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But this is not possible anyway. Contrary to popular belief, it is not medical school positions that are limiting the number of doctors. It is residency spots. Medicare funds residency programs, and there just isn't enough money in medicare to significantly increase the amount of positions. It costs more than $100,000 per year to train 1 resident. Your Indian friends would have to do a residency in the USA and there just isn't enough spots for all of them. There are enough positions for 125% of US graduates, and the Americans that go to foreign schools get first crack at the extra 25%. Then, the foreigners that DO manage to get through may not want to stay in NJ any more than the people fleeing the state now. There are lots of hurdles to jump before your plan can work.
so would the logical step (within the framework of the ACA) to take to either change what medical practitioner can do what to allow lower levels to do more and/or do some other modification to the regulations regarding education/practice to become a doctor or become a practitioner that can do more. I know when I go to the doctor now there are the MDs the DOs and then there is the nurse practitioner. in my experience, going to the nurse practitioner isn't much better than going to my mother.
My SIL is a CPA. Her client base is doctors and their businesses. She says the average doctor has a salary in the $80k range. She laughs when she sees articles about the lowly salary of doctors because over and above the salary all of her clients have business interests based off their medical degree. The salary is a pittance and their business interest which are tied in to their practice net large sums.
Average is 80k. Average does not tell the whole story. I remembered a joke that if Bill Gates walk into the office, the average network in the office is a billionaire.
80k is not a lot of money. Consider tax take out about 30 to 40% when living in the state of NJ. Then they have to repay the 1/4 to 1/2 million in student loan. Room can easily cost 1 to 2k/month. I doubt it they can save anything.
If they move out and still able to make the same if not more and save 7 to 8% from NJ income tax, then drop the rent to under 1000. That's add up to a lot of money.
so would the logical step (within the framework of the ACA) to take to either change what medical practitioner can do what to allow lower levels to do more and/or do some other modification to the regulations regarding education/practice to become a doctor or become a practitioner that can do more. I know when I go to the doctor now there are the MDs the DOs and then there is the nurse practitioner. in my experience, going to the nurse practitioner isn't much better than going to my mother.
Your experience with nurse practitioner has been very limited. I have had wonderful experiences with nurse practitioners in many settings, including specialty pediatrics, women's health, primary care and geriatrics settings. Nurse practitioners are often very experienced and always highly educated with advanced certifications by the American Nurses Association. With all due respect to your mom.
Just pointing out reality, doc. They've got Indians reading Xrays for 1/10 the cost right now. That's what globalism has unleashed. We should be thankful the Chinese don't speak English well.
I understand what you are saying. Of course those Indians reading the x-rays live in India, where 1/10 the reimbursement is probably not bad pay. Once you move them here, they may expect more, although probably considerably less than an American. To go to medical school in India, you do not need a 3.8 average like you do here in the US. There are many average students becoming doctors there. I don't know if that is what we want here. Also, medical school is free in many countries. I was in debt to the tune of $250,000 when I finished medical school, and that was 15 years ago. I have come across foreign trained physicians that are second to none, and others who shouldn't be involved in any job anywhere that involves people. Not all American graduates are superstars either, but there is definitely a lot more consistency with much fewer outliers. Thankfully with all that is going on, there is still an abundance of top applicants. Though I have to wonder how many potential superstar neurosurgeons and heart surgeons we have lost to hedge funds and investment banks.
My SIL is a CPA. Her client base is doctors and their businesses. She says the average doctor has a salary in the $80k range. She laughs when she sees articles about the lowly salary of doctors because over and above the salary all of her clients have business interests based off their medical degree. The salary is a pittance and their business interest which are tied in to their practice net large sums.
So many doctors graduate with combination MD/MBA degrees from medical schools these days. Times have sure changed.
so would the logical step (within the framework of the ACA) to take to either change what medical practitioner can do what to allow lower levels to do more and/or do some other modification to the regulations regarding education/practice to become a doctor or become a practitioner that can do more. I know when I go to the doctor now there are the MDs the DOs and then there is the nurse practitioner. in my experience, going to the nurse practitioner isn't much better than going to my mother.
Well, that has been going on for a long time already. Will the ACA push us further in that direction? Absolutely. If you increase the patient load without increasing the physician pool, someone is going to have to take up the slack. Practices that accept medicare/medicaid will have to hire mid-level providers to take care of these patients. In my own practice, as reimbursements for anesthesia has gone down, we have been hiring nurse anesthetists instead of doctors just to keep the cuts from cutting too deep. Practices that have always said they would never use nurse anesthetists have changed their tune due to economics. Same with Ob/Gyns and nurse midwives, general practitioners and nurse practitioners, etc.
Last I read, tax profession is the #1 profession in the United States. Their productivity? ZERO.
I use Turbo Tax like a lot of ppl. But if you have advanced tax issues it's wise to use a CPA.
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