NP wants the same level of compensation as a MD/DO.

[DO2015CA]

I agree that the 1 year experience stipulation is not nearly enough time, with somewhere along 5 years of experience prior to entering school to be reasonable.

To reiterate a prior point, if physicians truly believe that NPs produce much poorer results in the PCP setting, why aren't they studying the outcomes? No one has yet to post an article for support.

You don’t know if a study is happening currently. The only proper way to study that is longitudinally over 10+ years. This would also require NPs to have solo practice rights for that time as to not have collaborative physician input on the patients. Due to solo NP rights in states not being 10 years old there would be no valid studies at this point. The reason 10 years is a time point is because it takes that long to see chronic disease develop. The 3 month study NPs like to stand on is an invalid study due to Hawthorne effect bias. Anyone can be on their Ps and Qs for 3mo-1yr. It’s the outcome that is the important answer, which takes a decade plus. Another reason those studies are invalid is we are seeing that a generalized accepted value for bp,cholesterol,glucose, etc. doesn’t always lead to better outcomes because humans are all different so each ideal value would be different. It’s better to treat the clinical picture not the number (you’ll hear that a million times in training but it’s true). That is another reason a generalized value control study without outcomes associated is useless.

Ps I can tell you are trolling. But I will continue to respond in order to inform other Premed’s that have similar questions

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[Dr. Faust]

You don’t know if a study is happening currently. The only proper way to study that is longitudinally over 10+ years. This would also require NPs to have solo practice rights for that time as to not have collaborative physician input on the patients. Due to solo NP rights in states not being 10 years old there would be no valid studies at this point. The reason 10 years is a time point is because it takes that long to see chronic disease develop. The 3 month study NPs like to stand on is an invalid study due to Hawthorne effect bias. Anyone can be on their Ps and Qs for 3mo-1yr. It’s the outcome that is the important answer, which takes a decade plus. Another reason those studies are invalid is we are seeing that a generalized accepted value for bp,cholesterol,glucose, etc. doesn’t always lead to better outcomes because humans are all different so each ideal value would be different. It’s better do treat the clinical picture not the number (you’ll hear that a million times in training but it’s true). That is another reason a generalized value control study without outcomes associated is useless.

Ps I can tell you are trolling. But I will continue to respond in order to inform other Premed’s that have similar questions

How is asking for evidence trolling? These are valid questions. Are DO outcomes worse than MD outcomes? How can people say MD school is the best when they can't compare outcomes between MD and DO or NP? Without a study, how can there be a definitive answer? The assumption that keeps being made is "more training is better," but how much is enough?

Your ad hominem argument equivocates the lack of evidence in your position.

 

[DO2015CA]

How is asking for evidence trolling?

Previous responses. Please reply to the rest of my brick not the ps. That doesn’t add to the conversation

 

[Dr. Faust]

Previous responses. Please reply to the rest of my brick not the ps. That doesn’t add to the conversation

So it is confirmed that there is no definitive answer as to if PCP MD outcomes are better than NP outcomes.

 

[percyeye]

MDs are selling their practices to Private Equity and hospital systems all over the country. And now are mad these investment bankers and hospitals are trying to pinch pennies by hiring out cheaper alternatives like NPs. You either should own your own business or be good at legislation because medicine and many other health professions are giving up control trying to make a quick buck. But stop shooting yourself in the foot and then complaining your foot hurts.

 

[DO2015CA]

So it is confirmed that there is no definitive answer as to if PCP MD outcomes are better than NP outcomes.

lol if you know anything about studies, it’s not the job of the gold standard to prove experimental group false, but the Job of the experimental group to prove they are just as good or better than the accepted treatment. You can not put a drug on the market without extensive data studying in the above method because it can really affect patients lives/kill them. Why should we allow inadequate medical providers without these same studies. This deviated method from the gold standard can kill people as well

 

[DO2015CA]

MDs are selling their practices to Private Equity and hospital systems all over the country. And now are mad these investment bankers and hospitals are trying to pinch pennies by hiring out cheaper alternatives like NPs. You either should own your own business or be good at legislation because medicine and many other health professions are giving up control trying to make a quick buck. But stop shooting yourself in the foot and then complaining your foot hurts.

