Number of DOs "growing exponentially"

[peppy]

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You may have received the email recently from the AOA which links to some stats about the profession, including this:
http://www.do-online.org/index.cfm?PageID=aoa_ompreport_profession

They appear to believe these stats about rapid growth in DO schools are something to be proud of. It's unfortunate that it seems like nobody in a position of leadership seems to be questioning if "exponential growth" is really in the best interest of the profession. When I look at what has happened to the law profession (law schools have opened at such a rapid pace that the job market for lawyers is now over-saturated and many people are graduating with massive debt but no job prospects) I do fear that we are on the verge of medicine in general and osteopathic medicine in particular heading down the same road.
If we had a system where student loans were discharge-able in bankruptcy, then I wouldn't really object to this proliferation of schools - it would be up to the lenders to decide if a school's likelihood of producing candidates who can pay their debt justifies the risk of lending. However, if things continue the way they are now, a lot of people who go to school thinking they're bettering themselves are risking getting trapped in massive, life-ruining levels of debt.

 

[sylvanthus]

I agree completely that medical schools are expanding too fast, but think it is being done deliberately to force american grads into primary care fields and possibly push out foreign grads. It is unfortunate on so many levels. Would it be better to have a grateful foreign grad take a family medicine spot or an american grad who really wanted something else, but is forced into family medicine against his/her will?

I hope the situation gets better and really feel for students entering medical school in the next 5+ years.

 

[ProtossCarrier]

I feel like today's medical student (class of 2012-2015) are on a race against time before the residency competition just become brutal.

I feel that as a whole physician need to begin to take back specialized markets (such as surgerical field and anesthesia) and allow midlevels to enter lower level primary care. Training more physician is not a good solution to our current health care crisis.

Both MD and DO schools need to slow down their expansions.

 

[Limvostov]

Since there hasn't been too many new residency programs opened with all the new students added, I agree that it will force many into careers that they don't want out of financial obligation. It's truly unfortunate and I hope I'm not among that group. I sure hope more quality residencies are opened in the years to come, and I also hope that less schools open from here on out. How many physicians do we really need?

I'll know we're in trouble when I see ads for Devry College of Medicine

 

[NickHome]

The majority of students seem to apply for ACGME programs anyway, but I agree it would be most responsible for the AOA to push for new residencies to open up. To my understanding though, and based on ads in "the D.O." magazine looking for program directors for new programs, a lot of programs are opening up. I doubt it's enough to match the proportion of schools opening up.

 

[Dissected]

You may have received the email recently from the AOA which links to some stats about the profession, including this:
http://www.do-online.org/index.cfm?PageID=aoa_ompreport_profession

What happened from 1960 to 1965? A bunch of old DO geezers must have just croaked.. That is a ridiculous looking curve though. There is no way post graduate training can keep up with that. That just means more competition I guess

 

[p30doc]

What happened from 1960 to 1965? A bunch of old DO geezers must have just croaked..

The whole California DO -> MD thing...

 

[Dissected]

The whole California DO -> MD thing...

Haha...I like my theory better

 

[The Poet Sings]

Haha...I like my theory better

yours involves a bunch of people croaking and you like it BETTER?!?

haha i'm just messin' with you

 

[JaggerPlate]

To be completely honest ... I can see both sides of this coin:

Complaints here:

-huge proliferation of new DOs: where are the residency positions? What are the factors for new schools? What is the job security like? Will this devalue the degree, etc.

AOA side:

-Not only does increasing the number of DOs help their clout as a relevant governing body, it also increases $ all around (not saying they are driven by this, but hard to deny), and will definitely increase the visibility of DOs (which will act cyclically and increase their relevance and $ again).

My views:

1. It's nearly impossible for what's happening to lawyer to happen to docs at the same level. In theory, yes - a proliferation of schools and students (many of which were for-profit and didn't possess the connections, name, etc to set students up) led to huge deflation of the degree. However, law doesn't have the same sort of safety fail system that medicine does. 'Worst' case scenario in medicine is that you're 'forced' into a PC residency at make 180k a year. This is (thankfully) not the truth for law.

2. The AOA should really work hard to strike a balance and walk the thin line between making the DO degree a significant factor in the US/increasing visibility, etc, and simply making the DO degree something that is synonymous with degree mills and lesser education. It's not easy, and it seems like they are on a slippery slope right now.

