NEW Medical School in Florida (in the next few months)

[VCMM414]

If they want to build a med school to train rural physicians, you need to put them in rural areas. Miami already has a medical school and is as urban as you can get. Obviously FIU is full of it, because if it really wanted to expand rural medicine it would do so by placing the school in *gasp* a rural or underserved area-- not in a major city already with a medical school.

Also, by building a med school in rural area, there may be incentives to build a academic medical center close-by for student rotations. Voila, a medical center devoted to rural area.

How would this affect the rural area? What guarantee is there that a rural school would keep and hold rural docs?

No guarantees as far as medical students are concerned. But you will have faculty/attendings devoted to serving the rural area.

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[ctaborda]

long ass thread!

 

[Gutierrez001]

I think I read on the FIU web page that tution would only be $10K a year for in state. WHich would be great for any living in FL. Compare to UM or Nova which is 25 to 30K a year. So it would help many student living in S.FL who want to stay at home and dont have any state medical schools, So they dont have to pay that much money for private schools.

 

[Gutierrez001]

Myself some one who lives in s.fl would love the fact that FIu would open a medical school becuz I do want to stay in S.FL and would like to pay 10 K instead of 25k a year for school. Also to be around family and I am about to buy a place in nexts couple months. I know this out of the point of what some of you are talking about,why you dont want another school.But money is a big part of many student applying to med school.Its just a fact to point out why S.fl student would like a state med school in miami.

 

[ctaborda]

Myself some one who lives in s.fl would love the fact that FIu would open a medical school becuz I do want to stay in S.FL and would like to pay 10 K instead of 25k a year for school. Also to be around family and I am about to buy a place in nexts couple months. I know this out of the point of what some of you are talking about,why you dont want another school.But money is a big part of many student applying to med school.Its just a fact to point out why S.fl student would like a state med school in miami.

Exactly what I feel

go FIU!! 10,000 a year is badass!!!

 

[MedNole]

Did you know:

That the FSU medical school, created SPECIFICALLY to produce rural doctors, has produced exactly 1 doctor out of a class of 80 who plans to do rural florida medicine? 1 out of 80 is not a good hit rate.

How do your figure that 1 doctor out of a class of 80 plans to do rural medicine?? Who gave you this info?? It's completely wrong. First of all, our first class HASN'T EVEN GRADUATED! They are just getting ready to start their 4th year. Second, the class has 30 students, not 80 students. Third, I GUARANTEE more than 1 student will be practicing medicine in rural Florida. Fourth, the mission of FSU is not, as you say, "specifically to produce rural doctors." The mission is to serve the underserved people of Florida, whether that be in rural areas, urban areas, minorities, geriatrics, primary care, etc. Rural areas is only one part (and a very small part) of the mission. Fifth, why are you pissed off at students who might change their mind after getting to medical school? Did you change your mind after at all during the 4 years of medical school as to what you would like to practice?? I'm sure you did. So why would you expect FSU students to know exactly what they want to practice before they even start to see patients or learn how medicine really works? Plus, don't rural areas need specialists too? Why would you prohibit someone who wants to work in a rural town from specializing?? It makes no sense!! I'm not really in favor of adding more med schools, because the state would be much better off by adding more residency programs. Florida ranks 43rd out of 50 in number of medical residents per capita. But I still would love to know where you got your info from, because it's completely bogus.

 

[MacGyver]

I'm starting not to believe this any more. The pessimist in me (about to start med school) thought that there probably were too many doctors in wealthy urban areas, and not enough in rural and inner-city areas.

But of late I am starting to change my mind. In my home town (Cleveland) the two MAJOR urology practices (Cleveland Clinic and University Hospitals) had appointment wait times of 45 days and 60 days respectively. A bit over a month ago, I called the Dermatology practice at the Cleveland Clinic and was told the earliest appointment I could get was 60 days out - but good news, the Beechwood satelite office could get me in in 35 days. A year ago we waited almost 3 weeks to see a pediatric GI doc. What is going on?

Why do I have to wait two weeks to see my primary unless I've got an acute complaint? Why do I NEVER have to wait more than two days to see my dentist?

As I said, this is anecdotal. But I wonder if others have similar experience.

Judd

Judd, you cant use derm and uro as a basis for total availability. Its well known that those specialties are EXTREMELY hard to match into, and many people who apply dont match and have to choose something else. The remedy for that is not to open new medical schools, but to expand residency slots in those areas.

I've got no problem with more uro or derm residency slots. There is plenty of american competition for those, and they will fill with american medical grads.

 

[MacGyver]

On what basis should the LCME refuse to accredit it? Their mandate is restricted to granting or refusing accredidation based on the strength of the curriculum, not the political climate surrounding the school's charter.

Judd

They should refuse it on grounds that no new medical schools in large urban locations are needed. There is nothing wrong with that. Up to this point, this is what has distinguished medical schools from every other kind of professional/graduate program. Everybody and their brother has a PHD program which explains why PHDs get **** for salary and we have to bring in thousands of foreigners just to take the slots. Its also the reason why lawyers have to ***** themselves out to make money by chasing ambulances. There are so many lawyers out there that they are FORCED to take on nefarious activities to financially support themselves. Doctors should be above all that nonsense.

DO schools are spreading like wildfire. MDs need to hold the ranks instead of being infected with the same cancerous-like attitude that plagues law schools. If this goes unchecked, soon community colleges and commuter JUCOs will start opening up their own medical schools.

