Why the hell are DO programs expanding so much?

[sophiejane]

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ally posted by gioia [/i]
Another thing..

Has anyone mentioned BABY BOOMERS????? If any of you are familiar with popular with retirement meccas, like Florida, then you will be aware of the impending shortage of physicians on the horizon.

They are the largest demographic and we are going to feel the sting of their health care needs in the next 10 years if we aren't prepared.

What would REALLY hurt health care is if the government gave chiropractics a license to issue Rx.

AMEN to that!

"GERIATRICS, HERE I COME!" (to the strains of "We're In the Money" playing in the background)

 

[subtlewonder]

q

 

[DSM]

Yea Slickness!!!

 

[MacGyver]

Originally posted by cg1155
Actually, it is not, as has been discussed on the match lawsuit thread. If compared to the actual costs of having residents then the hospitals at best break even. You have to remember the increased costs of health insurance, malpractice, decreased staff productivity, etc. I'd be interested to see if anyone can post some research that shows that having residents are a financial benefit.

Casey

Its well known that most academic medical centers take the excess money generated by resident stipends and use it to fund indigent patient care (those without insurance, which make up a high % of academic medical center patients).

So yes, it is a cash cow. Especially compared to hiring attendings to take the residents places.

 

[Adapt]

Originally posted by subtlewonder
Thank God people like Slickness exist that actually have the numbers to back up their argument

😀 GO DOs!

Yes I do believe it is good to back up your argument with facts.

Looking at it logically, I would say adding 2 new DO schools producing 400 more graduates is nothing compared to the 6,750 foreign physicians that enter US residencies each year.

We could afford to add a few more DO schools.

 

[luckystar]

Originally posted by moo
I have to agree with MacGyver here. Opening more DO schools isn't necessarily going to solve the shortage of PCPs esp. in underserved areas. What we need is more active recruitment (loan forgiveness programs, etc.). If you open more DO schools, all that's going to happen is people will end up applying to competitive specialties... and pretty soon allopathic residencies will want to protect their own turf and will start favoring MDs over DOs (if that does not happen already). Then what are these students, who are 100k+ in debt, going to do?

That's how I see it too.

The problem lies in making underserved areas of medicine more attractive. Shortage isn't equally distributed. There are more than enough people who would love to be cardiologists, or ortho surgeons, for example.

It's not about "bashing new DO schools". It's questioning where this profession is headed, and what kind of problems it will face.

 

[DocWagner]

This really isn't a big issue...it is much more complex than looking at numbers quoting articles.
Medicine has changed considerably over the past few years, primarily with the admission of patients. One cannot simply look at PCP and dictate need from their numbers, rather, one must look how trends in admission and consultations are evolving.
Example, most FP's don't admit anymore (this trend is increasing), they either 1. admit to a hospitalist or 2. admit to staff 3. admit to an internist therefore, what once took only the FP for admission, now an additional Doc is needed for hospital care.
Furthermore, hospital trends seem to lean to the further addition of specialists consultation to simple patient admissions.
Example : Dr. Jones has a patient who presents to the ED for new onset a-fib...in 2004 Dr. Jones doesn't admit patients, but refers to Dr. Smith (hospitalist)...Dr. Smith who likely feels quite comfortable with the management, realizes this patient will need cardiology follow up, therefore Dr. Smith consults Dr. Black (cardiologist).
Now in this simple example, what once took only 1 doctor for this hospital admission, now gets three. Ask any internist and you will get a nod of agreement.
Many times it gets even more complicated:
Dr. Brown is a orthopod, he admits pt.X for a broken hip. Pt. X has NIDDM and CAD. WHile pt. X is perfectly stable, Dr. Brown no longer feels comfortable with medical management, and consults Dr. Smith for medical management...then consults Dr. Yellow (the physiatrist) for rehab management after surgery in the ECF.

See, the formula is complicated and simply doesn't reflect modern medicine.
I can tell you that we have a greater need of physicians today based upon trends in management, admission, and consultations that were NEVER used in the past.

You will never have to worry about jobs...nor will you have to worry about the "watering down of reimbursement". Just doesn't work like that..

 

[raptor5]

WOW. What a heated thread. I might as well put in my two cents.

First I will start with the facts.
1. The amount of medical graduates every year will rise as new schools open up. We can aggre with that.
2. The amount people in the US is rising. We can agree with that.
3. Residency spots are not increasing with the number of graduates. Therefore the increase in new doctors will force these doctors to obtain less than desirable residencies. This sounds right but I do not know the number of new residencies or the number of new graduate compared to previous years.

They're a bargain compared to attendings. How much do you have to pay an attending? 120-150k? Not to mention other perks, as well. A resident makes about 40-45k and works at least 2x as much as an attending.

I think for this comment what should be looked at is productivity. Even though a resident may work harder as an attending that does not neccessarily mean that the two have the same Productivity. I would imagine that a good attending has a higher productivity. Or at least productivity goes up as a resident progresses through training.

The opening of new DO schools will increase the number of DO's compared to MD's. Granted there will never be an equal proportion.

Something to ponder.

Like all businesses physicians who start a practice must make good business decisions to have a successful practice.

 

[gioia]

Residency spots are not increasing with the number of graduates. Therefore the increase in new doctors will force these doctors to obtain less than desirable residencies. This sounds right but I do not know the number of new residencies or the number of new graduate compared to previous years.

1. (response to Raptor) I don't know the actual residency numbers statistics either, but capping residency hours will enable more residents to enter competitive positions and continue to thrive.

2. We also have take into account that physicians are opting to retire at a younger age than in the past AND a whole boat load of Baby Boomers are on the way.


I agree with DocWagner.

 

[H0mersimps0n]

I happen to run across the pres and pres-elect of the AOA today and thought I'd ask him what's the deal with handing out all these accreditations and not having the residency spots to fill them.

He stated simply and clearly that the AOA is merely an organization that makes sure new schools meet certain criteria and if they do they are forced to give them their accreditation. If they were to refuse for a reason like that he said the Justice department would be on the AOA like white on rice for discrimination.

If anyone in the MSI class at LECOM today happened to pick up what the hell he was talking about with "the plans" for improving the residency situation chime in cause I'll be damned if I understood what the hell he was talking about.

I think it's funny how the pres-elect went around telling us to "come back to the profession, get involved and teach" when the main thing driving us away (lack of residencies) is due to their inadequacies.

I'm sure there is more to the story than these bits and pieces. Still, I feel a little left out in the cold when it comes to the AOA's efforts.

Also I was unimpressed with the current president standing in front of our class and drooling over the idea of AOA membership exceeding the AMA membership. Is this a game of numbers and who's better than who or are we physicians that would get the recognition we deserved if we spent as much time studying as we did worrying about ways to get somewhere we already are...

just my 2c