3. My guess is that not much will change. DO schools will keep opening up in the same style (lots of branch campuses, no directly affiliated university medical centers, etc), elitists in the MD world will turn their nose up at this (as the LCME copies the same model to reach some of the increases they want), DOs will continue doing well in the ACGME world, and more students will enter primary care (MD and DO) based on a strict number game.

Frankly, just be happy you aren't at a Caribbean school atm.

 

[TeamZissou]

To be completely honest ... I can see both sides of this coin:

Complaints here:

-huge proliferation of new DOs: where are the residency positions? What are the factors for new schools? What is the job security like? Will this devalue the degree, etc.

AOA side:

-Not only does increasing the number of DOs help their clout as a relevant governing body, it also increases $ all around (not saying they are driven by this, but hard to deny), and will definitely increase the visibility of DOs (which will act cyclically and increase their relevance and $ again).

My views:

1. It's nearly impossible for what's happening to lawyer to happen to docs at the same level. In theory, yes - a proliferation of schools and students (many of which were for-profit and didn't possess the connections, name, etc to set students up) led to huge deflation of the degree. However, law doesn't have the same sort of safety fail system that medicine does. 'Worst' case scenario in medicine is that you're 'forced' into a PC residency at make 180k a year. This is (thankfully) not the truth for law.

2. The AOA should really work hard to strike a balance and walk the thin line between making the DO degree a significant factor in the US/increasing visibility, etc, and simply making the DO degree something that is synonymous with degree mills and lesser education. It's not easy, and it seems like they are on a slippery slope right now.

3. My guess is that not much will change. DO schools will keep opening up in the same style (lots of branch campuses, no directly affiliated university medical centers, etc), elitists in the MD world will turn their nose up at this (as the LCME copies the same model to reach some of the increases they want), DOs will continue doing well in the ACGME world, and more students will enter primary care (MD and DO) based on a strict number game.

Frankly, just be happy you aren't at a Caribbean school atm.

I don't have time to write a lengthy response but +1 to JP's views.

If you want an example of what it's like to be a Caribbean grad at the moment, check out the EM interview thread for this season and look at the grads with 220+ who are having trouble even landing interviews. I'm not saying it's right but that's just the direction medical education in america is going.

 

[TeamZissou]

You may have received the email recently from the AOA which links to some stats about the profession, including this:
http://www.do-online.org/index.cfm?PageID=aoa_ompreport_profession

Peppy- as always solid post and thank you for backing up your views/info with published stats. This is the type of discussion we need to perpetuate in this forum.👍

 

[Igor4sugry]

I agree completely that medical schools are expanding too fast, but think it is being done deliberately to force american grads into primary care fields and possibly push out foreign grads. It is unfortunate on so many levels. Would it be better to have a grateful foreign grad take a family medicine spot or an american grad who really wanted something else, but is forced into family medicine against his/her will?

I hope the situation gets better and really feel for students entering medical school in the next 5+ years.

I agree that more students will have to go into primary care, but its probably not done deliberately. The reality is that there are many primary care spots that are unmatched every year, and there are much fewer specialty spots left unmatched. The number of residencies has stayed flat and so of course the only place to go is to the unmatched primary care. In a way this expansion of schools is responding to the shortage. One thing I read somewhere and found interesting was that some of these primary care programs that go unmatched are being converted to specialty programs so that the programs can keep their funding.

What is good is that ACGME accepts DO students. Imagine what would happen if we could not get into allopathic residencies?

 

[OncoticPressure]

I don't have time to write a lengthy response but +1 to JP's views.

If you want an example of what it's like to be a Caribbean grad at the moment, check out the EM interview thread for this season and look at the grads with 220+ who are having trouble even landing interviews. I'm not saying it's right but that's just the direction medical education in america is going.

Not so fast. Few programs are even sending invites out yet. You're jumping to conclusions way too fast.

 

[Everglide]

I would say the current IMGs are going to feel the pain before us....

 

[TeamZissou]

Not so fast. Few programs are even sending invites out yet. You're jumping to conclusions way too fast.