Remember, Florida already has 6 medical schools. FSU is expanding their enrollment by 50% next year and has a target of 150 students in the next 5 years. UMiami is expanding their class by 20%. LECOM will graduate 200 doctors a year, and other DO schools are also thinking about expanding into Florida.

 

[MacGyver]

How do your figure that 1 doctor out of a class of 80 plans to do rural medicine?? Who gave you this info?? It's completely wrong. First of all, our first class HASN'T EVEN GRADUATED! They are just getting ready to start their 4th year. Second, the class has 30 students, not 80 students. Third, I GUARANTEE more than 1 student will be practicing medicine in rural Florida.

I have a source from the FSU faculty who is disappointed in your schools effort. He's referring to the number of people he's taught so far, and they're not all M4 students.

Fourth, the mission of FSU is not, as you say, "specifically to produce rural doctors." The mission is to serve the underserved people of Florida, whether that be in rural areas, urban areas, minorities, geriatrics, primary care, etc. Rural areas is only one part (and a very small part) of the mission.

Whatever. You and I both know that very few members of your class or any future graduating class are going into those areas. I bet you 1 million dollars that less than 20% of your class ends up in one of those specialties in an federally designated underserved area.

Fifth, why are pissed off at students who might change their mind after getting to medical school? Did you change your mind after at all during the 4 years of medical school as to what you would like to practice??

I'm pissed because most of the students at FSU are liars. I bet if I read thru those applications EVERY SINGLE DAMN ONE OF THEM had a bunch of BS rhetoric about how they wanted to practice rural FP medicine. Like I said above, you and I both know that the VAST MAJORITY of them lied just to get accepted to medical school, and plan on either moving to a big city (NOT underserved) or into a cushy, non primary care specialty.

So why would you expect FSU students to know exactly what they want to practice before they even start to see patients or learn how medicine really works?

No, what I expect is that the state legislature of florida should put a strict mandate on numbers of students that go into primary care in underserved areas, and that if the school FAILS to meet this requirement, then drastic measures should be taken, including:

1) getting rid of all non primary care clinical rotations

2) no away rotations

The state of florida spent millions of dollars on a program to produce doctors for underserved areas, not so your colleagues can go run off to a plastic surgery residency in Miami.

If the premed applicants dont like that mandate, they can choose another school to apply to. Everybody who applies to FSU Med should know UP FRONT that they will be pushed into underserved primary care. If they dont like it, they can walk.

Plus, don't rural areas need specialists too?

The only docs required in rural areas are FPs, IMs, EM, and OB. Everything else can be relegated to the city.

Why would you prohibit someone who wants to work in a rural town from specializing?? It makes no sense!!

Rural towns dont need, nor can they support, dermatologists, radiologists, plastic surgeons, etc. If you wanted to do those specialties, you shoulda gone to another school.

I'm not really in favor of adding more med schools, because the state would be much better off at adding more residency programs.

Finally some common sense.

Florida ranks 43rd out of 50 in number of medical residents per capita.

That figure is bull**** because it excludes osteopathic graduates. Also, I wouldnt be surprised if that number also excluded FMGs. The spin doctor in charge of the FIU campaign is very sloppy with his numbers and statistics (see my email critique of his "statistics")

 

[TRUE]

MacGyver, just out of curiousity, what is your stake in all of this? You seem rather staunchly against it. Why are you so worried?

 

[MacGyver]

MacGyver, just out of curiousity, what is your stake in all of this? You seem rather staunchly against it. Why are you so worried?

Because I see the big picture and you dont. I see the expansion of midlevels at every opportunity, in EVERY state, in EVERY specialty. I see the influx of FMGs which now make up 35% of all medical residents. And now to add on to that, I see the rapid wildfire expansion of new medical schools. The most prolific medical school expansion phase in US history occurred between 1960 and 1985. We are 1 new medical school away from eclipsing that rate, measured from 1985 onwards.

The reason why I bring this up and nobody else does, is because unlike everybody else, I'm not focused on tomorrow--I'm focused on 25 years from now. The doctors who were focused on tomorrow found ways to get rich quick, at the expense of future generations of doctors by lowering the gate to midlevels. Hell they've already stormed the castle walls, and now they want to infiltrate the keep!

15 new medical schools in the last 20 years and counting.....

 

[MedNole]

I don't care who you're "faculty source" is...he/she is wrong and has no idea what is going on in their own school. There are a lot of people who want to do rural medicine, FP, geriatrics, work in urban areas, or treat a disproportionate number of minority patients. However, it is ridiculous to expect 22 year old kids to have their minds made up on what specialty to go into and where they want to practice 7-11 years down the road. The admission committee does its best to recruit and accept students they think will embrace the school's mission, but there is no way you can or SHOULD preven a student from specializing in what he/she wants to do. We work our whole lives to become physicians, and even though I have always planned on during rural FP, what if I decide that I hate FP and don't want to do it? Or what if I get married and my wife wants live in NYC? FSU students who earn an M.D. have the same rights and responsabilities as any other med school graduate. It's unfair to prevent these people from exploring all of their options, just because they thought they knew what they wanted to do before they started their clinical training.

