NYT editorial on residency shortage

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Would very much hesitate from characterizing NYT as anti doctor. NYT has been extremely pro medical education, pro US schools, pro debt relief, and supportive of doctors fights within the realm of scope of practice, and the never ending struggle for autonomy from both insurance dictums and hospital corporations dictating practice to their employees.

What they are often correctly accused of is supporting ideas (both poorly thought out and incredibly well thought out) that would decrease physician incomes as a side effect of implementation.

I see "well this is surprising from the NYT" 3x more often then I hear "here's the NYT going after docs again". Though I guess it's fair to say that supporting all of our pet projects is irrelevant if you don't support our paychecks. I guess so. I just find that when people assert the NYT to be anti doctor, I want to ignore what they say because the odds of them saying that without ever checking themselves is high. And I don't like to debate people with beliefs based on word of mouth.

Sorry for the side comment. I'm done. Article was awesome.
 
Would very much hesitate from characterizing NYT as anti doctor. NYT has been extremely pro medical education, pro US schools, pro debt relief, and supportive of doctors fights within the realm of scope of practice, and the never ending struggle for autonomy from both insurance dictums and hospital corporations dictating practice to their employees.
Um, no, actually, it hasn't.
 
Um, no, actually, it hasn't.

Bring it up with the medical society of the state of NY. They monitor every single article that comes through that newspaper that mentions doctors. Hell, we pen a lot of the articles ourself. MSSNY members might as well be on the staff given the number of editorials we've penned.

The NYT has supported doctors a lot more often then not. But some people (I'm one of them) dont forgive them for which issues they do split from us on. But it's just factually incorrect to label them as anti doctor. Just as I wouldn't label them pro doctor (but gun to my head and pick one, its pro doctor)
 
I just find that when people assert the NYT to be anti doctor, I want to ignore what they say because the odds of them saying that without ever checking themselves is high. And I don't like to debate people with beliefs based on word of mouth.

I've read the NYT daily for over 10 years, so I am not just parroting what others have said about this issue. Did you read the recent article titled, "Why Aren't Doctors Drug Tested?" which told the stories of negligence and drug addiction by 1) a surgical technician and 2) a medical technician as evidence that physicians should be drug tested? Or the Medicare reimbursement witch hunt they went on this Spring without qualifying that a physician who owned multiple practice sites with many employees would be listed as earning all those reimbursements himself? The majority of articles in the Times that are pro-physician were written by MDs.
 
Bring it up with the medical society of the state of NY. They monitor every single article that comes through that newspaper that mentions doctors. Hell, we pen a lot of the articles ourself. MSSNY members might as well be on the staff given the number of editorials we've penned.

The NYT has supported doctors a lot more often then not. But some people (I'm one of them) dont forgive them for which issues they do split from us on. But it's just factually incorrect to label them as anti doctor. Just as I wouldn't label them pro doctor (but gun to my head and pick one, its pro doctor)
Yes, then please look at the articles where they attack Dermatologists, Gastroenterologists, Emergency Medicine doctors, etc.
 
Stupid tangent. I apologize for bringing my facts and quantitative measurement where truthiness, the "feeling" of what must be the case, is what matters.

I apologize and will banish myself. Again, if you don't believe me feel free to contact MSSNY. Chances are they'll delegate the data collection to me for the response, since I've done it for them before on matters of media presence.
 
More residency slots is not the answer. We already have so many that we need FMGs and IMGs to fill them. The quality of training is on the decline with the proliferation of DO schools and substandard AOA residency programs. The real problem is a maldistribution of physicians by geography and specialty. The focus needs to be on incentivizing new grads to go into primary care and work in underserved areas. For the VA specifically uncompetitive salaries has caused this huge shortage of physicians. By creating more physicians without forcing the system to address the actual problem we are going to devalue ourselves in the marketplace.


I'm scrolling down this thread on my phone, and as soon as I see "meat tornado" as the author of this post I know with a certainty that it will contain a dig at DO's

How sad it must be to be so insecure that you resort to injecting such nonsense into virtually every single thread you post to.
 
