Future of MDs

[GuBa]

Having done fair amount of research on medical school entrance, I came across two issues of interest. 1) There are predictions about an MD glut, soon to be as with PhDs - way too many. 2) A number of medical institutions (if not all) are in serious financial constraints. There were even a few posts in this room I had come across. Will there be negative impacts? I would appreciate any comments (if possible with references). I don't want to jump onto a sinking ship. Thanks in advance.

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[Billie]

Hi,

There isn't so much a physician "glut" as there is an uneven distribution of physicians geographically. There are still many areas that are in great need of docs, especially the rural and inner-city/urban areas.

The financial problems I cannot speak of. Anyone else have info?

Billie

 

[turtleboard]

Many medical institutions these days are undergoing financial restructuring, and trying to cope with the constantly changing face of healthcare in America. It's difficult to keep up and, as we'll see in the next few years, some institutions will close their doors.

It's a never-ending cycle, however. Things go up and down even in medicine, so to get into medicine now or when it's at its highest point won't make one bit of difference. Med Schools have closed before only for others to open up.


Tim of New York City.

 

[dugan]

I think you're right, Billie. And not only is there a problem with geographical distribution, but there is also a problem with distribution among specialties.

If this is a sinking ship, we have the power to keep it afloat--and thus have no cause to complain.

And no matter what the naysayers say (usually "nay," I guess), there will *always* be a demand for MDs. They perform a basic and indispensible function. (Well, in theory.) Furthermore, if there were to be an MD glut, it would require either the founding of additional med schools or substantial class-size increase. This doesn't happen all that often, I don't think. (does it?)

 

[dugan]

check out this USN&WR article for info on the financial state of academic medicine:
http://www.usnews.com/usnews/edu/beyond/grad/gbhosp.htm

 

[rangers1]

My understanding about the financial difficulty is not so much directly with the med schools, but with the teaching hospitals they utilize. Beacuse at least half of the time in med school, assuming years 3 and 4, will be in that hospital, one can see how the stability of the hospital effects the foundation of the med school. The federal governments most recent cuts in Medicare reimbursement has srastically effected the busget of these teaching hospitals, costing them millions per year in revenue. Let us all hope that the federal governments record surplus finds its way back into the treasuries of these teaching hospitals so that tomorrows doctors will receive proper training.

Pertaining to the Glut of Doctors; in an effort to keep the number of doctors in the United States from reaching the levels seen by the evil and dreaded law profession (I appologize for not being able to contain my disdain), the aquisition of U.S. residencies by foreign med school graduates has been severly inhibited. The hope is that the MD/DO practicing in the US will also have trained there, preventing a saturation of the profession. The other comments about the geographic doctor distribution are also 100% accurate.

 

[GuBa]

Billie, you are right about the disproportionate distribution of MDs within the US. This prevalant "problem" seems to be continuous through out. However, it does not seems to have a significant negative impact on future MDs; applications numbers have been on the increase until recently. My main worry is addressed by what Dugan had provided in his link. Give it a read, I had come across a similar (though not as detailed) article in CNN.com. Also, my state school UCONN had just recently received a bailout of millions to keep on keeping on (for how long???). I wonder what that will do to the faculty - will some preceive it as a sign to move on, if so this will have negative impact on students at all levels.

Something else, being a PhD student in lab slated to be shut down, due to lack of funding, I am aware about the the funding issue. There are promises for "priority" issues, these tend to address the medical field. If these monies do not reach the teaching/MD production schools the future will look grim. I wonder if there is informal information available for schools that seem to be headed "non-MD" production. Will interviews be a wise place to raise this particular issue with the school?

Tell me what you think.

 

[Pilot]

Originally posted by dugan:
And no matter what the naysayers say (usually "nay," I guess), there will *always* be a demand for MDs.

I agree for the most part, but I worry that Insurance Companies will require more use of ARNP's and PA's for primary care in the future. Why pay a physician for an office visit, when an office visit for a PA or ARNP is cheaper?

This scenario became reality in pharmacy over the last decade, with reimbursement rates continually decreasing with each contract renewal. It has forced pharmacies to employ more technicians (at 1/3 the cost of R.Ph.'s) in order to increase volume to remain profitable. The national pharmacy organizations stood by and did nothing, and now are crying "foul."

I hope I am wrong. However, when I was asked during my med school interview what "the biggest issue facing medicine" was", I mentioned the potential of ARNP's and PA's taking over primary care, and the interviewer's jaw dropped, and he admitted he had never even thought of this.

Just something to keep an eye on, and let the national medical associations know if you see this occur so they can take up the battle for physicians everywhere.

Just my opinion, and enjoy the summer before next year's grind..... Pilot

 

[---123]

>I mentioned the potential of ARNP's and PA's taking over primary care

It's certainly been observed that the GP is being replaced by the NP, and the specialist is being replaced by the GP. These are unique times. Many institutions, particularly academic/research facilities, are facing big fiscal challenges. And in one sense, this isn't bad. A pruning of sorts can be healthy to longevity. I'll personally argue the overwhelming and undue influence of insurance companies/HMOs is an imbalance, and that the pendulum by necessity will swing towards the middle. Indeed, that paradigm shift has already started to occur(witness the recent Patient Bill of Rights legislation). The fact is MDs and hospitals needed to get more efficient. And now that that's happened for the most part, and they're monitoring themselves, it becomes increasingly more absurd to continue the current trend. It's ALWAYS easier and cheaper to have people police themselves. The numbers problem is largely a distribution issue, as previously noted. Indeed, the AMA, unlike the ABA, keeps a very tight reign on the numbers of new applicants each year. They are extremely committed to keeping the numbers within a specified range(largely to guarantee their own salary)