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I've been working on being my own doctor for decades and one needs to think about that more and more.
No one does not need to think about "being one's own doctor more and more"
Unfortunately with a physician shortage "doctoring oneself" won't make up for the lack of oncologists, nephrologists, cardiologists and the myriad other specialists whose acumen can't be replaced with a ridiculous Google search...
Dr William Osler commented on this years ago regarding your view point with his famous quote (and he was talking about actual "physicians" not internet wannabes):
and if you think it is bad now, just wait and see what happens if we go with free medical for all. Though I am not a huge supporter of NPR I do listen to them some and they do have some good information even if it is slanted very left. Talk personally to people in Canada who will give you a fair and unbiased opinion. If you think we have a shortage listen to what they deal with. I am not even trying to be my own doctor thank you. I will continue to listen to the man that I call DR. and I am not talking on line, or not talking about the guy who we lives above us.
This storm has been brewing for a while and is based on multiple factors:
1. Declining reimbursement, which has been the case for years, but has been increasing more exponentially recently (and not just government payors, but commercial insurance as well).
2. Uncertainty about Medicare for All or any Universal Health Care plan which will further decrease reimbursement, possibly very significantly.
3. Being squeezed from all sides, including administrators, insurers, Medicare/Medicaid and yes, even patients, and held accountable for issues that are often out of their control or for which they don't have adequate resources to improve (quality measures, patient satisfaction, cost containment requirements), while at the same time, increasingly losing control over clinical and patient care issues.
4. Spending far too much time on bureaucratic and non value added tasks, including government and system mandated electronic medical records, and less time with patients.
One thing I don't often see mentioned about the doctor shortage is simple demographics. Many physicians at or near retirement age, with a much smaller population in their 20s available to go into the field. This is not a problem unique to medicine, of course.
The whole discussion in the article of medical graduates not ever practicing because they can't secure residencies, though? I'm not buying that as being a significant number at all. Any graduate of a US allopathic medical school who has passed their boards should be able to match into a residency unless they have some red flags. It may not be in the specialty or location they want, but they should be able to match. No question we need more residency slots and more medical schools, but those can take years in the pipeline because they come to fruition, not to mention the funding issues since residency slots are paid for by the US taxpayer.
There are millions out there who struggle with not being able to afford health care, not everyone is hugely financially comfortable. Many who work to keep healthy and something comes up that lays them out and then grab a credit card to get to a doc to hopefully get some help and often do not.
I'm on other health groups and hear some doozie stories...from what I get here on this forum most are pretty comfortable or a good percentage are. But I don't know what lurks on this net.
And for those who do their best to attack what I do to keep healthy, you have no business and right doing that. But again the NET...
My own daughter has such a HIGH deductible that she stays away from doctors as best she can due to the insurance costs. So she works with all the alternative healing she can afford.
There are millions out there who struggle with not being able to afford health care, not everyone is hugely financially comfortable. Many who work to keep healthy and something comes up that lays them out and then grab a credit card to get to a doc to hopefully get some help and often do not.
I'm on other health groups and hear some doozie stories...from what I get here on this forum most are pretty comfortable or a good percentage are. But I don't know what lurks on this net.
And for those who do their best to attack what I do to keep healthy, you have no business and right doing that. But again the NET...
My own daughter has such a HIGH deductible that she stays away from doctors as best she can due to the insurance costs. So she works with all the alternative healing she can afford.
What does anything you just wrote have to do with the article you linked about a doctor shortage???
What does anything you just wrote have to do with the article you linked about a doctor shortage???
It's all about shortage or not, MANY can't afford to go to a doctor, even if they have health care NOW. So to many it won't make any difference when a real shortage hits or doesn't. None of us know what the future holds and can only do our best to keep ourselves as healthy as we can.. No one else cares about us like we care about ourselves.
Last edited by jaminhealth; 08-20-2019 at 06:28 PM..
This storm has been brewing for a while and is based on multiple factors:
1. Declining reimbursement, which has been the case for years, but has been increasing more exponentially recently (and not just government payors, but commercial insurance as well).
2. Uncertainty about Medicare for All or any Universal Health Care plan which will further decrease reimbursement, possibly very significantly.
3. Being squeezed from all sides, including administrators, insurers, Medicare/Medicaid and yes, even patients, and held accountable for issues that are often out of their control or for which they don't have adequate resources to improve (quality measures, patient satisfaction, cost containment requirements), while at the same time, increasingly losing control over clinical and patient care issues.
4. Spending far too much time on bureaucratic and non value added tasks, including government and system mandated electronic medical records, and less time with patients.
One thing I don't often see mentioned about the doctor shortage is simple demographics. Many physicians at or near retirement age, with a much smaller population in their 20s available to go into the field. This is not a problem unique to medicine, of course.
The whole discussion in the article of medical graduates not ever practicing because they can't secure residencies, though? I'm not buying that as being a significant number at all. Any graduate of a US allopathic medical school who has passed their boards should be able to match into a residency unless they have some red flags. It may not be in the specialty or location they want, but they should be able to match. No question we need more residency slots and more medical schools, but those can take years in the pipeline because they come to fruition, not to mention the funding issues since residency slots are paid for by the US taxpayer.
You are correct on the residencies. I think about 94% of allopathic medical students match. Osteopathic medical students now match at 84% in the traditional residency program. The rates are much worse in the AOA program, but that is going away next year and really shouldn’t be considered. Those who aren’t matched probably were outrageous with their match selections or did poorly on their licensing exams. It looks like the SOAP allows you over 40 applications, so if you can’t find SOMETHING with 40 applications, which is more than the average for the match, there is probably something seriously wrong with you.
I think part of the issue was that there were few new medical schools from the late ‘80s to around 2008, partially due to lack of demand/low birth rates. Now the acceptance rate is around 7% to allopathic medical schools, so it certainly isn’t a lack of interest by twentysomethings... We aren’t really going to see the benefit of the new medical schools cropping up since 2009 for a few years at least, since the first of these graduates have just recently finished residency and started practicing. I think osteopathic schools are popping up right and left, and I think my home state FL had a few new (allopathic) medical schools since 2009 as well so I know both are growing. There are a lot of states that still only have one school for the whole state, so if you have 150-200 students a year there is just no way to make up for people retiring.
Medicare for all? A single payer healthcare system, courtesy of your federal guv'mint? Certainly not free, someone has to pay for it, though it won't be many who get that care.
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