NY Times: Obamacare will exacerbate doctor shortages

[Katarina Witt]

Originally Posted by natalie469

We have always had a shortage of doctors. It has nothing to do with Obamacare. When I'm sick, I can't see my doc until weeks later so I just go to the clinic. Why would anyone want to become a doctor with all the enormous student loans. Their debt should be paid for either by us or government. I don't know, I don't care. We need more doctors.

I can't answer the bold, but I can tell you there is no shortage of applicants for med school slots.

[suzy_q2010]

Originally Posted by Katiana

That's not particularly the issue for medical schools. The number of slots is controlled in part by the AMA.

Meaningful Healthcare Reform in the U.S. Would Start With Training Twice as Many Physicians <META NAME="keywords" CONTENT="health care">

Originally Posted by Memphis1979

I'm still waiting for someone to post a link to the law that limits the amount of acting doctors nationally.

Bill Text - 105th Congress (1997-1998) - THOMAS (Library of Congress)

MMS: Error

"Indeed, federal funding is a key factor limiting the number of GME [Graduate Medical Education]positions, which, in contrast to medical school seats, has increased remarkably slowly — at an annual rate of 0.9% from 2001 through 2010.2 The major stumbling block over the past 15 years has been a payment cap that Congress imposed on Medicare's funding of advanced training in the Balanced Budget Act of 1997. Medicare is the primary supporter of GME programs, contributing $9.5 billion to fund a share of the costs of 100,000 positions in teaching hospitals and to offset the costs of services that are unavailable elsewhere in the community, such as trauma and serious burn care. About two thirds of Medicare's GME support is a payment adjustment for patient care, which was mandated by Congress to 'account fully for factors such as severity of illness of patients requiring the specialized services.'
Efforts by the AAMC and its allies to persuade Congress to increase Medicare GME support — funding an additional 15,000 positions — were thwarted during the debate over the Affordable Care Act (ACA). Newer bills that include a similar increase have been introduced in Congress, but they are long shots, given the emphasis on constraining government spending and a 2014 budget from the Obama administration calling for reducing Medicare GME support by $11 billion over the next decade. AAMC chief executive officer Darrell Kirch notes that medical schools have done their part to reduce the shortage of 'more than 90,000 primary care and specialty doctors . . . . However, this will not result in a single new practicing physician unless Congress acts now to lift the cap on residency training positions. '”

Originally Posted by saipandoc

Unlike almost all other professions, medical graduates must pass licensing exams, and then obtain a specialty residency training position to practice. Medical graduates and practicing doctors all over the world pass U.S. preliminary licensing exams, but none of them can get licensed without U.S. specialty residency training. In 2014, 40,300 medical graduates applied for 25,600 U.S. first year Allopathic "MD" medical residency positions. Once again, residency training is required for state medical licenses. Despite passing licensing exams, 14,000 medical graduates are not on the path of obtaining a state medical license to practice. The U.S. could produce an additional 10,000+ medical doctors in as little as 3 years (solving the physician shortage for almost all states) if government funding was available to increase residency positions.

The AMA has no control over medical school enrollment. The bottleneck, as saipandoc points out, is residency slots. Increasing medical school enrollment does no good if those who graduate cannot find residencies. The AMA supports funding more residencies:

AMA Urges Continued Support for Adequate Graduate Medical Education Funding to Meet Future Physician Workforce Needs

The legislation mentioned in the link apparently died in committee:

https://www.congress.gov/bill/113th-...ouse-bill/4282


The funding for those residencies comes largely through Medicare and is under the control of Congress. If you want more doctors, call your Congresscritter.

The government is convinced that the answer to too few doctors is more nurse practitioners and physician assistants. While there is a role for those, An NP or PA is not a doctor. They have far less education and a much shallower fund of knowledge than a physician. Churning out NPs and PAs to substitute for doctors rather than assisting them with mundane chores in order to free the doc to see more patients is not the answer.

[banjomike]

Originally Posted by Mircea

Thanks for sharing.

Would you care to speculate on whether or not s/he/it (in the event it's a robot) shows up in 2016?



Had you read the ACA you'd know it was effective shortly after it was signed into law.

SEC. 1004. EFFECTIVE DATES.
(a) IN GENERAL.—Except as provided for in subsection (b),
this subtitle (and the amendments made by this subtitle) shall
become effective for plan years beginning on or after the date
that is 6 months after the date of enactment of this Act, except
that the amendments made by sections 1002 and 1003 shall become
effective for fiscal years beginning with fiscal year 2010.


I case you don't get it, Fiscal Year 2010 started October 1, 2009.


The issue of shortages in the medical profession --- which includes nurses of various types as well as specialty technicians --- was a reality before the ACA.

The ACA will exacerbate an already existing problem causing it to be more acute and take place sooner.

Reality bites....

Mircea

All I know is whoever jt800 is showed up here for approx. 6 months, beginning in June and gone by December/January, and started around 500 threads in that time. That was a huge number of starts in such a short time.

Any conjection is up to you.

[Ponderosa]

The thread was started a couple years ago, one of the many chicken little threads about Obamacare of that time. I looked up today and noticed the sky is still there.

[hawkeye2009]

Originally Posted by Ponderosa

The thread was started a couple years ago, one of the many chicken little threads about Obamacare of that time. I looked up today and noticed the sky is still there.

It fell- you are stuck in "The Matrix".