I just used this application cycle as an example. The same thing happened last year.

http://forums.studentdoctor.net/showthread.php?t=764649

 

[Flushot]

I agree that more students will have to go into primary care, but its probably not done deliberately. The reality is that there are many primary care spots that are unmatched every year, and there are much fewer specialty spots left unmatched. The number of residencies has stayed flat and so of course the only place to go is to the unmatched primary care. In a way this expansion of schools is responding to the shortage. One thing I read somewhere and found interesting was that some of these primary care programs that go unmatched are being converted to specialty programs so that the programs can keep their funding.

What is good is that ACGME accepts DO students. Imagine what would happen if we could not get into allopathic residencies?

For starters, some of the osteo PC residencies opening up are highly questionable, hence why some programs didn't even fill one spot. I remember one being in Sierra Vista, AZ that had maybe 10 slots and not one match occurred that day. Just opening up residencies left and right isn't really the solution either.

The bolded would not only be devastating but interesting because it would literally force the AOA into a corner. I can't imagine what they would do if it happened.

EDIT -

I just used this application cycle as an example. The same thing happened last year.

http://forums.studentdoctor.net/showthread.php?t=764649

Yeah, I've been following this thread as well. It really reiterates what JaggerPlate says. If it looks bad for DO to ACGME, it's way worse for them and future grads. I still can't believe that one of them applied to 78 programs. I guess you do what gotta do.

 

[PacificBlue2012]

The whole California DO -> MD thing...

I am an IMG and I was once thinking of California, visited the Bay Area, changed my mind right away. If Californians do not like DOs, to heck with them, the state is a bankrupt shell of of state anyway. Its polluted and overcrowded, and its large cities are inundated with crime. DO students though have little right to complain because the other regions of the country do not seem to have a problem with DOs. Despite the expansion of DO schools, DOs will generally have an easier time getting residencies than IMGs, especially those from island schools.

 

[Antibodies]

I don't see a problem with expanding medical schools.

We need more doctors and we don't need more residency programs if spots are going unfilled. I believe there are a certain amount of spots in each specialty for a reason. If you tell the derm docs that there is going to be an increase in the residencies for derm, this is where you'll see the lawyer scenario. There will be more derm docs than we need and will drive down their earnings. That goes for any high paying specialty.

The need supposedly is for primary care physicians anyway. If more people are being admitted to med school, they need to accept the reality that competition will get harder for residency. If the idea is that we'll drive out foreign grads and fill our primary care programs... good.

On another note... if we can fill the unfilled spots and produce more doctors, maybe the nurses won't be so able to try to take our jobs. Push out the foreign grads and nurses from our field and fill the specialty that supposedly we need the most. If you go into med school and don't get the specialty you want, I hardly have any sympathy for you. You weren't guaranteed anything but an opportunity.

We will see what kind of song you will be singing when it is your time.

 

[ProtossCarrier]

I don't see a problem with expanding medical schools.

We need more doctors and we don't need more residency programs if spots are going unfilled. I believe there are a certain amount of spots in each specialty for a reason. If you tell the derm docs that there is going to be an increase in the residencies for derm, this is where you'll see the lawyer scenario. There will be more derm docs than we need and will drive down their earnings. That goes for any high paying specialty.

The need supposedly is for primary care physicians anyway. If more people are being admitted to med school, they need to accept the reality that competition will get harder for residency. If the idea is that we'll drive out foreign grads and fill our primary care programs... good.

On another note... if we can fill the unfilled spots and produce more doctors, maybe the nurses won't be so able to try to take our jobs. Push out the foreign grads and nurses from our field and fill the specialty that supposedly we need the most. If you go into med school and don't get the specialty you want, I hardly have any sympathy for you. You weren't guaranteed anything but an opportunity.

this is the kind of internal fractures that make people divide and conquer our profession.

 

[Doctor4Life1769]

Elftown, you're a prick.
You'll be the one who doesn't match and scrambles into BFE FP. Hope you understand that "it's just a need you need to fill" ... regardless of tuition you're doling out.

Honestly, people wouldnt have an issue with doing PC specialties if the tuition wasn't so darn high and the responsibility that comes with seeing these train-wrecks wasn't so great. Paperwork over patient care is the name of the game for PC.

 

[avatarftw]

So you either are only (right now, at least) interested in the least competitive specialties or don't care where you end up? Even without the financial implications of not getting your desired specialty is that fact that you could be professionally dissatisfied with not being able to get the specialty of your dreams. Do you want to put in 7+ years of post college work only to do something that you didn't want to do?

