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Prior to the 80's doctors made house calls. During that period an office visit might have cost you $2-5 and the doctor took as long as needed depending on the circumstances. People put their faith in their doctors and many people had one doctor from birth to death. Today we have an impersonal system where a visit to doctor is limited by the length of time on the timer in the doctor's pocket and cost between $120-$180 for a visit lasting no longer than ten minutes. What happened? HMO's plain and simple. Somewhere in the period a slimy south Philadelphia suit salesman slithered into a doctors office and convinced that doctor that if he allowed him to manage his patients the doctor would reap heaps of money. That same slimeball went to the patients and convinced them that if they allowed him to patient their healthcare they would save money and they were convinced. HMO's were born and much like Ponzi schemes all was well...for a while. The one thing no one considered was going to pay the slimy suit salesman for the managing job. As HMO's grew there was no stopping them and they controlled a doctors every move including having a clerk with no medical training, being paid $5/hr, making life and death decision that doctors had to follow. Fast forward, we now have a system that is "for profit" at every turn.
Doctors have little to no control over anything. Patients have no control over anything. Bean counters make the decisions.
The child who grew up with the desire and ambition to become a doctor and does so is soon swallowed up in a system that takes every heroic and good thought about being a doctor and smashes into the ground.
We live in America the world leader of medical innovation. America also ranks 37th in healthcare with a third world country providing better care for it's citizens. Then consider a child who wants to become a doctor to help people and does so finding him/herself as a doctor being told by an accounting clerk to let a patient go because their insurance or Medicare has run out. A doctor being told he can't see a patient because of no insurance or the wrong insurance. A doctor working in a system as in CA where hospitals charge anywhere from $18k to $180K for a simple appendectomy.
Is is any wonder doctors have have it?
Doctors quit making house calls starting in the 60s. A $2 doctor visit in the 70s? Maybe in Kenya! I remember doctor visits being about $15 in the very early 70s.
The amusing thing is anyone that works to earn wealth, including the highest paid doctors, is really wealth. Just look at Mitt Romney as an example. He has $250 million dollars. Even at 1% that yields an annual income of 2.5 million dollars. Nobody is paid that much for doing something as real AS BEING A DOCTOR.
donsabi - Doctors have been reduced from self employed respected professionals to just another employee. That is the primary failure of our medical system. The profits are being stolen by the executives and investors instead of going to the Doctors and other professionals.
what do you mean by 'something real'?
Investing/money management is a very 'real' job, and is extremely essential to a healthy economy.
Someone on this board was putting his son through med school. I can't remember who that was, but I think we all should be aware of the burdens placed on a doctor getting thru school and entering practice. The stress is horrendous, not to mention the debt and the mistreatment endured in training. I look at most of them as drug pushers, but they probably started out with dreams of helping people, just as many other fields do, lawyers, police, even politicians etc. Then you get caught up in this bureacracy which you have no control over.
Imagine trying to be a Naturopath in this environment. For that, I would tend to look to another country that is more accepting of alternative treatments.
Then they should stop placing artificial limits on how many doctors we can have.
Remember, schools are told how many seats they can offer for teaching new doctors.
And how far do you take this? Start accepting "B" students? What about "C" students? Why not lower the MCAT score requirements. Or even better, remove the MCAT requirement all together.
Why don't I get some investors together and open up the "Hollywood Upstairs Medical College", and I can run it like a trade school. I'll give DeVry a run for it's money. That will surely bring down the cost of medicine.
And how far do you take this? Start accepting "B" students? What about "C" students? Why not lower the MCAT score requirements. Or even better, remove the MCAT requirement all together.
Why don't I get some investors together and open up the "Hollywood Upstairs Medical College", and I can run it like a trade school. I'll give DeVry a run for it's money. That will surely bring down the cost of medicine.
Why not let the market control this? There is no shortage of consumer review information today. Let 'Hollywood Upstairs Medical College' start, and people can make the choice to not visit a doctor that got a degree from that school. That being said, visiting a doctor who was a 'B' or 'C' student for a dramatically reduced cost might be a favorable alternative to not being able to go to a doctor at all for some people.
