Med school designs to qualify fewer doctors

[Luddly Neddite]

Physician shortage: Should we shorten medical education?

We need more doctors. On a global scale, the shortage is staggering: The World Health Organization says we need 15 percent more doctors. In the United States, the American Association of Medical Colleges estimates the current deficit at almost 60,000 and forecasts a worrisome 130,600-doctor shortfall by 2025. There’s one simple solution: We have to consider ways to manufacture doctors faster and cheaper.

An American physician spends an average of 14 years training for the job: four years of college, four years of medical school, and residencies and fellowships that last between three and eight years. This medical education system wasn’t handed down to us by God or Galen—it was the result of a reform movement that began in the late 19th century and was largely finished more than 100 years ago. That was the last time we seriously considered the structure of medical education in the United States.

The circumstances were vastly different at that time. Until the Civil War, private, for-profit medical schools with virtually no admissions requirements subjected farm boys to two four-month sessions of lectures and sent them off to treat the sick. (The second session was an exact duplicate of the first.) The system produced too many doctors with not enough training. Abraham Flexner, the education reformer who wrote an influential report on medical education in 1910, put a fine point on the problem: “There has been an enormous over-production of uneducated and ill trained medical practitioners,” he wrote. (Emphasis added.) “Taking the United States as a whole, physicians are four or five times as numerous in proportion to population as in older countries like Germany.”

In other words, our current medical education system was originally designed to reduce the total number of people entering the profession. The academic medical schools that sprang up around the country—such as the Johns Hopkins Hospital in 1889—made college education a prerequisite. Medical school expanded from eight months to three years and solidified at four years in the 1890s. Postgraduate training programs were implemented, beginning with a one-year internship. These were brilliant reforms at the time.

We crank out lawyers but our training our medical doctors is a huge mess.

 

[dblack]

This has been the goal of state medical regulation since the very beginning of the AMA. I guess some of us are 'shocked and dismayed' by this stunning revelation.

 

[Katzndogz]

We don't need to shorten the very education that turns out quality doctors. obama capped residencies ar 15 ,000 a year meaning that fewer doctors can complete residency requirements. Remove the cap.

 

[auditor0007]

Physician shortage: Should we shorten medical education?

We need more doctors. On a global scale, the shortage is staggering: The World Health Organization says we need 15 percent more doctors. In the United States, the American Association of Medical Colleges estimates the current deficit at almost 60,000 and forecasts a worrisome 130,600-doctor shortfall by 2025. There’s one simple solution: We have to consider ways to manufacture doctors faster and cheaper.

An American physician spends an average of 14 years training for the job: four years of college, four years of medical school, and residencies and fellowships that last between three and eight years. This medical education system wasn’t handed down to us by God or Galen—it was the result of a reform movement that began in the late 19th century and was largely finished more than 100 years ago. That was the last time we seriously considered the structure of medical education in the United States.

The circumstances were vastly different at that time. Until the Civil War, private, for-profit medical schools with virtually no admissions requirements subjected farm boys to two four-month sessions of lectures and sent them off to treat the sick. (The second session was an exact duplicate of the first.) The system produced too many doctors with not enough training. Abraham Flexner, the education reformer who wrote an influential report on medical education in 1910, put a fine point on the problem: “There has been an enormous over-production of uneducated and ill trained medical practitioners,” he wrote. (Emphasis added.) “Taking the United States as a whole, physicians are four or five times as numerous in proportion to population as in older countries like Germany.”

In other words, our current medical education system was originally designed to reduce the total number of people entering the profession. The academic medical schools that sprang up around the country—such as the Johns Hopkins Hospital in 1889—made college education a prerequisite. Medical school expanded from eight months to three years and solidified at four years in the 1890s. Postgraduate training programs were implemented, beginning with a one-year internship. These were brilliant reforms at the time.

We crank out lawyers but our training our medical doctors is a huge mess.

We need less doctors. Healthcare is changing. While we could reduce educational requirements slightly for some doctors, the answer is not more doctors. The answer is more nurse practitioners. They require much less education but the can do pretty much everything a doctor does. The difference is that they must work under a doctor and receive doctor guidance and oversight.

I have cirrhosis of the liver due to hemochromatosis. I go to the doctor every three months so they can run a few blood tests and then I go to the infusion center for a quick phlebotomy. This is my hematologist that I go to and is separate of my family doctor whom I see once a year for a physical or if I get sick. I also have a gastroenterologist who monitors my liver and handles my colonoscopies and upper endoscopies. Anyway, my point is that when I go to see my hematologist, I see a nurse practitioner three times per year and only see my doctor once. He is responsible for checking over my liver ultrasound and just reviewing everything the nurse practitioner had covered during my previous three visits. It works great for me and for them.