Its posts like these and those that say, "Oh, I don't care about money. I'm happy with having the same net worth as somebody with a bachelor's degree. In fact, TAKE AWAY my money. Money is evil." (Bunnies and flowers in the background)

If you go into med school and don't get the specialty you want, I hardly have any sympathy for you. You weren't guaranteed anything but an opportunity.

 

[Antibodies]

So you either are only (right now, at least) interested in the least competitive specialties or don't care where you end up? Even without the financial implications of not getting your desired specialty is that fact that you could be professionally dissatisfied with not being able to get the specialty of your dreams. Do you want to put in 7+ years of post college work only to do something that you didn't want to do?

Its posts like these and those that say, "Oh, I don't care about money. I'm happy with having the same net worth as somebody with a bachelor's degree. In fact, TAKE AWAY my money. Money is evil." (Bunnies and flowers in the background)

This. The different specialties are .. well different. Some people love FM and hate surgery, others love surgery and hate FM. It all depends on the person's personality. A person can be quite miserable in the wrong specialty.

 

[Antibodies]

I hope you do.

That doesn't make sense at all. My post directly targets keeping our profession ours and not letting the shortage of physicians bring in nurses who think they can adequately do a physician's job.

I do like and agree with your second paragraph. Those are definitely aspects of PC that need a change, but avoiding the problem isn't the solution.

Like I said to Doctor4Life1769, avoiding the problem is not the solution. The debt is ridiculous and I too wish to have fair compensation. My post suggested that we shouldn't create a surplus of specialists because their income will take a hit (and if I end up as a specialist, I certainly will not like that). As far as myself, I'm keeping an open mind and working hard to keep my doors open.

I understand that it would be best for each of us to go into a specialty that we love. That's why I think we need to make changes to primary care so that maybe more people will enter it. Be honest with yourself, because of the stigma and low pay, people who may love practicing it don't even consider it. Even if you and I go into non-PC specialties, we shouldn't turn a blind eye to it and let future students continue to be discouraged from entering the field. We need more doctors and supposedly we need them to be primary care. If it was really sustainable for everyone to avoid PC, then I'd be completely ok with that.

The changes you are talking about need to be made by congress (increase the reimbursement for primary care). I am not sure why you want med students to pay the price (enter a specialty they don't want) just because congress can't get their stuff together.

 

[Dissected]

I believe there are a certain amount of spots in each specialty for a reason.

So the gods of medicine pre-determined that there are the perfect amount of spots for each specialty? Well that's a relief.

 

[NewAndImproved]

1. It's nearly impossible for what's happening to lawyer to happen to docs at the same level. In theory, yes - a proliferation of schools and students (many of which were for-profit and didn't possess the connections, name, etc to set students up) led to huge deflation of the degree. However, law doesn't have the same sort of safety fail system that medicine does. 'Worst' case scenario in medicine is that you're 'forced' into a PC residency at make 180k a year. This is (thankfully) not the truth for law.

Supply and demand does not work like this. If there are more physicians than there are positions, that $180 will decline, not remain fixed.

 

[JaggerPlate]

Supply and demand does not work like this. If there are more physicians than there are positions, that $180 will decline, not remain fixed.

Hmm, interesting point, but I've found that basic economics rarely apply to the US health service industry and physician's salaries in general. Where else do you see a shortage in a field deemed 'necessary' by society with continually dwindling salaries. The presence of a third party that cuts reimbursements based on a sustained growth rate formula takes the basics of supply and demand out of the equation. To my knowledge, the number of providers in a given field isn't something a price-setter (ie: Medicare) takes into account when cutting prices. Additionally, there are so many patients per physician, that I highly doubt any FP, IM, Ped, etc, is hurting for patients (ie: you could feasibly never have too many physicians to patients in something like PC).

This is just what I think/assume though. You could honestly be right, and I'd be interested to hear further input.

 

[engineeredout]

More students = more money. I know of a certain school with several branch campuses who follows this to the point where there aren't enough seats in the lecture hall and they don't think about rotation spots until the last minute.

 

[TriagePreMed]

I haven't read the entire thread, but my understanding is that this will become a problem only if the number of residency spots increase. Otherwise, it will just force foreign/Caribbean graduates out of the system.