I'm scrolling down this thread on my phone, and as soon as I see "meat tornado" as the author of this post I know with a certainty that it will contain a dig at DO's

How sad it must be to be so insecure that you resort to injecting such nonsense into virtually every single thread you post to.

oh sorry, didn't realize this thread was in the osteo forum where facts and reality are not welcome. i have erased my post and instead posted it in the allo forum where we can actually discuss these topics like adults. sorry to have temporarily pulled the wool from over your eyes.

you should also look up the definition of insecure.....
 
oh sorry, didn't realize this thread was in the osteo forum where facts and reality are not welcome. i have erased my post and instead posted it in the allo forum where we can actually discuss these topics like adults. sorry to have temporarily pulled the wool from over your eyes.

you should also look up the definition of insecure.....
I actually agree with you when you mention the maldistribution issue. Simply pumping up the slot numbers won't really get at the root problem here. As for the low quality AOA programs you mention... I don't know, but it will all be ACGME soon enough, so that will be a moot point. I bet we see a redistribution of slots as some programs get the ax over the next 6-10 years. Also, I may be wrong here, but aren't there a decent number of positions (AOA and ACGME) that go unfilled each year? Maybe they will focus in shifting those around before waiting for more funding for GME.
 
I actually agree with you when you mention the maldistribution issue. Simply pumping up the slot numbers won't really get at the root problem here. As for the low quality AOA programs you mention... I don't know, but it will all be ACGME soon enough, so that will be a moot point. I bet we see a redistribution of slots as some programs get the ax over the next 6-10 years. Also, I may be wrong here, but aren't there a decent number of positions (AOA and ACGME) that go unfilled each year? Maybe they will focus in shifting those around before waiting for more funding for GME.

I agree, most of what he said is true.

I just think it's sad that he can't make a point on this forum without injecting some DO hate into the post.

It's probably true that some AOA programs may be substandard (though I defy SkinMD...err meat tornado to identify some bad programs by name). But it's also true that not all ACGME programs are gems either. And there are some excellent AOA residencies too.

My main beef was with the comment that quality is on the decline with the proliferation of DO schools. Like that has anything to do with the quality of GME.

Meat Tornado is so insecure about DO's it's almost comical. I wonder what happened to make him that way?
 
The solution is to incentivize students to go into primary care. Put all that money into PCP reimbursement and loan repayment.

Bingo.

If the Medicare payment system wasn't so geared toward incentivizing procedures and acute care, PCP's could make a competitive (for physicians) wage, and primary care would be just as popular as most other specialties.

Also, reimbursement per RVU is way down there for Family Med compared to say...GI. A family doc could get trained to do scopes (and there are a few out there who have) but if said family doc is paid solely per RVU, as some are, then he/she might make half, or less, what a GI would make for the exact same procedure.

In the hospital I just finished my last rotation in, GI's are making $600k+ doing scopes all day and being paid by RVU only. While Family Docs are raking up more RVU's but still generally topping out at about $200K-$250K.

As long as that's the situation, Primary care will be less appealing, and for good reason.
 
I agree, most of what he said is true.

I just think it's sad that he can't make a point on this forum without injecting some DO hate into the post.

It's probably true that some AOA programs may be substandard (though I defy SkinMD...err meat tornado to identify some bad programs by name). But it's also true that not all ACGME programs are gems either. And there are some excellent AOA residencies too.

My main beef was with the comment that quality is on the decline with the proliferation of DO schools. Like that has anything to do with the quality of GME.

Meat Tornado is so insecure about DO's it's almost comical. I wonder what happened to make him that way?

Yes, I changed my SDN handle, it's no secret, it said "formerly skinMD" under my handle for months, you're allowed to do that when you're a verified physician. People thought I was doing derm because of my name and it was confusing. Also change is refreshing. It has become clear that you don't know the difference between changing your handle (something that's allowed) and creating a new handle (not allowed and usually indicates trolling).

I don't have to start naming AOA programs. That's the whole point of accreditation and minimum standards. With ACGME programs there are strict standards that have to be adhered to or the program gets put on probation or is shut down. AOA standards are much more lax and not really enforced. The proliferation of DO schools is directly linked to the proliferation of substandard AOA residency programs....just look at that new NM program that had to find all these new residency slots....a clear case of quantity over quality in the DO world.

As for the merger....I'm all for it! We need GME standardization and bring those AOA residencies up to par so we can at least know that when someone finishes residency there's a minimum level of competency which is, at the moment, not guaranteed. I'm fascinated that many of the DO students and especially pre-DOs on this board ignore all the negative consequences of the merger but hey, if you don't care then I don't care either. From the perspective of MDs there is no downside since ACGME programs can continue to function the way they always have without any new mandates.

There's nothing to be insecure about....we aren't competing, I hardly ever interact with any DOs on a daily basis since I'm in a desirable location flooded with MDs. I'm just concerned that becoming a physician is something the average joe can now do (3.0/25 ...come on in!) and that we're slowly going the way of law where the barrier to entry is going to be so low that being a "doctor" is going to be meaningless causing us to suffer all the consequences that lawyers now face (supply > demand, low salaries, no respect).
 