This is where I see our system moving and very quickly. Private practices are being gobbled up by much larger practices that have direct affiliations with hospitals. This is how they can reduce costs and keep doctor's earnings high without compromising quality care.

 

[CaféAuLait]

Physician shortage: Should we shorten medical education?

We need more doctors. On a global scale, the shortage is staggering: The World Health Organization says we need 15 percent more doctors. In the United States, the American Association of Medical Colleges estimates the current deficit at almost 60,000 and forecasts a worrisome 130,600-doctor shortfall by 2025. There’s one simple solution: We have to consider ways to manufacture doctors faster and cheaper.

An American physician spends an average of 14 years training for the job: four years of college, four years of medical school, and residencies and fellowships that last between three and eight years. This medical education system wasn’t handed down to us by God or Galen—it was the result of a reform movement that began in the late 19th century and was largely finished more than 100 years ago. That was the last time we seriously considered the structure of medical education in the United States.

The circumstances were vastly different at that time. Until the Civil War, private, for-profit medical schools with virtually no admissions requirements subjected farm boys to two four-month sessions of lectures and sent them off to treat the sick. (The second session was an exact duplicate of the first.) The system produced too many doctors with not enough training. Abraham Flexner, the education reformer who wrote an influential report on medical education in 1910, put a fine point on the problem: “There has been an enormous over-production of uneducated and ill trained medical practitioners,” he wrote. (Emphasis added.) “Taking the United States as a whole, physicians are four or five times as numerous in proportion to population as in older countries like Germany.”

In other words, our current medical education system was originally designed to reduce the total number of people entering the profession. The academic medical schools that sprang up around the country—such as the Johns Hopkins Hospital in 1889—made college education a prerequisite. Medical school expanded from eight months to three years and solidified at four years in the 1890s. Postgraduate training programs were implemented, beginning with a one-year internship. These were brilliant reforms at the time.

We crank out lawyers but our training our medical doctors is a huge mess.

Irony, many of those lawyers have made it so many doctors do not want to practice or can't afford to practice due to the price of malpractice insurance. I'm not talking warrented claims, but those that take a minor complaint and turn it into a multi-million dollar settlement.

 

[jasonnfree]

Physician shortage: Should we shorten medical education?

We need more doctors. On a global scale, the shortage is staggering: The World Health Organization says we need 15 percent more doctors. In the United States, the American Association of Medical Colleges estimates the current deficit at almost 60,000 and forecasts a worrisome 130,600-doctor shortfall by 2025. There’s one simple solution: We have to consider ways to manufacture doctors faster and cheaper.

An American physician spends an average of 14 years training for the job: four years of college, four years of medical school, and residencies and fellowships that last between three and eight years. This medical education system wasn’t handed down to us by God or Galen—it was the result of a reform movement that began in the late 19th century and was largely finished more than 100 years ago. That was the last time we seriously considered the structure of medical education in the United States.

The circumstances were vastly different at that time. Until the Civil War, private, for-profit medical schools with virtually no admissions requirements subjected farm boys to two four-month sessions of lectures and sent them off to treat the sick. (The second session was an exact duplicate of the first.) The system produced too many doctors with not enough training. Abraham Flexner, the education reformer who wrote an influential report on medical education in 1910, put a fine point on the problem: “There has been an enormous over-production of uneducated and ill trained medical practitioners,” he wrote. (Emphasis added.) “Taking the United States as a whole, physicians are four or five times as numerous in proportion to population as in older countries like Germany.”

In other words, our current medical education system was originally designed to reduce the total number of people entering the profession. The academic medical schools that sprang up around the country—such as the Johns Hopkins Hospital in 1889—made college education a prerequisite. Medical school expanded from eight months to three years and solidified at four years in the 1890s. Postgraduate training programs were implemented, beginning with a one-year internship. These were brilliant reforms at the time.

We crank out lawyers but our training our medical doctors is a huge mess.

Irony, many of those lawyers have made it so many doctors do not want to practice or can't afford to practice due to the price of malpractice insurance. I'm not talking warrented claims, but those that take a minor complaint and turn it into a multi-million dollar settlement.

Any proof of what you say? It sounds a little unbelievable that judges would allow this practice, not saying you're wrong.