 

[ProtossCarrier]

Just as college students don't have a right to medical school just because they complete the prerequisites, I don't think med students have a right to a certain specialty just because they are in med school.

You might be right and I hope congress gets their act together. However, the solution isn't not to expand the profession when there is a significant need for physicians. If congress needs to do something, then the medical community should pressure them to do it.



When they're opening residency programs, you don't think it is taken into account what is necessary?

college students aren't 200k+ in the hole. Thank god we got state MD school because of the outrageous tuition all DO and private school charges.

 

[Flushot]

I haven't read the entire thread, but my understanding is that this will become a problem only if the number of residency spots increase. Otherwise, it will just force foreign/Caribbean graduates out of the system.

Wait, do you mean this will become a problem if the number of residency spots stay the same/decrease? It's already sort of happening, for one reason or another. This thread from the EM 2010 FAQ is something to think about/read:
http://forums.studentdoctor.net/showthread.php?t=610932

Of the two that shared their scramble stories, both were FMGs.

 

[TriagePreMed]

Wait, do you mean this will become a problem if the number of residency spots stay the same/decrease? It's already sort of happening, for one reason or another. This thread from the EM 2010 FAQ is something to think about/read:
http://forums.studentdoctor.net/showthread.php?t=610932

Of the two that shared their scramble stories, both were FMGs.

What I'm saying is that an increase in DO schools and DO doctors will not affect the DO profession. DO students will simply take up the slots of Caribbean and IMG. The Caribbean and FMG will be scrambling. If they open more slots, then it will be a problem for everyone because there may be more doctors than needed and it will become like law school.

 

[PharmaTope]

college students aren't 200k+ in the hole. Thank god we got state MD school because of the outrageous tuition all DO and private school charges.

what do you mean not 200k in the whole? what state are you in?

IN-STATE tuition at the med schools here is over $30,000 a year. This doesnt include the mandatory $4,000 health insurance, other fees, house, food, etc

Even going to a state medical school is going to set you back to around the $200,000 mark. Also must factor in the increase in tuition each year.

 

[Dissected]

what do you mean not 200k in the whole? what state are you in?

IN-STATE tuition at the med schools here is over $30,000 a year. This doesnt include the mandatory $4,000 health insurance, other fees, house, food, etc

Even going to a state medical school is going to set you back to around the $200,000 mark. Also must factor in the increase in tuition each year.

That seems pretty expensive for an in-state school..and I assume you are referring to a STATE school, not a private school. What school do you go to? Most are well under 30k. Here is the data. A lot are even under 20k per year.

 

[Drrrrrr. Celty]

An exponential increase in physicians to meet an exponential increase in population and demand (such as retiring baby boomers). But hey lets continue making the same amount of physicians as 30 years ago for a population that has increase by 20 million people. Sounds like a grand idea.

Never compare law to medicine.
A lawyer will work ( Starting age 26) 40 years, a doctor will work ( Starting age 30) 35 years tops during their career before hitting the retirement age ( Implying it stays the same = 65-67). Simply being said that a lawyer will work more days where as doctors will work less and as such doctors need to be on average replaced much faster.

 

[ProtossCarrier]

An exponential increase in physicians to meet an exponential increase in population and demand (such as retiring baby boomers). But hey lets continue making the same amount of physicians as 30 years ago for a population that has increase by 20 million people. Sounds like a grand idea.

Never compare law to medicine.
A lawyer will work ( Starting age 26) 40 years, a doctor will work ( Starting age 30) 35 years tops during their career before hitting the retirement age ( Implying it stays the same = 65-67). Simply being said that a lawyer will work more days where as doctors will work less and as such doctors need to be on average replaced much faster.

residency starts at 26.

 

[Drrrrrr. Celty]

residency starts at 26.

I don't count training, not to mention the average age of a medical school freshman is 24. Overall I'd say 30 is a fair estimate since for the most part with fellowships and etc. you have doctors only working 25 years tops ( starting at ages 35+). And those highly specialized doctors are usually the most in demand.

 

[ProtossCarrier]

I don't count training

So residency and fellowship isn't working as in being productive? gotcha.

For the record, lawyers learn on their job because law school teaches useless, arcane materials.