There's nothing to be insecure about....we aren't competing, I hardly ever interact with any DOs on a daily basis since I'm in a desirable location flooded with MDs. I'm just concerned that becoming a physician is something the average joe can now do (3.0/25 ...come on in!) and that we're slowly going the way of law where the barrier to entry is going to be so low that being a "doctor" is going to be meaningless causing us to suffer all the consequences that lawyers now face (supply > demand, low salaries, no respect).

I share your concern about the rapid growth of the osteopathic profession (with the rate of new medical schools, and stand-alone medical schools) without accompanied growth in quality residencies. Unlike lawyers, where the bottleneck to the profession is law school admission (which is pretty low, especially for low-tier and unranked law schools), residency serves as a bottleneck for us. But with the unchecked expansion, it may come to a point where you have unmatched US graduates who will take have to try multiple years following graduation to get residency (unless the number of spots expands).

As for the "average joe", I think due to the rat race of becoming a physician, and being surrounded by academia (from high school, college, med school, residency), we lose sight of the fact that the majority of Americans are not college graduates. Nationwide, only 28.5% of the US population have a bachelor degree or higher. Boston, a city with a large cluster of colleges, the majority of their population don't have college degrees. Only 43.4% of Boston's population have Bachelor degree or higher (while 84.5% are high school graduates). NYC only has 34.0% of its population with bachelor degree or higher (79.4% high school graduates), Washington DC have 51.2% of its population being college graduates, Chicago with 33.6% college graduates (80.5% high school graduates), and San Francisco with 52.0% college graduates (85.9% high school graduates). To make it through college is still worth something in the US, and to make it through college, take the MCAT (which most college students don't do), make it through medical school, pass all 3 steps of COMLEX (and/or USMLE), make it through residency, and pass the boards (whether ABMS or AOA) is still challenge that most average joe can't or won't even consider doing. Besides, no one cares about the doctor's undergraduate GPA or MCAT scores. It's used as a screening/selecting tool for med school admission. That's all. It has as much relevance to practicing medicine as one's high school GPA and SAT/ACT score.

I apologize for the slight tangent in this thread. Now back to the NY Times editorial.

*statistical data on college graduates and high school graduates obtained from the US Census website - http://quickfacts.census.gov/
 
Yes, I changed my SDN handle, it's no secret, it said "formerly skinMD" under my handle for months, you're allowed to do that when you're a verified physician. People thought I was doing derm because of my name and it was confusing. Also change is refreshing. It has become clear that you don't know the difference between changing your handle (something that's allowed) and creating a new handle (not allowed and usually indicates trolling).

I've looked back over my posts and fail to see where I accused you of having multiple accounts...

I don't have to start naming AOA programs. That's the whole point of accreditation and minimum standards. With ACGME programs there are strict standards that have to be adhered to or the program gets put on probation or is shut down. AOA standards are much more lax and not really enforced. The proliferation of DO schools is directly linked to the proliferation of substandard AOA residency programs....just look at that new NM program that had to find all these new residency slots....a clear case of quantity over quality in the DO world.

I'd like you to source this claim, you know, the claim that the standards are much more lax, and not really enforced. It sounds a lot like you're just trying to spread FUD to me.

As for the merger....I'm all for it! We need GME standardization and bring those AOA residencies up to par so we can at least know that when someone finishes residency there's a minimum level of competency which is, at the moment, not guaranteed. I'm fascinated that many of the DO students and especially pre-DOs on this board ignore all the negative consequences of the merger but hey, if you don't care then I don't care either. From the perspective of MDs there is no downside since ACGME programs can continue to function the way they always have without any new mandates.

Why don't you educate us on the "negative consequences of the merger"; you sound like you've studied this out quite a bit. I'm genuinely interested in how you think it will go down, and why you think that way.

There's nothing to be insecure about....we aren't competing, I hardly ever interact with any DOs on a daily basis since I'm in a desirable location flooded with MDs. I'm just concerned that becoming a physician is something the average joe can now do (3.0/25 ...come on in!) and that we're slowly going the way of law where the barrier to entry is going to be so low that being a "doctor" is going to be meaningless causing us to suffer all the consequences that lawyers now face (supply > demand, low salaries, no respect).

Tell me about how you aren't fighting any insecurity again...because this paragraph sure doesn't convince!
 
I've looked back over my posts and fail to see where I accused you of having multiple accounts...
you keep mentioning that i changed my handle like i did something shady

Why don't you educate us on the "negative consequences of the merger"; you sound like you've studied this out quite a bit. I'm genuinely interested in how you think it will go down, and why you think that way.

i've written quite extensively about this in threads about the merger. you probably saw my posts and spewed your usual BS without actually reading or understanding anything I was saying.