 

[MacGyver]

I don't care who you're "faculty source" is...he/she is wrong and has no idea what is going on in their own school. There are a lot of people who want to do rural medicine, FP, geriatrics, work in urban areas, or treat a disproportionate number of minority patients. However, it is ridiculous to expect 22 year old kids to have their minds made up on what specialty to go into and where they want to practice 7-11 years down the road. The admission committee does its best to recruit and accept students they think will embrace the school's mission, but there is no way you can or SHOULD preven a student from specializing in what he/she wants to do. We work our whole lives to become physicians, and even though I have always planned on during rural FP, what if I decide that I hate FP and don't want to do it? Or what if I get married and my wife wants live in NYC? FSU students who earn an M.D. have the same rights and responsabilities as any other med school graduate. It's unfair to prevent these people from exploring all of their options, just because they thought they knew what they wanted to do before they started their clinical training.

Look the bottom line is that FSU ADVERTISES ITSELF as an "underserved" population medical school. You'll see what happens when the FSU match list comes out. Very few people will live up to that expectation.

Which is why I have to question the whole motive behind FSU Med's creation in the first place. Since we know that they are going to do a paltry job of producing underserved doctors, why the hell should the taxpayers of Florida continue to support such a program?

I have no sympathy for those WHO LIE IN THEIR APPLICATIONS just to get accepted to FSU Med and then run off to a dermatology residency. Those pepole KNEW they would not get accepted if they were honest on their apps, so intead they decide to make up a bunch of lies about how they want to treat the Florida Seminole tribe in rural Florida.

Like I said before, the Florida state legislature should carefully monitor the FSU Med graduates. If a significant percentage of them end off in big cities in Florida or out of state, or choosing cush specialties, they should drop the hammer on FSU. That includes taking away rotations in cush specialties, taking away money from the school, and forcing the med school to refuse to endorse students with letters of rec, deans letters, etc for those who try to sneak away into a radiation oncology residency.

I'm going to post the very first FSU match list when it comes out so I can show you how truly bogus their claims about FSU being an "underserved population" school are.

 

[Indebt4Life]

I see ur point, and ive seen may docs pack up and get the hell out of dodge. But NOT opening a medical school isnt going to affect it either! WHat do policy changes have to do wiuth FIU opening up a med school?!?!? I live in miami and dont plan on staying down here much longer anyway just because of the traffic!! The city itself is super saturated with people, and its these people who are suing docs trying to make a buck in the process. I dont see how a new medical school will affect malpractice?? Maybe you can elaborate?

I feel like I'm talking to my little brother. From the top. A new medical school will NOT affect malpractice. A new medical school will NOT provide care to all the uninsured south floridians. A new medical school will NOT easy the shortage of doctors in underserved areas either. The reason that Fl is in such bad shape has everything to do with malpractice. Don't you think that some doctors would rather be in Florida then the fridgid North? But they leave because they can't take the steadily increasing malpractice. So, how does opening a new medical school affect floridian? It's something called taxes. Yes, where do you think the money is going to come from to build a new PUBLIC medical school? eh? The sky. No. Taxes. My money. That money should be used for better things especially when it really isn't going to do good. Do you see my point?

 

[TRUE]

Like I said before, the Florida state legislature should carefully monitor the FSU Med graduates. If a significant percentage of them end off in big cities in Florida or out of state, or choosing cush specialties, they should drop the hammer on FSU. That includes taking away rotations in cush specialties, taking away money from the school, and forcing the med school to refuse to endorse students with letters of rec, deans letters, etc for those who try to sneak away into a radiation oncology residency.

Your comments show you've truly gone off the deep-end. Medical schools don't have (nor should they) any say in what speciality you choose to go into. They train you to help people. That's the bottom line. They don't make life decisions for you, and really, no one should but yourself. What you suggest in this previous post is quite ridiculous.

 

[Indebt4Life]

MacGyver,
I have a question. Do voters have any say in the proposal for a new medical? I am with you. The last thing I want is medical schools to start blooming like law schools.

Guys we need to be like DeBeers (the diamond people). They purposefully only release a fixed quantity of diamonds per year in order to maintain and increase the value of diamonds. Supply and Demand people. Any goddamn economic majors out there agree with me?

 

[seacatch]

There are 20 Osteopathic med schools, not 30.

http://www.aacom.org/home-applicants/

 

[TRUE]

MacGyver,
I have a question. Do voters have any say in the proposal for a new medical? I am with you. The last thing I want is medical schools to start blooming like law schools.

Guys we need to be like DeBeers (the diamond people). They purposefully only release a fixed quantity of diamonds per year in order to maintain and increase the value of diamonds. Supply and Demand people. Any goddamn economic majors out there agree with me?

Are you worried about your job prospects? More competition?

 

[Indebt4Life]

Are you worried about your job prospects? More competition?

Yeah...Duh! We all should be. Especially when a job is turned down by some MD cause it pays too low, then some DO or FMG takes it. What ends up happening? The demand is filled and thus drives down salaries. On top of that is malpractice bending you over for a quickie. And on top of is compensation issues. Soon, we will be working for nickels.

 

[TRUE]

Yeah...Duh! We all should be. Especially when a job is turned down by some MD cause it pays too low, then some DO or FMG takes it. What ends up happening? The demand is filled and thus drives down salaries. On top of that is malpractice bending you over for a quickie. And on top of is compensation issues. Soon, we will be working for nickels.

Talk about exaggeration. The facts of the matter are that physicians in the US really are not begging for spare change during their days off. More doctors hopefully = faster care (instead of waiting months for appointments). If you can't sacrifice a few thousand dollars (which won't happen anyway since there is not a surplus of physician) of a physician's salary for better patient care, then perhaps you need to find yourself a new profession. In case you missed the memo, medicine is not about you or your money. It's about the people you serve.