 

[boggvir]

I am legitimately wondering if there remains a practical difference in the style of medicine between the osteopathic medical school graduates and the allopathic graduates? If the last survey I saw is any indication, an exceedingly small and continuously dwindling number of practitioners incorporate OMM into their practice, and that being the case, is there a point to having two separate structures for producing physicians?

 

[Drrrrrr. Celty]

So residency and fellowship isn't working as in being productive? gotcha.

For the record, lawyers learn on their job because law school teaches useless, arcane materials.

Is there a reason your attacking an irrelevant point I made about why Banana's aren't oranges? Sure you're working and being productive, thats fine. Then we will count lawyers clerkships after law school which will lift the amount of time lawyers are working by 2 years.
For the record, doctors learn on the job because medical school teaches useless, arcane material. See we both can make half-truth statements.

 

[sylvanthus]

I am legitimately wondering if there remains a practical difference in the style of medicine between the osteopathic medical school graduates and the allopathic graduates? If the last survey I saw is any indication, an exceedingly small and continuously dwindling number of practitioners incorporate OMM into their practice, and that being the case, is there a point to having two separate structures for producing physicians?

No there isn't a point in keeping the separation imo. But, it will continue to happen for a couple of reasons. Power and money. Those in the AOA are not going to give up their control even if it is in the best interest of everyone involved, plus theres money to be had!

 

[ProtossCarrier]

Is there a reason your attacking a irrelevant point I made about why Banana's aren't oranges? Sure you're working and being productive, that fines. Then we will count lawyers clerkships after law school which will lift the amount of time lawyers are working by 2 years.
For the record, doctors learn on the job because medical school teaches useless, arcane material. See we both can make half-truth statements.

Not trying to attack you at all, just trying to clarify some points since I have some knowledge about legal education.

 

[Flushot]

Not trying to attack you at all, just trying to clarify some points since I have some knowledge about legal education.

I don't think serenade took it as an attack. It seemed more like you chose to focus on a poor point and attack that. I can understand why serenade didn't count training as being "productive", but to hone in on it evaded the main point.

 

[scpod]

That seems pretty expensive for an in-state school..and I assume you are referring to a STATE school, not a private school. What school do you go to? Most are well under 30k. Here is the data. A lot are even under 20k per year.

Even though many of these publicly funded schools cost less than 20k, the average cost of those 77 schools is $25,230 and the median is $26,814. 33.8% of the schools cost more than $29,000 yearly to attend. These are publicly funded allopathic institutions. A couple are over $37,000 per year for in-state students. That's way tooo much for anyone!

 

[Dissected]

A couple are over $37,000 per year for in-state students. That's way tooo much for anyone!

Yea that's insane. So much for saving money at a state school! And I only saw about 5 of those in state schools being over 30k. Where is your data coming from?

Edit: you were probably including fees. got it.

 

[dozitgetchahi]

Hmm, interesting point, but I've found that basic economics rarely apply to the US health service industry and physician's salaries in general. Where else do you see a shortage in a field deemed 'necessary' by society with continually dwindling salaries. The presence of a third party that cuts reimbursements based on a sustained growth rate formula takes the basics of supply and demand out of the equation. To my knowledge, the number of providers in a given field isn't something a price-setter (ie: Medicare) takes into account when cutting prices. Additionally, there are so many patients per physician, that I highly doubt any FP, IM, Ped, etc, is hurting for patients (ie: you could feasibly never have too many physicians to patients in something like PC).

This is just what I think/assume though. You could honestly be right, and I'd be interested to hear further input.

To be blunt, the reason for this is the fact that the dynamics of the healthcare market are completely screwed up by the presence of insurance, Medicare, etc.

You want to know why the level of service (note I said service, not "patient care" - there is a difference) sucks ass in so many doctor's offices? It's the fact that people aren't directly connected to the process of paying for the services. Consequently, they tolerate the office with the ultra-rude desk staff, jerk doctors that never are on time, etc. because "insurance is paying for it" and they don't feel compelled to search for anything better. Would these same people tolerate that piss-poor level of service if they were paying out of pocket? I doubt it. (I could go on and on about this, but I digress. Needless to say, one of the things that frustrates me the most about health care in America today is that the concept of "customer service" has totally vanished only to be replaced by ridiculous MBA-inspired mumbo jumbo about "patient management". Given this, many doctor's offices frankly treat patients like dirt and seem to get away with it. I wouldn't mind being treated a little more like a "customer" by today's medical profession, and a little less like a "patient".)