I'd like you to source this claim, you know, the claim that the standards are much more lax, and not really enforced. It sounds a lot like you're just trying to spread FUD to me.

if these programs are so great then why aren't you applying solely in the AOA match?
 
@MeatTornado and @SLC ... I think you are derailing this thread. The average Joe can not be a physician when only 5% of the population has a PhD/Professional degree... Admission to med school is still rigorous even if we do have some DO and to some extent MD proliferation recently... It has been well documented that the quality of DO education is for the most part inferior to MD. Therefore, this discussion is not going anywhere if you keep arguing about stuff that are well known to everyone in this forum....
 
if these programs are so great then why aren't you applying solely in the AOA match?

Because there are no AOA programs in the area I wish to settle. And I'm not big on OMT, so I'm looking to match a program that won't expect/require it.

But I can assure you it isn't because I'm scared that I'll get a substandard education at an AOA residency program.
 
the "average joe" comment was obviously hyperbole ....the point was you can basically be an average college student and do average (or even below average) on the mcat and get into med school nowadays as long as you're willing to jump through all the other hoops like ECs and aren't afraid of the debt.
 
the "average joe" comment was obviously hyperbole ....the point was you can basically be an average college student and do average (or even below average) on the mcat and get into med school nowadays as long as you're willing to jump through all the other hoops like ECs and aren't afraid of the debt.

And as long as you can pass medical school, licensing exams, and perform adequately in residency then what's the problem with having had those undergrad qualifications in the end?

In other words, what exactly does your undergrad GPA and your MCAT score say about you as a physician?

At the end of the day, I think that you want to be part of some elite community. You require ego stroking and the praise and admiration of the community to justify your choice to become a physician. The inclusion of those who may have academic pasts that aren't as "elite" as you'd like into your physicians club is threatening to your whole idea of what being a doctor is all about.

Like I said, insecurity...
 
lets stay professional here, avoid accusations, and try to get back onto the topic at hand.

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It has been well documented that the quality of DO education is for the most part inferior to MD.

This is absolute BS and it only exists because places like SDN are a rat’s nest for dumb theories. DO education is inferior according to who? All the anonymous mouths on this forum?


Here is the reality from health policy circles: osteopathic schools are a winner at the state level, the federal government loves them, and patients love DO physicians. The general arguments used to claim that DO education is inferior typically come down to a few points:


1) Faculty to student ratios (14:1 MD vs. ~2:1 DO). The only place this silly argument has traction is on this forum. There are tons of people in the policy sphere that have been absolutely bitching for years about the “waste” in modern medical education. “Blah, blah…subsidizing researchers who come in and give a lecture twice a year.” Furthermore, most MD faculty numbers come from associate and assistant professors that, for all intents and purposes, are full time attendings in their affiliated hospitals. I think it’s great that MD schools have, on average, larger and more advanced hospitals attached to their programs but I haven’t seen an ounce of evidence about how this leads to better doctors. The evidence that does exist is anecdotal and crazy susceptible to individual bias, e.g. “Well, I don’t think DO students are as well prepared based on my experience.” Do I think that having an attached hospital is great? Yeah. Do I think it probably has educational benefit? Sure do. How measurable a difference does it make? Got me? :shrug: Show me a study.

2) DO schools rely more on tuition to run their services. Only in the ivy tower of medical education would anyone nod their head and go, “YEAH!” Everyone else in the world (state legislatures, policy makers) think this works out to a good deal for them. Less tax dollars and more doctors. Personally, I actually agree that tuition needs to be lower and that one of the ways this happens is through subsidy, but I don't think anyone trying to pay for it (taxpayers) cares.

3) There are some who believe that the DO model is actually the future of medical education. There are more than a few calls to “trim the fat” in medical education. You can’t read a NYTimes article without someone complaining about the 4th year or all the pomp and circumstance and wasted money that go into the process. I don’t agree with all of this personally, but the tide is on the other side.

4) NPs!!! There is literally an entire other profession whose central point is that we (physicians and future physicians) are all over educated and yet people on this forum have the audacity to sit and run the same tired MD vs. DO debate.

Medical school is hardly at a point where an “average Joe” can stumble his way into a class. Despite the fatalistic attitudes on this forum, gaining admission into any U.S. medical school still remains competitive. So competitive in fact that it’s hard to miss an article about the barriers to entry being so high that only rich kids can enter.

