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The main reason medical schools are so selective is to limit the number of doctors. This allows the limited number of physicians to charge what the market will bear with little competition. One of the reasons healthcare in the US is the highest in the world by far with the results middle of the pack.
Same with nursing school, they learned from the AMA!
It reminds me of what China did with the rural areas of China where there were zero doctors and they put into place the barefoot doctor programs.
"A major platform of the Communist Party was a revolution in agriculture. A "Great Leap Forward" was needed in China. But Party leaders, including Chairman Mao Zedong, knew that improving the health of peasants was integral to increasing agricultural production.
What followed was a backlash against Western-style "elite" medicine. The "bourgeois" policies of "self-interested" physicians who only treated rare and difficult diseases were denounced as "disregarding the masses."
In the 1970s, the World Health Organization and leaders in some developing countries -- even the Soviet Union -- began to consider China's program as an alternate model to Western-style health care. They were looking for inexpensive ways to deliver health care to rural populations; China had seemed to set up a successful model.
But the barefoot doctors program largely fell apart in the 1980s and '90s: The central government provided less financial support for the program, and the country's emerging free-market system began forcing farmers to pay for their health care. The World Health Organization recently ranked China as fourth-worst out of 190 countries for equality of health care. Yet 40 years after the program began, the program still holds allure, and lessons, for health officials around the world looking for a solution for inadequate rural health care."
Rather than going the barefoot doctor route the US has gone the NP and PA route. Most of the doctors are in the big cities and far fewer in the countryside. Simply having more medical students won't change that. There isn't any evidence that admitting students by providing incentives will increase their diagnostic abilities.
Some things are just hard to diagnose at this point and time. We just don't know enough.
That said, I have had some horrible doctors in my time. Ones that overlooked the obvious diagnosis for years, due to me being outside of the normal demographic. Gallstones. Undiagnosed from 9th grade til the mid 20s. Written off as drug seeking.
I was young, and didn't know how to advocate for myself.
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This is why I advocate ending licenses for physicians.
With their "license to kill" the only other remedy is a malpractice lawsuit, which shifts the cost to the patient who has to fund the premiums for insurance.
. . .
I'd rather see "Satisfaction guaranteed, or your money back!"
A doc with a lot of happy patients would be more likely to get my business...
Let's flip it then when a doctor sees a patient that is hopeless or drug addicted or is overweight with diabetes then a doctor can refuse to see such a patient or be labeled as a doctor who sees patients with bad outcomes. Nobody would want to do surgery on you or lose their license because of possible bad outcomes.
Hospital outcomes are reported to the state as it monitors such things as surgery. There was one hospital liver transplant program that was revoked because it statistically had poorer outcomes compared to other hospitals. The director of the program said that they took the more severely ill patients compared to others who refused to do the surgery.
Let's flip it then when a doctor sees a patient that is hopeless or drug addicted or is overweight with diabetes then a doctor can refuse to see such a patient or be labeled as a doctor who sees patients with bad outcomes. Nobody would want to do surgery on you or lose their license because of possible bad outcomes.
Hospital outcomes are reported to the state as it monitors such things as surgery. There was one hospital liver transplant program that was revoked because it statistically had poorer outcomes compared to other hospitals. The director of the program said that they took the more severely ill patients compared to others who refused to do the surgery.
aaaannnnnd..... mic drop.
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It reminds me of what China did with the rural areas of China where there were zero doctors and they put into place the barefoot doctor programs.
"A major platform of the Communist Party was a revolution in agriculture. A "Great Leap Forward" was needed in China. But Party leaders, including Chairman Mao Zedong, knew that improving the health of peasants was integral to increasing agricultural production.
What followed was a backlash against Western-style "elite" medicine. The "bourgeois" policies of "self-interested" physicians who only treated rare and difficult diseases were denounced as "disregarding the masses."
In the 1970s, the World Health Organization and leaders in some developing countries -- even the Soviet Union -- began to consider China's program as an alternate model to Western-style health care. They were looking for inexpensive ways to deliver health care to rural populations; China had seemed to set up a successful model.
But the barefoot doctors program largely fell apart in the 1980s and '90s: The central government provided less financial support for the program, and the country's emerging free-market system began forcing farmers to pay for their health care. The World Health Organization recently ranked China as fourth-worst out of 190 countries for equality of health care. Yet 40 years after the program began, the program still holds allure, and lessons, for health officials around the world looking for a solution for inadequate rural health care."
Rather than going the barefoot doctor route the US has gone the NP and PA route. Most of the doctors are in the big cities and far fewer in the countryside. Simply having more medical students won't change that. There isn't any evidence that admitting students by providing incentives will increase their diagnostic abilities.
I don’t think the NP/PA route is necessarily a bad one. Most NP/PAs do quite well with most routine issues and follow-up visits. Now if you have a complex issue, that’s when you probably want to see a doctor. I have to say that from my own experience, the doctor hasn’t always been able to do better than the NP/PA. The NP/PA route is also much faster. You typically need some patient experience already to do these programs and the total training is a few years as opposed to a minimum of 7 from the time you start medical school. I think going into those fields or allied health is more appealing since you can make a good salary without the insane commitment of medical school.
This whole PA thing is new to us this last 3 years, never had those in Hawaii. But yeah, they seem good for basics. I'm still on the fence whether I like it better, or not. But that like/dislike is going to be specific to my area.
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Let's flip it then when a doctor sees a patient that is hopeless or drug addicted or is overweight with diabetes then a doctor can refuse to see such a patient or be labeled as a doctor who sees patients with bad outcomes. Nobody would want to do surgery on you or lose their license because of possible bad outcomes.
Hospital outcomes are reported to the state as it monitors such things as surgery. There was one hospital liver transplant program that was revoked because it statistically had poorer outcomes compared to other hospitals. The director of the program said that they took the more severely ill patients compared to others who refused to do the surgery.
Heh yeah if I was a doctor who had to obey a "satisfaction guaranteed" mandate, I'd only see healthy patients. Come in for a consultation and complain of anything more than a case of dandruff and I'd tell you to go see a specialist.
Heh yeah if I was a doctor who had to obey a "satisfaction guaranteed" mandate, I'd only see healthy patients. Come in for a consultation and complain of anything more than a case of dandruff and I'd tell you to go see a specialist.
And your consultation will cost you $500.
Seriously. Especially when so much of what goes wrong is kinda on the patient, where diet and exercise would fix a lot of their problems. "Your 60 lbs overweight, and it you lose that you will save yourself a knee replacement" isn't going to get a "satisfaction guaranteed" from most people.
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And check this out: FAQ
Moderator: Relationships Forum / Hawaii Forum / Dogs / Pets / Current Events
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