It's not "forcing" if they know what it is before entering and agree to it. If they don't want to do primary care, they shouldn't apply to the program. Plenty of other regular med school programs out there if that's what you want. But if we need primary care physicians in underserved areas, the only way to ensure medical grads will do that is if they commit to it ahead of time, forgoing other options. Only the people that would actually want to do this should apply to that program, as it'd be stupid to do so if you didn't want that. It eliminates the "oh yeah i totally wanna do primary care" at interviews followed by "j/k i wanna do derm in socal" once school starts factor and streamlines the process. Just like how you shouln't go to med school if you don't want te be a doctor, you shouldn't go to a primary-care-only program if you don't want to do primary care.
You realize there are postive incentives like reimbursing people in accordance to their skill, training, and importance to patients health?
You can't force people into any of these contracts, if you forgot we have a bill of rights and forced servitude violates it plus the 13th amendment.
Its unenforceable in court and people can do whatever they want, people put all types of crazy crap into employee contracts to try to squeeze people knowing they have no legal recourse if they violate
I'll sign my name on a contract right now for $500 and 10 years as your personal assistant. But when you come to collect I'm gonna wipe with it and show you the door.
Furthermore when people are under duress or not fully informed to consent a contract is unenforceable. It protects you from extortion, so when you are desperate loan sharks and others can't take advantage.
Quit thinking like such a obedient dunce and realize theres 2.6 trillion in healthcare spending. Wages for physicians is a nominal percentage that could be increase for society's benefit if they had any representation as citizens or employees
And don't worry about NPs or other workers as they don't control whats keeping physicians down like corporate interests and lobbying.
The knowledge base,clinical productivity, and ability to grow with the science of medicine is clearly more evident if you see mid levels and doc after pgy1. Patients see it too, maintain integrity and patient care as a focus and the public is the one friend physicians don't want to lose.
Nurses are more middle management and have great labor conditions compared to docs. They farm out duties to techs and administer some meds, break on the reg, get OT and all the other stuff a person should be entitled to. Hospitals still pay it out cause there bottom line works and nurse unions lobby to keep themselves relevant
State hosptial licensure, medicare payments and facility eligibility has specific nurse staffing requirements per shift, floor, unit, patient.
You don't see that with docs, the existence of a medical director for some places is it. They do have requirements like a doc has to do an admission, orders, discharge summaries, certain procedures, etc. But that gives hospitals the ability to spread MD labor as thin as they want and payment is based on billing alone. An MD doesnt make money till the hospital does. The nurses don't allow their labor the opening to be abused because they are there on their shift and can move as slow as they want or do as little as they want and clock out.
There should be a line between encouraging productivity (if patient care is in mind) and giving a worker some security and stability. As well as being foundation of healthcare that cant be worked around like nurses have. Or else they will find cheaper labor to do as much of the MD work as they can get away with, bill the same, and pay the MD less