If you are still trembling over your financial future with more "competition", see this page on what you can expect to make in your first year out of residency (subject to variation, of course): http://www.physicianssearch.com/physician/salary1.html

 

[doc3341]

I feel like I'm talking to my little brother. From the top. A new medical school will NOT affect malpractice. A new medical school will NOT provide care to all the uninsured south floridians. A new medical school will NOT easy the shortage of doctors in underserved areas either. The reason that Fl is in such bad shape has everything to do with malpractice. Don't you think that some doctors would rather be in Florida then the fridgid North? But they leave because they can't take the steadily increasing malpractice. So, how does opening a new medical school affect floridian? It's something called taxes. Yes, where do you think the money is going to come from to build a new PUBLIC medical school? eh? The sky. No. Taxes. My money. That money should be used for better things especially when it really isn't going to do good. Do you see my point?

First of all, I never said a new medical school would affect malpractice. Second, You dont know that a new medical school will or wont provide care to the uninsured and underserved floridians. And if you did, do me a favor and gimme some numbers to play the Lottery with, I could use the cash. Yes florida is in bad shape because of malpracice. But PLEASE explain to me how opening a new medical school or NOT opening a new medical school will exacerbate or fix this malpractice problem???? I hate to say this but our taxes will never go to helping doctors . Who is going to vote on that when the idea in the heads most people is their physician driving a nice shiny Benz. The lawyers, senators and congressmen that run our government probably have many more lawyer friends that screw doctors in malpractice suits than doctor friends. So how do you figure that any policy in the next ten years is going to fix this??? And you know what for someone thats foing to be making 6 figures one day, your pretty cheap.

 

[Indebt4Life]

First of all, I never said a new medical school would affect malpractice. Second, You dont know that a new medical school will or wont provide care to the uninsured and underserved floridians. And if you did, do me a favor and gimme some numbers to play the Lottery with, I could use the cash. Yes florida is in bad shape because of malpracice. But PLEASE explain to me how opening a new medical school or NOT opening a new medical school will exacerbate or fix this malpractice problem???? I hate to say this but our taxes will never go to helping doctors . Who is going to vote on that when the idea in the heads most people is their physician driving a nice shiny Benz. The lawyers, senators and congressmen that run our government probably have many more lawyer friends that screw doctors in malpractice suits than doctor friends. So how do you figure that any policy in the next ten years is going to fix this??? And you know what for someone thats foing to be making 6 figures one day, your pretty cheap.

Dude, are you reading anything I am writing. I stated "A new medical school will NOT influence malpractice." Meaning no influence. I repeat No influence. No influence. No better, No worse. I never said you said that a new medical school will influence malpractice. I was trying to take things from the top (sum things up). I know that our taxes won't help doctors. I didn't say it would. But taxes that are not used for a new medical school will be put into public elementary schools, potholes, etc.

Lawyers are out to screw docs over because of the reasons you stated. However, policies will correct the problem...like a cap on pain and injury awards for malpractice at 250K. Then, the lawyers won't be interested in helping sue for something that they will not make a million of dollars killing.

Policies are being set in place. For instance, emergency medicine in Florida has a cap at 150K. This was put in last year. However, it's effects are yet to be seen because it takes time.

Furthermore, a new medical school especially in an urban area will probably send students to the local hospitals or community clinics. I doubt that they are going to build a free community clinic. They will send students to precept along with a local doc which is not going to help the uninsured. What I was trying to say that a new medical school is not all of the sudden gonna give money to the uninsured around Miami so that they can get insurance. Now, if they opened a PUBLIC (like Jackson) hospital with a huge ER (uninsured go to ER to be seen when they have a problem because they won't be denied) then they would be directly helping the uninsured.

Point is this: A new medical school will not help anyone. It will use up tax money. It will also put more physician out there in the world. (remember think DeBeers diamonds analogy). Will not help the shortage of physicians in underserved areas.
Enough said.

I am not going to even touch the cheap part.
Whatever.

 

[doc3341]

Policies are being set in place. For instance, emergency medicine in Florida has a cap at 150K. This was put in last year. However, it's effects are yet to be seen because it takes time.
QUOTE]

Please Elaborate...I really havent heard of this.

 

[MedNole]

MacGyver, since you clearly have all the answers, help me out with a few questions.

How many state supported medical schools have been opened in the last 15 years? (The reason I said state supported is because that is the only thing that the public has control over, and it is central to your whole argument)

Do you know any physicians that are underworked, or who suffer because of a lack of demand for their services (ie oversupply of physicians)?

Do you know of any patients that have a hard time getting an appointment with a physician, particularly in specialty areas like dermatology?

Do you believe that the U.S. population is aging (and increasing in number) and will require significantly more medical care in the coming decades?

Do you believe that since 9/11 it has become extrememly difficult for FMGs to get U.S. residencies and domestic docs will have to pick up the slack?

Does an orthopaedic surgeon, opthamologist, general surgeon, ER doc, or any other "specialist" working in Perry, FL meet the standards of serving an underserved population?

There is a clear need for more physicians in Florida. Personally, given the limited resources of government, I don't think that more state supported medical schools is the best option. Florida needs more MD residency programs badly, and this is where the money should be spent. Studies show that you are much more likely to practice in the state where you did your residency than in the state you atteneded medical school. I'd like to see another teaching hospital be built in the state, and public demand will require one within the next 10-20 years. However, educating more physicians will not cause an oversupply anytime soon. There is a continuous increasing demand for our services, and the more physicians there are, the better health care will be for our patients (which is ultimately what government is trying to achieve).