Agreed. I would like to see my generation take back the practice of medicine by hanging a shingle. I do not think this will happen because we have a ton of loans to pay back that it’s easier to become an employee

 

[Goro]

The reason this alarms me as a premed is I know in this "progressive" society it will probably come a reality, and at some point in my career I will be crucified to criticize it.

All you need to get is patient outcome stats and then you should be on solid ground when comparing NP bad outcomes to clinician bad outcomes. That data has to be out there somewhere.

 

[AnatomyGrey12]

To reiterate a prior point, if physicians truly believe that NPs produce much poorer results in the PCP setting, why aren't they studying the outcomes? No one has yet to post an article for support.

Have you ever heard of an inferiority study? Yeah me either. That’s not how Research is done. It’s not the job of the gold standard (physician training) to disprove the one claiming to be equal (NPs). NPs have tried to mask their lack of efficacy with studies so poor they aren’t fit to use as toilet paper claiming they are just as good. The only reason they have the rights they do currently is because their lobby groups are well oiled machines and politicians are *****s who don’t know any better how to evaluate a study than you do.

Is a doctor who receives a degree from Vietnam the same as one who goes to a state school in the US?

Well seeing as to practice in the US a Vietnamese doctor will have to do residency in the US yes they are equal. You are showing exactly how little you understand about any of this.

How is asking for evidence trolling? These are valid questions. Are DO outcomes worse than MD outcomes? How can people say MD school is the best when they can't compare outcomes between MD and DO or NP? Without a study, how can there be a definitive answer? The assumption that keeps being made is "more training is better," but how much is enough?

Because both MDs and DOs do the exact same training. Residency training has been studied time and time again, hence why the process is standardized.

Your ad hominem argument equivocates the lack of evidence in your position.

Someone needs to review the definition of “ad hominem”

 

[DO2015CA]

How is asking for evidence trolling? These are valid questions. Are DO outcomes worse than MD outcomes? How can people say MD school is the best when they can't compare outcomes between MD and DO or NP? Without a study, how can there be a definitive answer? The assumption that keeps being made is "more training is better," but how much is enough?

Your ad hominem argument equivocates the lack of evidence in your position.

Solid post edit after I responded instead of responding with another comment. MD=DO due to standardization of residency. It’s been studied ad nauseam. Your question about how much training is enough training is the question at the heart of this. To reiterate, it is the NPs job to provide the study (that is of quality) to change the accepted practice. You may be correct regarding the upper tier of practicing NPs but without standardization we can’t allow public safety to be threatened without data backing it up the efficacy.

 

[DO2015CA]

As for as an ad hominem, I didn’t use one. I did not attack a NP or the profession. The only thing I have said is prove your claims and therefore without proof there should not be deviation from accepted gold standard. I have given evidence as to why current studies do not support the claim. Again this is not attacking anyone.

 

[Moko]

It’s really easy to play monkey see monkey do until monkey has never seen that presentation before and they are solo practice

Agreed. The problem occurs when someone doesn't realize the limits of their knowledge and therefore doesn't ask for help. A few months ago, I needed to teach someone why overcorrecting a sodium from 120 to 135 over the course of one day was dangerous. Another missed a diagnosis of DIC from sepsis as it wasn't even on their mind despite an unexplained INR elevation.

I agree that the 1 year experience stipulation is not nearly enough time, with somewhere along 5 years of experience prior to entering school to be reasonable.

To reiterate a prior point, if physicians truly believe that NPs produce much poorer results in the PCP setting, why aren't they studying the outcomes? No one has yet to post an article for support.

