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Interesting how California wants to cap the number of nursing students that private universities can enroll and make a nursing shortage much worse and then they want to add penalties to hospitals who don't meet nurse to patient staffing ratio's.
They won't admit to this but this has everything to do with the nursing unions who want a massive shortage of nurses to cause wages to increase by artificially causing supply to plummet in the midst of rising demand.
Just as the AMA successfully lobbied congress to limit the amount of doctors through the regulating of medical residencies and limiting medical schools. Get rid of all govt licensure.
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Originally Posted by Frank DeForrest
Just as the AMA successfully lobbied congress to limit the amount of doctors through the regulating of medical residencies and limiting medical schools. Get rid of all govt licensure.
Could it be they limit residencies to prevent overcrowding and ensure the quality? What reference are you using?
I think licensure should be mandatory, have every doctor belong to the AMA and they should be the clearing house for all reports, incidents, documentation on a doctor similar to the American Bar Assy. If the AMA had all this data when a physician moves to a state and applies for licensure this agency would be the go to for all the past information on how a doctor performed elsewhere. How often do we hear about a doctor who lost his license in one state going to another and they have no knowledge of what happened.
Probably only 50-75% of students that enroll will end up being licensed due to drop outs or failures. Medical school at any level is hard.
There is clinical time where students have to spend a certain number of hours in various clinical settings from hospitals to dialysis clinics, mental health, OB and so on. All this has to be coordinated. There can be several educational institutes in a given geographic region with only 2 or 3 hospitals. Now you potentially have hundreds of students vying for clinical time slots in a limited number of settings. You can generally only have a small group of less than 10 students at each setting or it creates too much confusion.
Nursing to patient ratios are a real problem and California is one only a very few places where hard caps are put on those ratios. So many nurses are seriously over worked which can lead to all kinds of errors in care. Most times, facilities just add more checks to the care process, put the responsibility for the checks falls onto the nurses which only increases their work load.
Overall its a very complex process and trying to achieve some kind of balance in order to achieve the quality in patient care needed is not easy.
I am not so sure about trying to blame the state for measures that maintain quality education and patient safety.
Could it be they limit residencies to prevent overcrowding and ensure the quality? What reference are you using?
I think licensure should be mandatory, have every doctor belong to the AMA and they should be the clearing house for all reports, incidents, documentation on a doctor similar to the American Bar Assy. If the AMA had all this data when a physician moves to a state and applies for licensure this agency would be the go to for all the past information on how a doctor performed elsewhere. How often do we hear about a doctor who lost his license in one state going to another and they have no knowledge of what happened.
1. We already have a national source to identify physician misconduct. It is called the National Practitioner Data Bank. Every time a physician gets a license or applies for priveledges, the data bank is accessed. One can look up anyone anytime there.
2. The AMA is a left wing political organization populated by primary care docs in the northeast US. The AMA does not represent the interests of most physicians. Our independent boards (which actually do our certification for each specialty through the American Board of Medical Examiners) have lobby groups, but also provide education and board certification. I'm not an AMA member- never want to be a member.
3. All state medical boards are "linked" now, such that disciplinary action can be found at the board level, as well as the data bank. If one does not check these sources, one is simply being lazy.
4. New medical schools are being built as we speak.
5. There are currently more medical students graduating from MD and DO schools than there are US residency slots, leaving some students without a residency. Without a residency, it is very, very difficult to practice anywhere.
6. Congress limits the number of residency slots. Every training program wants more residents, as it makes the life of the staff easier. However, without funding, they cannot increase residency positions. The AMA has nothing to do with residency slots at all- it is a political organization (like AARP is for seniors) that has nothing to do with training or certification.
Only 20% of physicians in the U.S belong to the AMA. As Hawkeye has stated, they have an agenda that does not represent the views of most physicians. Most docs belong to, and are active in, the board organizations that better represent their specialty specific needs and views.
The NPDB is the central clearinghouse for data and information about physicians, and states routinely share information. The process to obtain licensure and privileges often takes months and requires copious amounts of information being regurgitated over and over. The stories of doctor's losing their licensure in one state are few and far between, and almost always involve information being withheld or fraudulently reported by the physician.
Do we need to train more physicians? Yes, but it's not as simple as Congress just decided to fund more slots. Speciality specific Residency Review Committees (RRC's) have to carefully assess each new (and existing) residency program to ensure that residents will have the necessary didactic and clinical training to be completely independent and competent physicians the day they complete their training. This requires enough faculty to train them, adequate patient volume, all the facilities they need etc. As VA Yankee points out above, a lot of it has to do with quality.
Just as the AMA successfully lobbied congress to limit the amount of doctors through the regulating of medical residencies and limiting medical schools. Get rid of all govt licensure.
As far as economics is concerned, that would be the smartest thing to do. Licensing is ALWAYS a means of limiting competition. Milton Friedman spoke of this very issue, and I believe he did it to members of the Mayo Clinic.
Just as the AMA successfully lobbied congress to limit the amount of doctors through the regulating of medical residencies and limiting medical schools. Get rid of all govt licensure.
????????????
Are you kidding? Licensure and board certification is at minimum, some inkling that the physician you are seeing has been trained and been through all the certification processes. It is not a guarantee of quality, but is the best step toward that goal.
Are you really serious? Have you every operated on anyone? Medicine may seem quite easy to all of you, but believe it or not, there are actually highly technical skills that one must master and that can only be accomplished through years of training.
Medicine and surgery is not something for amateurs. Have you not read about "fake" surgeons and physicians maiming patients? Would you want someone working on you who had no training?
The situation which you pine for existed prior to 1906, at which time the Flexner report was made about the quality (and lack of) in many medical schools and training programs across the country. This was the first step in reducing quackery and saving the public from gross acts of incompetence by individuals with poor training.
Having physicians without licenses would be like having non-engineers build a space shuttle. The results would be disasterous anarchy and the public would suffer terribly.
Are you kidding? Licensure and board certification is at minimum, some inkling that the physician you are seeing has been trained and been through all the certification processes. It is not a guarantee of quality, but is the best step toward that goal.
Are you really serious? Have you every operated on anyone? Medicine may seem quite easy to all of you, but believe it or not, there are actually highly technical skills that one must master and that can only be accomplished through years of training.
Medicine and surgery is not something for amateurs. Have you not read about "fake" surgeons and physicians maiming patients? Would you want someone working on you who had no training?
The situation which you pine for existed prior to 1906, at which time the Flexner report was made about the quality (and lack of) in many medical schools and training programs across the country. This was the first step in reducing quackery and saving the public from gross acts of incompetence by individuals with poor training.
Having physicians without licenses would be like having non-engineers build a space shuttle. The results would be disasterous anarchy and the public would suffer terribly.
Except I'm not advocating for no licensure, no training, no competency so ?????????????? right back at ya.
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