 

[doc3341]

MacGyver, since you clearly have all the answers, help me out with a few questions.

How many state supported medical schools have been opened in the last 15 years? (The reason I said state supported is because that is the only thing that the public has control over, and it is central to your whole argument)

Do you know any physicians that are underworked, or who suffer because of a lack of demand for their services (ie oversupply of physicians)?

Do you know of any patients that have a hard time getting an appointment with a physician, particularly in specialty areas like dermatology?

Do you believe that the U.S. population is aging (and increasing in number) and will require significantly more medical care in the coming decades?

Do you believe that since 9/11 it has become extrememly difficult for FMGs to get U.S. residencies and domestic docs will have to pick up the slack?

Does an orthopaedic surgeon, opthamologist, general surgeon, ER doc, or any other "specialist" working in Perry, FL meet the standards of serving an underserved population?

There is a clear need for more physicians in Florida. Personally, given the limited resources of government, I don't think that more state supported medical schools is the best option. Florida needs more MD residency programs badly, and this is where the money should be spent. Studies show that you are much more likely to practice in the state where you did your residency than in the state you atteneded medical school. I'd like to see another teaching hospital be built in the state, and public demand will require one within the next 10-20 years. However, educating more physicians will not cause an oversupply anytime soon. There is a continuous increasing demand for our services, and the more physicians there are, the better health care will be for our patients (which is ultimately what government is trying to achieve).

WELL SAID!

 

[MacGyver]

a couple of new schools that crank out a few hundred physicians a year are a drop in the bucket compared to the whole physician population and the increasing number of physicians that are willingly going into early retirement.

Sorry, but its more than a "couple" of new schools that are under consideration:

UMiami/FAU (done deal)
LECOM-Bradenton (done deal)
FIU (final stretch)
UCF (pending)
PCOM-Atlanta (done deal)
TUCOM-Las Vegas (done deal)
FSU (done deal)
Cleveland Clinic (done deal)
UT El Paso/Texas Tech (done deal)
UT Austin (pending)

There are at least a dozen other colleges who also want new medical schools, they just havent started an official push for it yet.

 

[MacGyver]

MacGyver, since you clearly have all the answers, help me out with a few questions.

How many state supported medical schools have been opened in the last 15 years? (The reason I said state supported is because that is the only thing that the public has control over, and it is central to your whole argument)

Its central to my argument against FSU Med, not against proliferation of schools in general.

This is a red herring. The number of state supported medical schools is irrelevant, the only relevant factor is the TOTAL number of medical schools.

Do you know any physicians that are underworked, or who suffer because of a lack of demand for their services (ie oversupply of physicians)?

In certain geographic areas? Absolutely.

Do you know of any patients that have a hard time getting an appointment with a physician, particularly in specialty areas like dermatology?

No.

Do you believe that the U.S. population is aging (and increasing in number) and will require significantly more medical care in the coming decades?

MDs are not the sole providers of healthcare.

Do you believe that since 9/11 it has become extrememly difficult for FMGs to get U.S. residencies and domestic docs will have to pick up the slack?

No data on this one way or the other. Show me a link proving that the number of FMGs has fallen drastically since 9/11

Does an orthopaedic surgeon, opthamologist, general surgeon, ER doc, or any other "specialist" working in Perry, FL meet the standards of serving an underserved population?

Perry FL doesnt need an optho, gen surgeon, or ortho surgeon. the only "needed" docs in Perry are FPs, IMs, ob/gyn, ER, and peds. Everythign else is a luxury.

There is a clear need for more physicians in Florida.

Based on what? Faulty data that doesnt include contributions by NPs/PAs, and a data set that IGNORES DOs? that doesnt sound like very complete information to me.

I'll tell you what. You show me a study of florida doctors that accounts for ALL of those factors and I'll reconsider my position on this debate.

 

[TRUE]

MacGyver:

If you honestly believe getting appointments for specialty care is not a problem in the US, you really need to start listening to the news a little more often and plug into the real world.

For those of you out of the loop:
http://washingtontimes.com/national/20040604-115923-6015r.htm

People in Boston, for instance, have to wait 24-50 days for appointments with specialists, with the average time being over a month.

As for underworked physicians, give me a break. I've never heard of a physician who can't find enough work. There are so many people needing medical care in this country that they far outnumber those providing such care.

 

[MedNole]

Its central to my argument against FSU Med, not against proliferation of schools in general.

This is a red herring. The number of state supported medical schools is irrelevant, the only relevant factor is the TOTAL number of medical schools.



In certain geographic areas? Absolutely.



No.



MDs are not the sole providers of healthcare.



No data on this one way or the other. Show me a link proving that the number of FMGs has fallen drastically since 9/11



Perry FL doesnt need an optho, gen surgeon, or ortho surgeon. the only "needed" docs in Perry are FPs, IMs, ob/gyn, ER, and peds. Everythign else is a luxury.



Based on what? Faulty data that doesnt include contributions by NPs/PAs, and a data set that IGNORES DOs? that doesnt sound like very complete information to me.

I'll tell you what. You show me a study of florida doctors that accounts for ALL of those factors and I'll reconsider my position on this debate.