"The current system has costs beyond making doctors expensive and rare. The long process doesn’t just weed out the incompetent and the lazy from the potential pool of physicians—it deters students who can’t pay for so many years of education or who need to make money quickly to support their families. That introduces a significant class bias into the physician population, depriving a large proportion of the population of doctors who understand their background, values, and challenges." -Source

Absent the MCAT, admission still requires jumping through hoops that 95% of the general public considers insane. Do DO schools have some room for improvement? Yeah, of course. Is it well established that they're producing inferior doctors? No, not at all.
 
...
There's nothing to be insecure about....we aren't competing, I hardly ever interact with any DOs on a daily basis since I'm in a desirable location flooded with US MDs. I'm just concerned that becoming a physician is something the average joe can now do (3.0/25 ...come on in!) and that we're slowly going the way of law where the barrier to entry is going to be so low that being a "doctor" is going to be meaningless causing us to suffer all the consequences that lawyers now face (supply > demand, low salaries, no respect).

You do know that there are plenty of docs around that had 3.0s/25s, not just DOs or Carib grads, but MDs as well, right? Heck, go back 10 yrs and there are tons of docs that went to MD schools that wouldn't get in now and would be going DO. The profession hasn't collapsed yet.

And I'm not so sure its the DOs contributing to the devaluation of the profession, especially when DO matriculant averages have only consistently gone up in the recent past, even with the opening of a bunch of new schools.

In any case as its been alluded to already, to be a licensed physician, you have to jump over the same hurdles as a DO as you would an MD.

But its ok, you don't need to even think about a whole population of your colleagues, after all you don't compete with DOs at your institution, I mean its not like any DOs ever match competitive ACGME residencies in competitive programs... you know... except when they do...
 
Seriously guys I deleted the post because it wasn't meant for the osteo forum. Please just move on and stop whipping yourselves into a frenzy. I'm done responding to anything else in this thread as it is very clear differing opinions are not welcome in this forum.
 
Seriously guys I deleted the post because it wasn't meant for the osteo forum. Please just move on and stop whipping yourselves into a frenzy. I'm done responding to anything else in this thread as it is very clear differing opinions are not welcome in this forum.
Do you know how condescending this sounds? I think what SLC is trying to say is that you post in this forum only to input some sort of dichotomy between DOs and MDs. The reality is that this thread is relevant to both DO and MD students, and separating the issue between the two is not fixing anything. You're essentially contributing nothing.
 
Something that I have noticed in SDN is that there some med students or residents who were on the borderline MD competitiveness and got admitted to DO and many of them think that they are too good to be DO and always feel the need to show that and especially if they did good on step1.... I think @MeatTornado might be one of them.
 
Something that I have noticed in SDN is that there some med students or residents who were on the borderline MD competitiveness and got admitted to DO and many of them think that they are too good to be DO and always feel the need to show that and especially if they did good on step1.... I think @MeatTornado might be one of them.

I'm an MD but excellent guess
 
Lets try to refocus this conversation/thread back to the topic and not on any particular individual.

If you want, there is a "ignore" feature so you won't have to see future posts by certain posters - click on the profile name and select ignore.

Lets go back to the original topic please.
 
In 100 years... All new people. Petty squabbles waste precious grains of time. Do right by your patients and those that matter and all is well!
 
Going back on topic, I actually saw that article earlier, and thought it made some good points. The real problem is that none of this is new. Articles like this have been all over the place for years (the problem definitely isn't new), but nothing has really changed. I'm hoping that physicians as a whole (MD, DO, specialists, PCPs, etc.) can come out in support of both the healthcare needs of our country and for physician's rights.
 
...I'm fascinated that many of the DO students and especially pre-DOs on this board ignore all the negative consequences of the merger...
I, too, am fascinated by this.

...becoming a physician is something the average joe can now do (3.0/25 ...come on in!) and that we're slowly going the way of law where the barrier to entry is going to be so low that being a "doctor" is going to be meaningless causing us to suffer all the consequences that lawyers now face (supply > demand, low salaries, no respect).
3.0/25 was much more competitive for both DO and MD schools in the past than it is now.

Going back on topic, I actually saw that article earlier, and thought it made some good points. The real problem is that none of this is new. Articles like this have been all over the place for years (the problem definitely isn't new), but nothing has really changed. I'm hoping that physicians as a whole (MD, DO, specialists, PCPs, etc.) can come out in support of both the healthcare needs of our country and for physician's rights.
This won't happen until physicians are unionized or the AMA or some other organization representing a larger portion of physicians than the AMA currently does actually focuses its efforts exclusively on advancing the medical profession. Until then we'll just get steamrolled by the DNP's when it comes to primary care.
 
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