As with most research, if you study outcomes in allcomers, there probably won't be a statistically significant difference. The sheer number of run-of-the-mill cases will drown out any potential signal from the more complicated cases where being managed by a physician would produce superior outcomes.

 

[VA Hopeful Dr]

All you need to get is patient outcome stats and then you should be on solid ground when comparing NP bad outcomes to clinician bad outcomes. That data has to be out there somewhere.

Not really. NPs haven't had independent practice anywhere long enough for a decent study looking at clinical outcomes.

 

[DO2015CA]

Agreed. The problem occurs when someone doesn't realize the limits of their knowledge and therefore doesn't ask for help. A few months ago, I needed to teach someone why overcorrecting a sodium from 120 to 135 over the course of one day was dangerous. Another missed a diagnosis of DIC from sepsis as it wasn't even on their mind despite an unexplained INR elevation.

As with most research, if you study outcomes in allcomers, there probably won't be a statistically significant difference. The sheer number of run-of-the-mill cases will drown out any potential signal from the more complicated cases where being managed by a physician would produce superior outcomes.

Quite frankly that is terrifying because sodium correction is so commonplace in the hospital. If they didn’t know the #1 rule of sodium correction how can we trust that person to make any clinical judgments. Does not matter if it’s a medstudent, resident, attending, or midlevel. You absolutely have to know that.

 

[Dr. Faust]

Solid post edit after I responded instead of responding with another comment. MD=DO due to standardization of residency. It’s been studied ad nauseam. Your question about how much training is enough training is the question at the heart of this. To reiterate, it is the NPs job to provide the study (that is of quality) to change the accepted practice. You may be correct regarding the upper tier of practicing NPs but without standardization we can’t allow public safety to be threatened without data backing it up the efficacy.

You are trying to "have it both ways" here. You are simultaneously saying that the MD has superior clinical knowledge and yet the NP should be in charge of the clinical studies.

 

[Dr. Faust]

As with most research, if you study outcomes in allcomers, there probably won't be a statistically significant difference. The sheer number of run-of-the-mill cases will drown out any potential signal from the more complicated cases where being managed by a physician would produce superior outcomes.
[/QUOTE]
Agreed. And in this instance, these cases should absolutely be managed by an MD PCP. Being that there are so many run of the mill cases that can be adequately managed by an NP, it does not economically make sense to have an MD see every patient. The MD should do the initial H&P and set up the treatment plan and then the NP could do the subsequent check up appointments and call the physician if there are any questions. This idea isn't crazy. It could be reasonably agreed upon that many outpatient cases are less complicated and severe than inpatient hospital cases. In the hospital, the person providing most of your care often has an associate's degree or less. Additionally, the hospital often does not even have a physician physically present on that floor during most of the opening hours of the hospital sans the ER and a hospitalist to oversee many floors.

 

[DO2015CA]

You are trying to "have it both ways" here. You are simultaneously saying that the MD has superior clinical knowledge and yet the NP should be in charge of the clinical studies.

That is not both ways lol. It’s a fact MD has the superior knowledge. Now is the knowledge overkill is the question. To deviate from the gold standard places responsibility on the deviated party to prove, not the accepted standard. That is not having it both ways. It’s simple research design 101.

 

[AnatomyGrey12]

You are trying to "have it both ways" here. You are simultaneously saying that the MD has superior clinical knowledge and yet the NP should be in charge of the clinical studies.

They do have superior knowledge. That fact isn’t even disputed. And yes, it is their responsibility to be in charge of their clinical studies since they are the ones trying to prove their equivalence. That is literally what happens with any clinical study in medicine, people design a new drug/treatment/guideline and then they are responsible for proving its efficacy by pitting it against the gold standard. The designers of the gold standard are not responsible for designing this study.

I suggest you stop chasing your tail and making asinine arguments that clearly show how little you know. You are currently sitting on what we call Mount Stupid.

