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When malpractice is the third leading cause of death, certainly the argument for govt licensure is diminished. Why not allow for market competition? You can still have your govt certified docs while others can choose what they feel is best for them in a free market.
The source for your comment is a recent John Hopkins study that concluded MEDICAL ERRORS cause 10% of deaths, the third leading cause of death in the US.
When you dig into this study, what becomes apparent is that medication errors are one of the leading causes of otherwise preventable death. Pharmacy Techs, not Pharmacists, are compounding nearly all IV medications. Many states have no requirements or proof of competency for Pharmacy Techs.
Techs are used because they are substantially cheaper to employ than Pharmacists.
For the same reason we have the FDA- to protect the public.
Again, the "free market" was tried in medicine prior to the Flexner report in 1906. It was in response to widespread quackery and unsuspecting patients being injured/harmed. Such a "free for all" would result in massive deaths/injuries to an unsuspecting public, who may be in a poor position to judge quality. I always point out that the most "popular" physician in my specialty was the most incompetent- he has lost his license. However, he was very friendly and got high praise from patients, even though he was incompetent. That state you dislike so much revoked his license so he would not harm/kill/injure more patients.
Saying that physicians are the third leading cause of death is outrageous. Certainly patients die- we all do. And when patients are faced with life threatening and potentially deadly conditions, they don't go to their auto mechanic or attorney- they go to a physician. As such, there is going to be a higher number of deaths associated with medical care, as that's where people go when they are potentially dying.
It would be like saying that attorneys are the third leading cause of divorce. People getting divorced see attorneys, so there is an expected association. However, association does not equal causation.
It’s MEDICAL ERRORS, not Physican errors- third leading cause of death in the US.
Medication errors and hospital- acquired infections are at the top of the list.
Pharmacy Techs, not Pharmacists, compound nearly all IV medications. Many states have little or no requirements or proof of competency of Techs.
Some one up thread hit on a big issue that is gets overlooked- if a certification/license requires a residency, internship or similar- schools should not be cranking out students in numbers that are too high for available residencies/rotations. If left to their own devices many for-profits in particular will simply take all comers. Creating a situation where people have a degree but no path to a job. I have seen people with CAD certificates who thought they were working their way into architecture or engineering and people with quasi computer or health degrees that thought their degrees aligned with jobs. At least with nursing it is more direct and you can go from LPN to RN and more with additional school or certification. But some of the other fields really do leave a lot of students on the hook for loans and degrees with little value.
Some one up thread hit on a big issue that is gets overlooked- if a certification/license requires a residency, internship or similar- schools should not be cranking out students in numbers that are too high for available residencies/rotations. If left to their own devices many for-profits in particular will simply take all comers. Creating a situation where people have a degree but no path to a job. I have seen people with CAD certificates who thought they were working their way into architecture or engineering and people with quasi computer or health degrees that thought their degrees aligned with jobs. At least with nursing it is more direct and you can go from LPN to RN and more with additional school or certification. But some of the other fields really do leave a lot of students on the hook for loans and degrees with little value.
Well...................................
1. there is a shortage of doctors
2. we need more doctors
3. if we need more doctors, we need more medical schools
4. Congress controls the residency slots- it is simply a "switch" that has not been flipped to fund more residency slots.
5. congress simply needs to authorize funding for more residency slots.
The FDA or 1906 isn't much of a case against independent medical rating agencies, or medical schools, or hospitals, etc.
Many things were different in 1906, like medical knowledge and the dissemination of information. If a restaurant poisons its customers or a doctor mistreats his/her patients how long will either be around after its made public?
No one on this thread is advocating for a "free for all", and I'm arguing specifically for freedom for choice and alternatives. What could be your beef with that?
And again malpractice by govt certified healthcare professionals is the third leading cause of death, so where is your "protect the public" argument now?
According to a recent John Hopkins study, MEDICAL ERRORS are the third leading cause of death in the US.
Pharmacy Techs, not Pharmacists, compound the majority of IV medications. Many states do not license Techs.
Not that a licensed tech or Pharmacist can’t have a bad day and make a mistake. It’s then incumbent on the hospital to have appropriate processes to detect and prevent error before administering an IV medication.
Then there’s the hospital- acquired infection thing. Medicare provides financial incentives to hospitals to create and use best practices and processes that mitigate hospital- acquired infections.
3. if we need more doctors, we need more medical schools
4. Congress controls the residency slots- it is simply a "switch" that has not been flipped to fund more residency slots.
5. congress simply needs to authorize funding for more residency slots.
I agree with your conclusion and acknowledge is exists as a result of the general welfare thing within the 16th amendment, ratified more than 100 years ago.
Imagine there would be substantially fewer slots in residency programs without Government subsidy.
Last edited by middle-aged mom; 02-19-2019 at 09:15 AM..
The FDA or 1906 isn't much of a case against independent medical rating agencies, or medical schools, or hospitals, etc.
Many things were different in 1906, like medical knowledge and the dissemination of information. If a restaurant poisons its customers or a doctor mistreats his/her patients how long will either be around after its made public?
No one on this thread is advocating for a "free for all", and I'm arguing specifically for freedom for choice and alternatives. What could be your beef with that?
And again malpractice by govt certified healthcare professionals is the third leading cause of death, so where is your "protect the public" argument now?
The Flexner report was an independent rating agency that eliminated most of the bad med schools in the nation.