Your answers to my questions demonstrate that you are either completely ignorant of what's going on in health care in Florida, or you just refuse to accept certain truths. Do you honestly expect the increasing demands on the health care system to be alleviated only by NPs, DOs, and PAs? Do you not think that more MDs will be required to accommodate the health care needs of the state? What part of the state do you live in where you've never heard of patients who can't get into see a specialist for months? As I've stated previously, adding more state med schools isn't the best solution. Clearly, tort reform (#1) and adding more residency slots in the state (distant #2) would have a far greater impact on access and quality of care in Florida. However, I have serious problems with you trying to assert that there is an oversupply of docs in the state (or country, for that matter).

Also, here's a link about FMGs post 9/11. I just did a quick google search and this was one of several dozen articles addressing the issue. http://www.aamc.org/newsroom/reporter/june03/post911.htm

Also, for someone who has probably never been to Perry (or any of the hundreds of towns in the state just like Perry), there is a huge demand for docs. The small number of primary care docs and specialists (yes, even radiologists) are overworked and comparatively underpaid. There is a HUGE demand for more MDs in cities like this across the state, and the hospitals in cities like Perry are even paying some of my classmates' tuition and living expenses if they agree to come back to practice in Perry. Does this sound like a town that has an oversupply of physicians?

 

[mlw03]

Why everyone is getting so upset about this is beyond me. NOTHING we do or say on these boards is going to affect the state legislature. Macgyver seems the most pissed, so to him/her I would say that if you're an FL resident, write you state congressman and express your views.

As for a worry that MDs will become like lawyers... that seems a bit over the edge. While not every doctor can do the exact specialty they want, any doctor that wants to work can do so, and can make WELL above the national mean salary.

As for opening STATE med schools, I think this can help produce more general practitioners or rural-serving doctors because state schools require less debt, and less debt means less pressure to go into a more lucrative specialty. Had I ended up at an out-of-state school I'd have felt more pressured to specialize to pay off the $250,000 debt I'd have incurred. Now I'll be able to do whatever I want to. I would imagine my line of thinking is rather common.

Putting a med school in a rural setting, even if the goal is to produce rural-serving MDs has problems. Med students need cases to see and cities provide much more diversity and volume than rural areas.

Last, I can't believe they'd open another Florida med school anywhere other than UCF. Orlando has grown into a big city. I heard somewhere it's the largest metropolitan area in the US without a med school. FIU would give the Miami area 3 med schools, and I just don't understand why the legislature wouldn't want to take advantage of UCF, which is growing in stature and size.

 

[Indebt4Life]

to expand on your analogy....the wealthy diamond industry limits production and as a result the native people of the area where they are mined do not benefit from it (and instead suffer). is limiting the production of doctors in your own financial interest any different? maybe we could even cut down on the total physicians in practice by forcing old doctors into retirement early and stealing their patients. a couple of new schools that crank out a few hundred physicians a year are a drop in the bucket compared to the whole physician population and the increasing number of physicians that are willingly going into early retirement.

Ventulus,
When your honey starts nagging you to buy her "The Rock" just remember that you are putting money into the hands of those diamond whales. And if you try to bargain with her about it and suggest that you buy her a birth stone or zirconia...it is the dog pound for you boy! No love.

 

[ventulus18]

hahaha youre too much, im dyin over here

 

[akpete]

Perry FL doesnt need an optho, gen surgeon, or ortho surgeon. the only "needed" docs in Perry are FPs, IMs, ob/gyn, ER, and peds. Everythign else is a luxury.

since when is surgery a "luxury"?

 

[MacGyver]

MacGyver:

If you honestly believe getting appointments for specialty care is not a problem in the US, you really need to start listening to the news a little more often and plug into the real world.

For those of you out of the loop:
http://washingtontimes.com/national/20040604-115923-6015r.htm

People in Boston, for instance, have to wait 24-50 days for appointments with specialists, with the average time being over a month.

The problems in Boston are due to MALPRACTICE ISSUES, not physician supply. Your own source claims thats the case. Boston has one of the highest doctor/patient ratios in the country, but is in a temporary situation due to malpractice. Building new med schools WONT help that situation. The new med graduates will just leave for other states due to malpractice issues. Its the same way in Florida.

As for underworked physicians, give me a break. I've never heard of a physician who can't find enough work. There are so many people needing medical care in this country that they far outnumber those providing such care.

What kind of justification is this? We know for a fact that most big cities/suburbia have doctor surpluses. That doesnt necessarily translate into docs not findign work. WHAT IT DOES TRANSLATE TO is higher healthcare costs for everybody. When you have a 3 fold increase of specialists in a city whose population is flat, you have specialists hunting for problems that get MUCH MORE AGGRESSIVE in their screening/diagnostic/treatment patterns. Otherwise, they'd make substantially less money.

 

[ventulus18]

somebody needs a hug

 

[MacGyver]

Your answers to my questions demonstrate that you are either completely ignorant of what's going on in health care in Florida, or you just refuse to accept certain truths. Do you honestly expect the increasing demands on the health care system to be alleviated only by NPs, DOs, and PAs?

Maybe, maybe not. My point is that NONE of the so-called doctor shortage studies account for DOs, NPs, or PAs. Thats a SUBSTANTIAL portion of the market that is left out. Those studies are worthless due to that unforgivable omission.

Like I said, you show me a study projecting shortage that ACCOUNTS for DOs, NPs, and PAs, and I'll be the first one to recommend new schools.

Do you not think that more MDs will be required to accommodate the health care needs of the state?