 

[Dr. Faust]

That is not both ways lol. It’s a fact MD has the superior knowledge. Now is the knowledge overkill is the question. To deviate from the gold standard places responsibility on the deviated party to prove, not the accepted standard. That is not having it both ways. It’s simple research design 101.

The MD absolutely has more clinical knowledge; therefore, the MD should be the one delegating what responsibilities and standards of care the NP is capable of treating and when to refer to a superior.

 

[DO2015CA]

As with most research, if you study outcomes in allcomers, there probably won't be a statistically significant difference. The sheer number of run-of-the-mill cases will drown out any potential signal from the more complicated cases where being managed by a physician would produce superior outcomes.

Agreed. And in this instance, these cases should absolutely be managed by an MD PCP. Being that there are so many run of the mill cases that can be adequately managed by an NP, it does not economically make sense to have an MD see every patient. The MD should do the initial H&P and set up the treatment plan and then the NP could do the subsequent check up appointments and call the physician if there are any questions. This idea isn't crazy. It could be reasonably agreed upon that many outpatient cases are less complicated and severe than inpatient hospital cases. In the hospital, the person providing most of your care often has an associate's degree or less. Additionally, the hospital often does not even have a physician physically present on that floor during most of the opening hours of the hospital sans the ER and a hospitalist to oversee many floors.
[/QUOTE]

I think you are going in circles at this point. What you describe with physician seeing the initial visit with follow up with NP is how collaborating is supposed to work. You can’t have that model if you have solo practice rights. I think a lot of physicians would be on board with how you describe it. That’s how NPs used to function. In a perfect world, that’s how it would function right now. Some physicians have gotten greedy and make their midlevels do a lot of work they are not qualified to do. That is their fault. If there were bad outcomes then that’s on the physician not the midlevel for litigation.

 

[DO2015CA]

The MD absolutely has more clinical knowledge; therefore, the MD should be the one delegating what responsibilities and standards of care the NP is capable of treating and when to refer to a superior.

Literally describing collaboration not solo practice rights.

 

[AnatomyGrey12]

The MD absolutely has more clinical knowledge; therefore, the MD should be the one delegating what responsibilities and standards of care the NP is capable of treating and when to refer to a superior.

Lol so now you have moved the goal posts to the point that you are actually describing the way midlevels are supposed to function. Nobody is arguing against this in this thread except you.

 

[Dr. Faust]

My initial position was that MDs should focus on treating more complicated cases while filling many PCP voids with NPs, not necessarily practice independently, but manage type II diabetes, etc.

 

[DO2015CA]

My initial position was that MDs should focus on treating more complicated cases while filling many PCP voids with NPs, not necessarily practice independently, but manage type II diabetes, etc.

And I think that’s perfectly acceptable but this isn’t NPs taking over PC. It’s still the PCP being first contact to triage it to the NP if it is uncomplicated. By using the term take over PC that means NPs would be at the helm of the team.

 

[Goro]

Not really. NPs haven't had independent practice anywhere long enough for a decent study looking at clinical outcomes.

How about in"dependent" practice? ie, current situations where they have clinician supervision?

 

[VA Hopeful Dr]

How about in"dependent" practice? ie, current situations where they have clinician supervision?

But then the results aren't helpful because ultimately the physician is still in charge and its hard to prove how often each NP consults their supervising physician.

 

[Dr. Faust]

How about in"dependent" practice? ie, current situations where they have clinician supervision?

Yea I agree. I think I was trying to get at that in one of my posts where you have an MD medical director to take call and observe cases while the NPs take care of the non-complicated issues.

 

[KeikoTanaka]

I would love to sit 10,000 people (5000 physicians, 5000 NPs) in a huge football stadium with a computer in front of everyone. You would go through 15 clinical cases with several multiple questions/options you can go down. The computer will then compare everyone to see which % of NPs and % of MD/DOs ultimately got to the correct diagnosis, and in what period of time/without as many tests.

