren't enough physicians to staff anything in california. PALO ALTO MEDICAL CLINIC...has already started turning patients away...because there aren't enough physicians to cover them.

    The future: market driven healthcare. Private will be group practices. Greater competition, but greater reward. We'll see if people start coming back to medicine. It'll be interesting times my friends..interesting times.
     
  7. BellKicker

    BellKicker Twisted Miler

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    I'm a MD-to-be from Denmark. We have an extreme lack of doctors right now. We're importing from abroad but there are still openings.

    Try this one on for size: The shortage is so severe in certain areas that we ENTER A RESIDENCY-LOTTERY TO PLACE US IN A REGION OF THE COUNTRY. That means you in up doing your residency in Greenland or the Faeroe Islands, if you're unlucky enough.

    I don't really know the particulars of the American situation but I do know that it could be a lot worse. At least all of your residencies fill.

    Just my two cents......
     
  8. BellKicker

    BellKicker Twisted Miler

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    Oh, and Brownman....

    About option #3.

    Here in Scandinavia almost everything is government run. NOT GOOD. People are screaming for private hospitals and private insurances.

    So you're right. We have the highest taxes in the world. And our health care system isn't even that good. The government should stay out.
     
  9. ckent

    ckent Banned
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    I don't understand why people are talking about the government and number of residency spots. I know that the government funds residency spots, but my understanding was that it was the individual specialty governing organizations (ie American College of Cardiology, ACP, ACS, ACR) that determined the number of spots and that they purposely hold down the number of spots so that physicians in practice can get paid more.
     
  10. Goofy

    Goofy Senior Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by ckent:
    <strong>I don't understand why people are talking about the government and number of residency spots. I know that the government funds residency spots, but my understanding was that it was the individual specialty governing organizations (ie American College of Cardiology, ACP, ACS, ACR) that determined the number of spots and that they purposely hold down the number of spots so that physicians in practice can get paid more.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">My post wasn't about who controls the slots. It was about a rampant and wholly uninformed idea that the government has perpetuated. Namely, that there is a surplus of physicians. This is simply not the case as evidenced by recent research studies. How to deal with the problem is entirely different matter.
     
  11. Goofy

    Goofy Senior Member

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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by MacGyver:
    <strong>Is the number of DO schools tightly regulated (like MD schools) or can any university start one up if they want to?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Starting a school and gaining accreditation are two entirely different things. You cant 'just start' another school.
     
  12. MacGyver

    MacGyver Banned
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    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by Klebsiella:
    <strong> </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by MacGyver:
    <strong>Is the number of DO schools tightly regulated (like MD schools) or can any university start one up if they want to?</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Starting a school and gaining accreditation are two entirely different things. You cant 'just start' another school.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Kleb,

    I realize that its complicated to start up a new DO school. Is accreditation based on the number of schools already out there? Say for example there were 10 new DO schools that wanted accreditation and that ALL 10 of them were deemed to have a good structure, organization, etc.

    Would the accreditation body actually grant the schools accreditation based SOLELY on the individual merits of each school or do they also consider the number of schools, market, demand already in existence (i.e. the accreditation board stating something like "You have a good proposal for a school, but no matter how good you are we cant allow any new DO schools right now")
     

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