 

[CrusaderFrank]

We need another 2,700 page law covering the health care system

That'll fix it!

 

[CrusaderFrank]

Physician shortage: Should we shorten medical education?

We need more doctors. On a global scale, the shortage is staggering: The World Health Organization says we need 15 percent more doctors. In the United States, the American Association of Medical Colleges estimates the current deficit at almost 60,000 and forecasts a worrisome 130,600-doctor shortfall by 2025. There’s one simple solution: We have to consider ways to manufacture doctors faster and cheaper.

An American physician spends an average of 14 years training for the job: four years of college, four years of medical school, and residencies and fellowships that last between three and eight years. This medical education system wasn’t handed down to us by God or Galen—it was the result of a reform movement that began in the late 19th century and was largely finished more than 100 years ago. That was the last time we seriously considered the structure of medical education in the United States.

The circumstances were vastly different at that time. Until the Civil War, private, for-profit medical schools with virtually no admissions requirements subjected farm boys to two four-month sessions of lectures and sent them off to treat the sick. (The second session was an exact duplicate of the first.) The system produced too many doctors with not enough training. Abraham Flexner, the education reformer who wrote an influential report on medical education in 1910, put a fine point on the problem: “There has been an enormous over-production of uneducated and ill trained medical practitioners,” he wrote. (Emphasis added.) “Taking the United States as a whole, physicians are four or five times as numerous in proportion to population as in older countries like Germany.”

In other words, our current medical education system was originally designed to reduce the total number of people entering the profession. The academic medical schools that sprang up around the country—such as the Johns Hopkins Hospital in 1889—made college education a prerequisite. Medical school expanded from eight months to three years and solidified at four years in the 1890s. Postgraduate training programs were implemented, beginning with a one-year internship. These were brilliant reforms at the time.

We crank out lawyers but our training our medical doctors is a huge mess.

If only Democrats would pass a law making it all OK

 

[Boatswain2PA]

We crank out lawyers but our training our medical doctors is a huge mess.

Irony, many of those lawyers have made it so many doctors do not want to practice or can't afford to practice due to the price of malpractice insurance. I'm not talking warrented claims, but those that take a minor complaint and turn it into a multi-million dollar settlement.

Any proof of what you say? It sounds a little unbelievable that judges would allow this practice, not saying you're wrong.[/QUOTE]

Jury awards $4.8 million in death of 23-year-old man whose heart ailment was misdiagnosed - Metro - The Boston Globe

Not only do judge's allow it, but jury's often fall for it because they see a grieving family, and feel that they "DESERVE" to be recompensated for a bad outcome, even if the provider gave excellent care.

In the ED and urgent care setting we see dozens of people every day during the winter months who have viral bronchitis. The pipes (bronchi) that go to your lungs are attacked by a virus (many different types of viruses), which causes inflammation, coughing, and increased green/yellow mucous production. The afflicted patient also often goes through a period where their chest HURTS from all of the coughing (the bronchi has a large number of pain receptors to help prevent you from choking to death). The patient also often has a low grade fever. This is easily diagnosed by a clinical exam, although many providers get a chest x-ray on the elderly or smokers to rule out pneumonia, etc. Unless we suspect a cardiac cause of the chest pain we won't get an EKG or cardiac enzymes.

Every shift, every ED, we see dozens of people with bronchitis. I don't have the numbers, but there has to be millions of ED visits per year in America for viral bronchitis. This is almost always a self-limiting disease, which means the patient will get better on their own!

But once in a kabillion times a usually benign virus can get to the heart muscle and cause viral myocarditis. Again I don't have the numbers for this, but it is EXCEEDINGLY rare. Typical presentations of this is a very sick looking patient and a strange sound that goes along with the heart beat.

Because of our legal lottery system that we currently have in the US, I risk losing everything I have, and most of my future earnings, if I miss that one-in-a-kabillion viral myocarditis.

So now, becasue of this one lawsuit, I get a lot more chest x-rays, cardiac enzymes, and EKGs on these dozen cases of bronchitis I see every shift. This comes with an enormous public cost (probably adds a 500-$1000 to every ER bill) simply to catch that one-in-a-kabillion viral myocarditis....and protect my assets.

 

[mamooth]

obama capped residencies ar 15,000 a year meaning that fewer doctors can complete residency requirements.

You mean Obama now personally controls the numbers of residencies?

And here I thought that it was Congress which set the medicare funding for residencies.