And of course this could be extrapolated upon for various specialties/how big of samples/difficulty of questions

 

[KeikoTanaka]

[/QUOTE]
It could be reasonably agreed upon that many outpatient cases are less complicated and severe than inpatient hospital cases. [/QUOTE]

This is technically true. But, I would like to point out that the inpatient patient is only more complicated due to the chronicity of their conditions culminating to a point that they are now battling with everything all at once. If you come through the ED, its because your body was put through a lot of trauma (Assuming the patient is using the ED correctly). Complicated patients are complicated because they were already walking that tight rope, and their sudden turn in life was just enough to push them over the edge. This could be minimized with increased focus on PCPs and having well trained PCPs who know how to manage a **** ton of co-existing conditions.

 

[Drrrrrr. Celty]

Lets face it. We brought this **** on ourselves when we started making medicine an elitist club and not producing enough doctors. We have massive deficits of physicians in primary care, psychiatry, obgyn, etc. We need to stop recruiting these smart asses to fill medical school classes and recruit people from small towns who have a reason for wanting to go back to treat their communities.

NPs are not equivalent. And no I don't trust them to manage major medical conditions. Truth of the matter is I spend more time undoing nursing med recs than I do prescribing new medications.

Medicine requires knowledge and it requires a respect for the process of learning. NPs haven't done that. They learned the basics and then decided they are qualified while residents who know far more will be far more skiddish to prescribe because they know enough to respect medicine and be afraid.

 

[DO2015CA]

I would love to sit 10,000 people (5000 physicians, 5000 NPs) in a huge football stadium with a computer in front of everyone. You would go through 15 clinical cases with several multiple questions/options you can go down. The computer will then compare everyone to see which % of NPs and % of MD/DOs ultimately got to the correct diagnosis, and in what period of time/without as many tests.

And of course this could be extrapolated upon for various specialties/how big of samples/difficulty of questions

Hahaha now if that’s not unfair idk what is. Physician are nothing if not good MCT takers. That’s all we do for years and years. It’s almost a prerequisite for the mcat. Good MCT taker does not equal good doctor

 

[DO2015CA]

Lets face it. We brought this **** on ourselves when we started making medicine an elitist club and not producing enough doctors. We have massive deficits of physicians in primary care, psychiatry, obgyn, etc. We need to stop recruiting these smart asses to fill medical school classes and recruit people from small towns who have a reason for wanting to go back to treat their communities.

NPs are not equivalent. And no I don't trust them to manage major medical conditions. Truth of the matter is I spend more time undoing nursing med recs than I do prescribing new medications.

Medicine requires knowledge and it requires a respect for the process of learning. NPs haven't done that. They learned the basics and then decided they are qualified while residents who know far more will be far more skiddish to prescribe because they know enough to respect medicine and be afraid.

I agree about med school selection but unfortunately all med school metrics are judged. Even by applicants. They want the school with the highest entrance scores, the highest steps, the most prestigious match list, etc. It just goes on and on. I think the best thing for medical school would be each state following TX. All state schools mandate 90% in state students. Even within a state there should be selection for more medically poor counties. California offers relatively little physicians to the Central Valley and NorCal compared to SoCal and Bay Area.

 

[KeikoTanaka]

Hahaha now if that’s not unfair idk what is. Physician are nothing if not good MCT takers. That’s all we do for years and years. It’s almost a prerequisite for the mcat. Good MCT taker does not equal good doctor

True, but you can take direct case studies from real-life NP or MD visits in primary care over the course X amount of time to get a really good random assortment of uncomplicated to complicated cases. Yes, it would be slightly biased toward the physician given the intense testing we undergo, but at the end of the day, I don't care if the NP takes longer, I just want to know if they'll actually get the right diagnosis, and begin the correct treatment. I would be willing to bet you'll find some horrendously scary performances.

 

[calvnandhobbs68]

call me when a nurse is doing spine surgery. but i agree on the second point.