FL already has 3 new medical schools (UMiami/FAU, FSU, and LECOM-Bradenton). Until you show me a study like I suggested above, I'm not going to endore even more schools. Hell UCF wants a school. Pretty soon the community colleges in FL will start opening med schools.

However, I have serious problems with you trying to assert that there is an oversupply of docs in the state (or country, for that matter).

I never said that. I said there is a surplus of doctors in big cities such as Miami where the new FIU school would be based, which is true.

If you want to build more schools, the burden of proof is ON YOU to show a valid study that shows doctor shortage. No such study exists, for Florida, any other state, or the nation at large.

Also, here's a link about FMGs post 9/11. I just did a quick google search and this was one of several dozen articles addressing the issue. http://www.aamc.org/newsroom/reporter/june03/post911.htm

That link is mostly speculation. It doesnt show the total number of FMGs and prove that they have been drastically reduced since 9/11. Its a collection of personal anecdotes and nothing more.

Also, for someone who has probably never been to Perry (or any of the hundreds of towns in the state just like Perry), there is a huge demand for docs. The small number of primary care docs and specialists (yes, even radiologists) are overworked and comparatively underpaid. There is a HUGE demand for more MDs in cities like this across the state, and the hospitals in cities like Perry are even paying some of my classmates' tuition and living expenses if they agree to come back to practice in Perry. Does this sound like a town that has an oversupply of physicians?

I never said Perry had an oversupply. I said they dont need fancy specialists like plastic surgeons. If they have a problem recruiting primary care docs, then they should use incentive programs, not build a new medical school in Perry.

 

[MacGyver]

As for a worry that MDs will become like lawyers... that seems a bit over the edge. While not every doctor can do the exact specialty they want

Its more than just not getting the specialty you want, its also the fact that FPs and IM, which account for well over half of all doctors are facing massive downward salary pressure. This will only get worse with new med schools.

any doctor that wants to work can do so, and can make WELL above the national mean salary.

what kind of bull**** standard is that? The national average is like 30k, so I guess your opinion is that its OK as long as doctors make above that. Sorry, but there is somethign WRONG with doctors making 60 or 70k per year.

As for opening STATE med schools, I think this can help produce more general practitioners or rural-serving doctors because state schools require less debt, and less debt means less pressure to go into a more lucrative specialty.

There is a MUCH better way to deal with that. Get rid of all clinical rotations in the fancy specialties. Then the only people who apply to that school will be people who are HONEST about practicing underserved medicine.

Putting a med school in a rural setting, even if the goal is to produce rural-serving MDs has problems. Med students need cases to see and cities provide much more diversity and volume than rural areas.

Med students wanting to practice in underserved areas dont need to see diversity or zebra cases. They need the bread and butter exposure that community clinics easily provide. There is no need for FSU med students to rotate at big city hospitals so they can get exposure to the latest and greatest orthopedic surgery procedures.

Last, I can't believe they'd open another Florida med school anywhere other than UCF. Orlando has grown into a big city. I heard somewhere it's the largest metropolitan area in the US without a med school. FIU would give the Miami area 3 med schools, and I just don't understand why the legislature wouldn't want to take advantage of UCF, which is growing in stature and size.

Dont worry, I'm sure UCF is working on their press conference right now about how Orlando is some underserved area that needs more doctors. Hell, using selective statistics, I can make a claim that ****ing NEW YORK CITY (which has the highest doctor/patient ratio in the WORLD) needs more doctors. Statistics is an easy way to mislead and lie to people.

 

[MacGyver]

since when is surgery a "luxury"?

I didnt say surgery was a luxury, I said that surgeons located in Perry ****ing Florida are a luxury. Helicopter med evac for emergency surgery; for other non-emergency surgeries everybody can choose their nearest big city medical center.

 

[TRUE]

In regards to my saying that no doctor is in need of work, you wrote:

What kind of justification is this? We know for a fact that most big cities/suburbia have doctor surpluses. That doesnt necessarily translate into docs not findign work. WHAT IT DOES TRANSLATE TO is higher healthcare costs for everybody. When you have a 3 fold increase of specialists in a city whose population is flat, you have specialists hunting for problems that get MUCH MORE AGGRESSIVE in their screening/diagnostic/treatment patterns. Otherwise, they'd make substantially less money.

Show me some proof that doctors are being "MUCH MORE AGRESSIVE" in order to make more money. Show me some stats that say that there is a doctor surplus in "most big cities/suburbia". Your comments that doctors are lacking work and can't find jobs is just a ridiclous claim, that up to now, you have not backed up with a single shred of evidence, like many other claims you've made on this site including, but not limited to:

Miami-FAU being a brand new medical school with a whole big huge class of 100+ students (it's actually a 2 year program, with 16 students that is then joined with the UM class. Future plans take it to 32 students, which is the mandated limit).

That FSU is planning on increasing it's class size dramatically and has already done so (when the facts of the matter, pointed out by MedNole, are completely contrary).

You talk a lot, but you don't back up what you say. While that might serve you well on forums, good luck in the real world, or in medicine. You're gonna have a tough time convincing doctors of things when you just talk out of your ass.

 

[UT_OC]

3 words: BLATANT MONEY GRAB!

This is a total joke. There have been a grand total of 15 new medical schools within the past 10 years. We dont need anymore.

Lets see, there are already 6 medical schools in Florida and now they want 7?

Thats total bull****, besides MIAMI ALREADY HAS A MEDICAL SCHOOL!