The internet does not create an MD degree. As the information is not peer reviewed, much of the "medical" information on the net is just plain wrong. In addition, lay people lack the training or skills to determine what constitutes a valid study and what does not.
"Popular" physicians can be incompetent. Patients give friendly docs, regardless of skill, high marks. The worst doc in my specialty (5 out of 5 stars) lost his license due to incompetence. The best neurosurgeon in our state gets 1.5 out of 5 stars, as he is abrupt. The public is simply not in a good position to judge medical quality.
If anything, medicine needs MORE training. Due to PC whining, residency hours have been cut in half. Now physicians come out of training with half the training they had in the past and are expected to hit the ground running. The sad fact is that we have to train these guys further for three years until they are up to snuff.
For the same reason we have the FDA- to protect the public.
Again, the "free market" was tried in medicine prior to the Flexner report in 1906. It was in response to widespread quackery and unsuspecting patients being injured/harmed. Such a "free for all" would result in massive deaths/injuries to an unsuspecting public, who may be in a poor position to judge quality. I always point out that the most "popular" physician in my specialty was the most incompetent- he has lost his license. However, he was very friendly and got high praise from patients, even though he was incompetent. That state you dislike so much revoked his license so he would not harm/kill/injure more patients.
Saying that physicians are the third leading cause of death is outrageous. Certainly patients die- we all do. And when patients are faced with life threatening and potentially deadly conditions, they don't go to their auto mechanic or attorney- they go to a physician. As such, there is going to be a higher number of deaths associated with medical care, as that's where people go when they are potentially dying.
It would be like saying that attorneys are the third leading cause of divorce. People getting divorced see attorneys, so there is an expected association. However, association does not equal causation.
The FDA protects the public? This is a new one to me. How does the FDA protect the public when it approves drugs, devices and implants, which are later a part of some class action lawsuit because they caused harm? Is that protecting the public? Is making a pharmacy spend millions if not billions to get through the FDA's red tape process, causing the cost of that medicine, device or implant material to skyrocket... is that protecting the public or is it fleecing the public and limiting competition because unless you've got real deep pockets to get through that red tape, you'll NEVER bring a potentially life saving medicine, device or implant to the market?
The purpose of government was written in the original founding document for this nation, the Declaration of Independence. It says:
Quote:
That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed
That's it. The purpose of government is to secure our rights. The purpose of government is NOT to protect us from our own free will choice. In one of the videos I posted earlier, Milton Friedman talked about beta blockers that are available in other countries but (maybe just at that time or maybe still aren't) aren't available in the US because they aren't approved by the FDA.
My question then becomes, if this government agency supposedly exists to protect me, why can't I get certain medications in the US, medications which have been proven effective in other countries, yet simply aren't approved by the FDA? My next question becomes, by what right do some people in government get to determine what medications I can or cannot take? Who are they to prohibit me from purchasing a drug which is proven to fight a condition I may have?
I would honestly argue that any time the government claims to do something that limits my free will choice, in the name of protecting the public, the government causes me harm by prohibiting me from making my own free will choices.
This is EXACTLY what is happening with the decision to put a cap on nursing students AND penalizing hospitals that don't meet government mandated ratios. These things HARM the public, especially via higher prices because simple supply and demand says that if a commodity or resource (nurses) is made more scarce, the cost of that commodity or resource will rise. This proposal certainly does not help, nor does it protect the public.
But then again, that's just MY opinion, for what it's worth.
Except I'm not advocating for no licensure, no training, no competency so ?????????????? right back at ya.
Sounds like you're advocating for private third party organizations to handle the licensure instead, which would be regulated by customer demand.
Two problems with that...one, getting medical attention isn't like going shoe shopping. People generally don't have the luxury of selecting their hospital when they need one, much less the specific doctors and nurses that work on them. They're limited to what's near them and who happens to be available.
Two, shoe companies get bad press and go out of business when the shoes fall apart quickly after purchase for a lot of people. The equivalent for outing shoddy medical personnel (and their licensing organizations by extension) would be masses of people dying or suffering from what was done for them.
I don't think human lives are an acceptable gamble to make. There is a LOT of things that should be deregulated, but healthcare standards should not be one of them.
Last edited by ohhwanderlust; 02-19-2019 at 09:50 AM..
Sounds like you're advocating for private third party organizations to handle the licensure instead, which would be regulated by customer demand.
Two problems with that...one, getting medical attention isn't like going shoe shopping. People generally don't have the luxury of selecting their hospital when they need one, much less the specific doctors and nurses that work on them. They're limited to what's near them and who happens to be available.
Two, shoe companies get had press and go out of business when the shoes fall apart quickly after purchase for a lot of people. The equivalent for outing shoddy medical personnel (and their licensing organizations by extension) would be masses of people dying or suffering from what was done for them.
I don't think human lives are an acceptable gamble to make. There is a LOT of things that should be deregulated, but healthcare standards should not be one of them.
Every hospital that hires (Milton Friedman was addressing the Mayo Clinic in one of his videos) put THEIR name on the service provided by a doctor, nurse, etc. No business would knowingly keep a person on their staff if they believed that person incompetent at what they do. Licensing doesn't matter on this. But for argument's sake, let's say it is a small clinic. How long will that clinic remain in business if they had a bad doctor or nurse working for them? The free market does an excellent job of protecting the public from bad <insert profession here>.
I love how no one addressed my comment about licensed drivers who shouldn't be behind the wheel. (My best guess is we all know at least one person that fits this description. So a license does NOT mean proficient, qualified or competent.
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