There are very few fields NPs do not permeate in. There are NP "dermatologists". NPs are doing EGDs and colonoscopies (the bulk of income for many GI docs). NPs are being trained to do cardiac caths. As mentioned before, NPs all over the place in gen surg and ortho. Ha I've even seen job openings for NPs in radiology/IR.

Ophtho is really the only field that doesn't have an NP problem it seems like but that's probably because everyone who would try to do that just does optometry instead.

 

[calvnandhobbs68]

What I am saying is that you do not need to go to school for 7+ years to learn how to treat and monitor type II diabetes, prescribe albuterol or metoprolol. PCP is too expensive and could be managed by NPs in many scenarios. These aren't scenarios that require the hospitalization and specialist attention. This is part of the reason why healthcare is so expensive in America, and there is also over-utilization of many services in America as well.

Yo thanks for telling all the doctors on here how easy primary care is pre-med. Now I know how it really is.

 

[Dr. Faust]

Yo thanks for telling all the doctors on here how easy primary care is pre-med. Now I know how it really is.

SO easy an NP can do it. 😉

 

[Drrrrrr. Celty]

I agree about med school selection but unfortunately all med school metrics are judged. Even by applicants. They want the school with the highest entrance scores, the highest steps, the most prestigious match list, etc. It just goes on and on. I think the best thing for medical school would be each state following TX. All state schools mandate 90% in state students. Even within a state there should be selection for more medically poor counties. California offers relatively little physicians to the Central Valley and NorCal compared to SoCal and Bay Area.

Residency, Medical School, etc is too prestige based and it shows. I still believe fully that anyone with a 3.2 and a 27 on their mcat can easily pass medical school and become a competent primary. But medical school averages are 3.8 and 32. Why? Because it makes the program look strong and it makes people think it's better worth attending.

In the end we have to rethink medical education and do so quicker than later.

 

[libertyyne]

Residency, Medical School, etc is too prestige based and it shows. I still believe fully that anyone with a 3.2 and a 27 on their mcat can easily pass medical school and become a competent primary. But medical school averages are 3.8 and 32. Why? Because it makes the program look strong and it makes people think it's better worth attending.

In the end we have to rethink medical education and do so quicker than later.

It is 3.8 and 32 because there are many applicants with those characteritics willing to apply. Also your point doesnt really make sense considering there are many DO schools with averages close to or below 3.2 , 27.



And frankly it is due to the tight control of physicians that has lead to physician income where it is. What is the solution I don't know, but don't train or stop working with NPs would be a start.

 

[Little Green Mensch]

The physician shortage is exacerbated by the low threshold for referring to specialists. Yesterday in clinic, half the consults I saw could probably have been treated by their primary care physician. For example, a dog bite resulting in a superficial laceration and two small < 1 cm puncture wounds is firmly within the scope of general practice. Nonetheless, the fly-by-night midlevels at urgent care refer to the specialist, costing the patient more money and further fragmenting care.

Giving midlevels a longer leash will make this problem exponentially worse.

(As an aside, reflexive, medico-legal consults to other services during residency also fuel this issue.)

 

[Dr. Faust]

It is 3.8 and 32 because there are many applicants with those characteritics willing to apply. Also your point doesnt really make sense considering there are many DO schools with averages close to or below 3.2 , 27.



And frankly it is due to the tight control of physicians that has lead to physician income where it is. What is the solution I don't know, but don't train or stop working with NPs would be a start.

Wouldn't it be better for patients if more medical schools opened in order to reduce the shortage of physicians, even if it meant reducing the average physician income?

 

[libertyyne]

Wouldn't it be better for patients if more medical schools opened in order to reduce the shortage of physicians, even if it meant reducing the average physician income?

Sure, but the problem in this country is not a severe shortage, but a maldistribution in location where physicians practice.

Opening more schools and lowering standards is not necessarily a good thing either .

There is also an almost limitless supply of physicians willing to move to the United States to fill any gaps, but our residency system is moreso the bottleneck.

