<p>Hi everyone! I'm new but I have extensively read the previous threads on the premed forum.
Basically, I have noticed how doctors complain (or herald) their long hours and busy schedule. If society demands so much work from a doctor, why not simply graduate more doctors from medical schools to alleviate the other doctors from their burden?
With this in mind, medical school admission should become easier, and not harder which is what statistics reflect (current trend since 2000 approximately)</p>
<p>Is there a reason for this?<br>
Also, will there be a penury of doctors, or an excess of doctors in the future (if PA, chiropractors, ... take over the lead in medecine)</p>
<p>76 million baby boomers are headed, en masse, to their 'need a lot of medical care years". 1/2 of all practicing physicians in this country are, themselves, baby boomers. huge lack of physicians coming. (data from my baby boomer physican dad).</p>
<p>I think it also has to do with where doctors choose to live. Overall overages and shortages effect ongoing demand and medical school admissions, but locally, a given doctor may have to work pretty hard to stay lucrative.</p>
<p>It's my personal theory -- and I think I could give an economically grounded argument for this -- that in fact there is an extremely severe shortage of physicians in the US right now.</p>
<p>Supply and demand for physician services is highly localized and varies by specialty. There's no shortage of private practice plastic surgeons in Hollywood, but try to find one to consult on an uninsured trauma patient in a LA hospital ER.</p>
<p>I would argue that shortages anywhere represent an overall shortage. If the overall situation is not a shortage, then a local shortage in Arizona must mean a surplus in Los Angeles. In that case, the market would not sustain that many physicians in LA.</p>
<p>What that means is that LA is at best at equilibrium, while Arizona is having a shortage.</p>
<p>As baby boomers age, a greater proportion of all patients will have Medicare as a third party payor. Medicare rates, already poor, must decline because of the "sustainable growth rate" formula which limits aggregate Medicare expenditures without regard to overall volume of heath care delivered.</p>
<p>
[quote]
Individual scenarios are generated by randomly selecting the 2006 and 2007 growth rates for both real GDP per capita and the volume and intensity of physicians services from a frequency distribution given their estimated variability. Tenthousand scenarios were generated, and a frequency distribution of the resulting update adjustments is shown in figure 1. The statutory limits of 7.0 percent and 3.0 percent were not applied for illustrative purposes. The results indicate that 95 percent of the time the 2008 update adjustment can be expected to fall between 30.0 percent and 24.5 percent. The calculated update adjustment did not exceed 7.0 percent in any of the ten-thousand scenarios generated, therefore, it is essentially certain that the update adjustment for 2008 will be 7.0 percent.
<p>I can talk about India. No shortage of doctors. Like biology? Do medicine! I vowed never to take that beaten path. It's too commonplace here. No wonder a lot of Indian doctors are shipping themselves to the US; what's there for them? Cash, name recognition, a higher standard of living. Maybe the shortage ain't too acute!</p>
<p>Application rates will have to drop a great deal before the US system slows its production of physicians. Currently half of all medical school applicants are not admitted anywhere, and half of all MCAT-takers are deterred from even applying in the first place by (at least partly) low admissions rates.</p>
<p>Of course, academic standards (GPA and MCAT score, etc.) will probably drop as the application pool thins.</p>
<p>during the mid-1970's(height of baby boomer med school applications) there were 3 applicants per med school position, it was so bad that SEN. Kennedy pushed through the 5th pathway process where american medical schools were forced to take med students that had spent their first two years in a caribbean or mexican medical school or risk losing government funding. Now it is about 2 applicants to one med school position, in the mid 1990's it was about 1.7 to 1. Always driven by demographics, not market driven.</p>
<p>If the problem is too poor an applicant to admit ratio, then:
A.) This strikes me as a trivial problem. Who cares?
B.) Adding an influx of Caribbean students would worsen the problem, not improve it, since they take spots that would otherwise be filled by American applicants.</p>
<p>They started as third year students so did not take up classroom slots and it was pushed through by Kennedy to address the perceived 'doctor shortage' at the time; the 'who cares' involved the med school students who had to share clinical rotations with foriegn educated students; it's a bit of forgotten history(but my father had bad memories of that time).</p>
<p>I believe two negative incentives that keep a lot of kids from even going for pre-med:
long years of studying
$$$$$</p>
<p>I'm pretty sure something could be easily done w/ long years.......say like cutting the undergrad by a year or two and making it intensive if required..... (I know there r new crash programs at some colleges, but it must get a national shape)</p>
<p>Sorry -- I meant that if Kennedy was just trying to be nicer to failed premeds, I can't imagine that's a worthy cause. In other words, if his SOLE concern was that too many premeds were getting rejected from medical school, I would say: "Who cares?"</p>
<p>Obviously including lots of undertrained medical students WOULD be a major problem and I would certainly care about that -- I meant that the problem this was meant to "fix" strikes me as trivial IF the problem was that premeds were getting too many rejections.</p>
<p>Of course, it seems to me that Kennedy may well have been right about the shortage, and that DOES strike me as a worthy cause provided the solution is well-designed.</p>
<hr>
<p>The problem at this point is simply that there isn't enough funding to train all the kids who want to be doctors. There's no shortage of kids who want to be doctors, so you don't need to worry about the long years of studying or the financial arrangements involved. The problem is that there's a bottleneck in the training arrangement.</p>
<p>Geez - the last profession I'd consider is the medical one. I do not want to work 18 hours at a stretch in hospitals during training. I do not want to be around people with contagious diseases, especially when I have kids. I do not want to be on-call my working life. I do not want to spend week-ends and holidays in hospitals. I do not want to have to fight insurance companies for payment. I do not want to have to deal with legal battles for malpractice claims. There are plenty of reasons why people do not want to become physicians.</p>
<p>I think nurse practitioners and physician's assistants will end up handling primary care patients with increasing frequency, and physicians will handle the specialties more and more. I would not be surprised to learn that physicians make less money 15 years from now than they do now, adjusted for inflation. I think our nation is headed towards nationalized medicine, and that will lead to lower salaries for physicians along with increased use of mid-level practitioners.</p>
<p>It's my impression that there are places with too many physicians, which encourages them to sign up with unfair managed care companies. Negotiating power and demand is further eroded by the staff model groups use of "physician extenders" (and sometimes replacements). An extreme result of Psychiatrist shortages are Psychologist's prescribing priviledge (in New Mexico?). The reverse is also true; in some areas, shortages in certain specialties allows the MD to call the shots, up to and including, a cash only practice. I think there are different spins a "the truth", and that "the truth" can change quite a bit with advances over ten years.</p>