University of Miami (MD)
University of Florida (MD)
University of South Florida (MD)
Florida State (MD)
NSUCOM (DO)
LECOM-Florida (DO)

The board of governors better reject this, and if they dont, then the LCME should refuse to accredit it. Lets see how they like spending millions of dollars on an unaccredited medical school. Good luck attracting students to a school in which you have zero chance of practicing medicine.

If that is for real (the new F Med School) I'm all for it, the more the merry for other ppl. But I do think that if Florida already has that many they don't really need anymore.

 

[bmcgilligan]

Since there has been such a controversy on this thread regarding speculation of where FSU's first graduating class will match, I thought I would post the results:

32 students in the graduating class

Family Practice: 5
Internal Medicine: 3
Peds 2
Medicine-Preliminary: 1
Emergency Med: 7
Gen. Psych: 1
Gen. Surg: 3
OB/Gyn: 1
Ortho Surg: 2
Surg Prelim: 4
PG-2 Emerg. Med: 1
PG-2 Otolaryngology: 1
PG-2: Urology: 1

 

[latinfridley]

Since there has been such a controversy on this thread regarding speculation of where FSU's first graduating class will match, I thought I would post the results:

32 students in the graduating class

Family Practice: 5
Internal Medicine: 3
Peds 2
Medicine-Preliminary: 1
Emergency Med: 7
Gen. Psych: 1
Gen. Surg: 3
OB/Gyn: 1
Ortho Surg: 2
Surg Prelim: 4
PG-2 Emerg. Med: 1
PG-2 Otolaryngology: 1
PG-2: Urology: 1

Looks like that MacGyver fella was wrong bout the number of Prim Care docs graduating from this school.

 

[Doctor&Geek]

Actually, the number of primary care docs graduating is not that many.

 

[bmcgilligan]

Actually, the number of primary care docs graduating is not that many.

True, there is only 11 grads that went into some sort of primary practice...but there were only 32 graduates.

So... 34% of the class went into primary care. That's a pretty high percentage.

But the mission of FSU is not to just go into primary care, but also to reach the elderly, urm, and underserved areas...be that in primary practice or some other specialty. (and yes...er docs are needed in underserved areas...small hospitals need a couple of er docs too and there are quite a few small hospitals in north florida)

 

[LowlyPremed]

AAMC Calls for Modest Increase in Medical School Enrollment
Association Adopts New Position on Physician Supply
For Immediate Release Press Release
Contact: Retha Sherrod
202-828-0975
[email protected]


Washington, D.C., February 22, 2005 - Concerned that America may experience a physician shortage in the next few decades, the AAMC today recommended that enrollment in U.S. medical schools be increased 15 percent by 2015. Assuming that schools respond to the AAMC's recommendation, the result would be an increase of about 2,500 M.D. graduates per year.

"The AAMC's new position responds to mounting evidence that the demand for physicians will outstrip the supply in future years," said AAMC President Jordan J. Cohen, M.D. "Given the extended time it takes to educate and train tomorrow's doctors, efforts to increase enrollment must get underway as soon as possible to assure that the health care needs of the nation in 2015 and beyond are met."

In calling for the expansion, the AAMC recommended that the increases be targeted, in part, to areas of the country that have seen a rapid rise in population over the past several decades and are expected to grow in the future. The association also recommended the removal of the current restriction on the number of residency and fellowship positions funded by Medicare in order to ensure that the new U.S. medical school graduates can complete the training necessary to practice.

A survey of medical school expansion plans, conducted by the AAMC's Center for Workforce Studies in late 2004, shows that many of the nation's medical schools have already begun to increase their class sizes. Of the 118 allopathic schools (institutions that grant M.D. degrees) that responded to the survey, 36 (31 percent) indicated that they were "definitely" or "probably" going to boost first-year enrollment over the next several years, which would yield about a four percent increase in M.D.s. Another 23 schools (20 percent) said they would "possibly" increase enrollment over the next six years.

Several factors were considered in making the recommendation for an increase in medical school capacity, including U.S. population growth, a demand for more medical care by aging Baby Boomers, the retirement of practicing physicians, and younger doctors working fewer hours.
However, given the inherent uncertainties in predicting future physician workforce needs, the AAMC's Center for Workforce Studies will continue to analyze and monitor changes over time in the physician supply, as well as identify strategies to retain doctors in the workforce and make more effective use of practicing physicians. To help achieve this goal, the AAMC will sponsor the first annual Physician Workforce Research Conference, May 5-6 in Washington, D.C.

 

[TripleDegree]

Just boil it down to Supply and Demand. That will drive the economics of the industry.

It appears that the overall supply is adequate, but there are two issues:

(1) Not enough MDs are going into primary care in certain areas of FL
(2) There are disproportionate pockets of concentration of MDs


The second is a nationwide issue, not just FL, and therefore not germane to this discussion.

As far as the 1st point is concerned, here's some analysis - if the total number of MDs in FL is "Y", and the percentage of those going into primary care is "X" - then the issue boils down to the fact that X < need. If this is the case, then the solution is *NOT* to increase Y (add medical schools). The solution is to allow the natural dynamics of the industry to redistribute specialties within Y, so that more folks will be interested in primary care. In other words, to get a bigger share of the pie, you should not be increasing the size of the pie, but instead try and get two pieces.

Hope y'all were able to follow this argument.

 

[jvphd]

http://health.fiu.edu/current_affairs/briefing_notes.htm

Creating an affordable, accessible medical school

Is this not an oxymoron?