The alternative is you could have a glut of physicians and no one wants to go into medicine and spend a large chunk of their life to be trained if you are going to get 70k/year at the end of training.

 

[AnatomyGrey12]

Wouldn't it be better for patients if more medical schools opened in order to reduce the shortage of physicians, even if it meant reducing the average physician income?

Maybe it’s time to take a step back and educate yourself on, well, any of this before commenting further. Medical schools have literally nothing to do with the number of physicians in this country.

 

[DO2015CA]

Wouldn't it be better for patients if more medical schools opened in order to reduce the shortage of physicians, even if it meant reducing the average physician income?

Yes and there has been increasing numbers each year. Like said above the maldistribution is a huge part. That is why selection from certain parts of the country/state would work better. Medical school only requires intelligence up to a certain point, the rest is all just hard work/dedication.

There are people that would rather be a general pediatrician in SF earning 120k (non-academic) than working in the valley earning 200-220k. The 2018 SF poverty line for a single person was 82k. Add in a family of 4 it’s 102k. That means people would rather be near the poverty line than work 1.5-2 hours outside of a major population hub.

 

[DO2015CA]

Maybe it’s time to take a step back and educate yourself on, well, any of this before commenting further. Medical schools have literally nothing to do with the number of physicians in this country.

I think it’s also a good question to ask sdn because they will avoid a lot of propaganda that is out there. I don’t see the question as malicious and it’s a good chance to provide real information.

 

[AnatomyGrey12]

I think it’s also a good question to ask sdn because they will avoid a lot of propaganda that is out there. I don’t see the question as malicious and it’s a good chance to provide real information.

Isolated by itself I’d agree, but not with the posting history in this thread.

 

[DO2015CA]

Isolated by itself I’d agree, but not with the posting history in this thread.

I agree. I feel like there has been a resolution of previous disagreements and maybe learning has occurred, perhaps the hard way, but learning regardless. Maybe I’m naive, but I read a tone/word choice change that makes it more of a real question.

 

[Drrrrrr. Celty]

It is 3.8 and 32 because there are many applicants with those characteritics willing to apply. Also your point doesnt really make sense considering there are many DO schools with averages close to or below 3.2 , 27.



And frankly it is due to the tight control of physicians that has lead to physician income where it is. What is the solution I don't know, but don't train or stop working with NPs would be a start.

And you've missed my point. I'm saying that we've been choosing the 'smartest and best' types who will go for cardiology not pcp in Montana. We need to reevaluate how we select medical school students.

 

[VA Hopeful Dr]

And you've missed my point. I'm saying that we've been choosing the 'smartest and best' types who will go for cardiology not pcp in Montana. We need to reevaluate how we select medical school students.

So pre-meds will learn to talk about how much they want to practice rural primary care.

Wait, isn't that already a thing?

 

[Dr. Faust]

Sure, but the problem in this country is not a severe shortage, but a maldistribution in location where physicians practice.

Opening more schools and lowering standards is not necessarily a good thing either .

There is also an almost limitless supply of physicians willing to move to the United States to fill any gaps, but our residency system is moreso the bottleneck.

The alternative is you could have a glut of physicians and no one wants to go into medicine and spend a large chunk of their life to be trained if you are going to get 70k/year at the end of training.

I would rather have more physicians schooled and trained here instead of just importing from around the world, especially since American medical school is so expensive

Maybe it’s time to take a step back and educate yourself on, well, any of this before commenting further. Medical schools have literally nothing to do with the number of physicians in this country.

“The AAMC supports legislation to increase federal support for graduate medical education as part of a multifaceted strategy to ensure that Americans have access to the care they need when they need it,” Kirch said. “The data consistently show a significant physician shortage. Because it takes seven to 15 years to train a doctor, we urge Congress to remove the freeze on federal funding for residency training that has been in place for over two decades without delay.”

Does this not say that one way to help ease tension is to increase GME?

 

[Dr. Faust]

There is no cure-all for the shortage, but I still find this a viable option.