This same issue exists with healthcare cost allocation etc. You wanna bring costs in line and balance compensation more equitably among specialties? Dump insurance and make everyone pay out of pocket. (This will never happen, of course, and it's not the only solution...but one can dream.)

 

[tkim]

Needless to say, one of the things that frustrates me the most about health care in America today is that the concept of "customer service" has totally vanished only to be replaced by ridiculous MBA-inspired mumbo jumbo about "patient management". Given this, many doctor's offices frankly treat patients like dirt and seem to get away with it. I wouldn't mind being treated a little more like a "customer" by today's medical profession, and a little less like a "patient".)

When you are on the other side, i.e., seeing patients clinically, come back and stare at what you wrote.

 

[dozitgetchahi]

When you are on the other side, i.e., seeing patients clinically, come back and stare at what you wrote.

I'm well aware of the challenges that practicing doctors face. My point included the fact that the service delivered by non-doctor members of the staff often totally sucks. For instance, is there any reason why desk staff should be cursing and swearing at patients (and yes, I've seen it - on multiple occasions in multiple offices - and the patients weren't being obnoxious or doing anything unreasonable either), failing to forward medical records in anything resembling a timely fashion (happened to me many, many times), lolling around doing nothing while a line of patients extends out the door, etc? No.

And if you think stuff like this is irrelevant in the realm of delivering effective care, think again. What if a 65 y/o retired smoker is finally persuaded to come to the doctor for the first time in years and has to put up with this type of crap? Is he gonna be back for follow-ups or next year's visit? Some studies say no - i.e. people's desire to seek medical care is affected by their interactions with workers at every level of the medical system.

This said, I'll admit that in my own personal experience the physicians have usually been terrific and trouble-free.

 

[tkim]

I'm well aware of the challenges that practicing doctors face. My point included the fact that the service delivered by non-doctor members of the staff often totally sucks. For instance, is there any reason why desk staff should be cursing and swearing at patients (and yes, I've seen it - on multiple occasions in multiple offices - and the patients weren't being obnoxious or doing anything unreasonable either), failing to forward medical records in anything resembling a timely fashion (happened to me many, many times), lolling around doing nothing while a line of patients extends out the door, etc? No.

And if you think stuff like this is irrelevant in the realm of delivering effective care, think again. What if a 65 y/o retired smoker is finally persuaded to come to the doctor for the first time in years and has to put up with this type of crap? Is he gonna be back for follow-ups or next year's visit? Some studies say no - i.e. people's desire to seek medical care is affected by their interactions with workers at every level of the medical system.

This said, I'll admit that in my own personal experience the physicians have usually been terrific and trouble-free.

Thanks so much for the lecture on medicine.

 

[ProtossCarrier]

To be blunt, the reason for this is the fact that the dynamics of the healthcare market are completely screwed up by the presence of insurance, Medicare, etc.

You want to know why the level of service (note I said service, not "patient care" - there is a difference) sucks ass in so many doctor's offices? It's the fact that people aren't directly connected to the process of paying for the services. Consequently, they tolerate the office with the ultra-rude desk staff, jerk doctors that never are on time, etc. because "insurance is paying for it" and they don't feel compelled to search for anything better. Would these same people tolerate that piss-poor level of service if they were paying out of pocket? I doubt it. (I could go on and on about this, but I digress. Needless to say, one of the things that frustrates me the most about health care in America today is that the concept of "customer service" has totally vanished only to be replaced by ridiculous MBA-inspired mumbo jumbo about "patient management". Given this, many doctor's offices frankly treat patients like dirt and seem to get away with it. I wouldn't mind being treated a little more like a "customer" by today's medical profession, and a little less like a "patient".)

This same issue exists with healthcare cost allocation etc. You wanna bring costs in line and balance compensation more equitably among specialties? Dump insurance and make everyone pay out of pocket. (This will never happen, of course, and it's not the only solution...but one can dream.)

You mean you want a system where Harvard doctors, no matter how ****ty, gets all the patients and $$ while those of us who goes to no name MD and DO schools gets to deal with people who don't want to be in our practice but can't afford to?