Way to completely forget to use any comprehension there...
Where does it say to lower requirements?
Just a quick googling...
In 1963 we had 135 law schools, now 200.
100 years ago we had 160+ medical schools, today it's roughly 130.
Population goes up.
Medical need goes up.
Schools go down.
Wonder why all the burnout...
Let me go find a rocket scientist... It's tough figuring out this one...
Maybe that's your problem. Instead of a rocket scientist, you should find an economist. Your current post says nothing about your original statement.
If you remove the limits, you are opening up more spaces.
These spaces are filled by people who did not qualify for the spaces that were there before your removed the limits.
There is no escaping the economics that the more spots you open up, the lesser the quality of the student you are willing to accept.
The question I have for you, is how far do you take this. I gave an extreme example, which was not so "extreme" to another poster, but you made the original statement, without quantifying anything, so I am just wondering if you advocate the Hollywood Upstairs Medical College too?
Maybe that's your problem. Instead of a rocket scientist, you should find an economist. Your current post says nothing about your original statement.
If you remove the limits, you are opening up more spaces.
These spaces are filled by people who did not qualify for the spaces that were there before your removed the limits.
There is no escaping the economics that the more spots you open up, the lesser the quality of the student you are willing to accept.
The question I have for you, is how far do you take this. I gave an extreme example, which was not so "extreme" to another poster, but you made the original statement, without quantifying anything, so I am just wondering if you advocate the Hollywood Upstairs Medical College too?
It is ironic that you talk about economics but want to impose artificial demand by placing a hard ceiling on a market. As long as you are on the topic, look up the term 'economic deadweight loss'. Do you care to address the points I made responding to you in my previous post?
But of course, following your logic, shouldn't we further limit spots? After all, if we cut the current number of doctors by 25%, the quality we get would be even better, so with your logic that is a great thing, isn't it?
Where's the data saying all of those who qualify are getting seats then?
My second post is the same as the first. The "artificial limits" are not academic ones, but school capacity ones.
Quote:
There is no escaping the economics that the more spots you open up, the lesser the quality of the student you are willing to accept.
Maybe it's a lack of capacity problem, and not quality of the student. Medical school applications have exceeded expansion in capacity by a large margin for awhile.
I haven't answered your question because your example is asinine and not related to either post. Not about lowering the bar...
The youngsters are sissies. We used to have to work three days without sleep, were punched, and subjected to the most horrific verbal abuse that one can imagine. I tell people about my training and they find it unbelieveable.
It is, however, a part of the process. If you can work and think effectively with someone screaming obscenities at you, you can work calmly and effectively in an emergency. Further, if you can work after not sleeping for a few days, then an overnight call is not that tough.
Today's physicians, when they come out of training, are not prepared for practice, as it is much harder than thier residency/fellowship. For us, practice, while grueling for most, is not a big deal, as it is easier than training. Today there are limits to the number of hours that a resident can work per week and "guarantees" that they will be able to sleep a certain number of hours. Further, the staff abuse is a thing of the past, due to the potential for litigation.
Medicine is a little like military training, in that in addition to information, one must be "toughened up" to be prepared for practice. Modern training is failing in that regard. I have a part time clinic at the VA, in which I used to have residents and med students. They said I was "too mean" to them, such that they no longer rotate through my clinic. I was on stafff at two universities and was considered to be one of the most mild staff members, although that was 20-25 years ago. Things have changed.
If you go into medicine- man up
The idea that you have to be "toughened up" by abuse and lack of sleep is a fallacy. Even the military no longer believes it. The U. S. Military Academy has cut way back on plebe hazing, for example.
The cut in residency working hours initially came about because there was clear evidence that patient care suffered.
There are rest requirements for pilots. Would you want to be on an airplane flown by a pilot who had not slept in three days? I suspect not. Lack of sleep impairs judgment and it impairs fine motor skills. I do not want a surgeon operating on me who has not slept in three days.
As far as teaching is concerned, there is a difference between demanding excellent performance and being abusive for the sake of being abusive. You will always know more and have more experience than the residents and medical students entrusted to you. Perhaps you need to sit down with one of those residents and find out why he thinks you are "mean."
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