re: Why do we have such shortage of doctors in the US?

quote:

---

Why can’t we admit more students to Med schools?

---

quote:

---

What do we have such shortage of doctors in the US?

---

quote:

---

Yes, We Have No Physicians
And we’re selling them to Uncle Sam.
By JODIE T. ALLEN
FEB 23, 1997

So generous are the government subsidies for resident training (as much as $100,000 a year), that hospitals have reaped nice profits by using these journeymen doctors to do things that less-skilled personnel could do as well. And since the longer a resident trains, the larger the total subsidy, the system has also encouraged doctors to extend their educations and become specialists rather than lower-paid general practitioners. Now with managed care and government regulators cracking down on in-hospital care, residents are facing a shortage of patients to practice upon.
....

Cutting back on resident subsidies seems the obvious solution. But teaching hospitals, the undisputed crown jewels of the medical system, are already under great financial strain. (And in New York, they are guarded by two senior U.S. senators and a politically potent union.) As in the case of agriculture–in which a complex edifice of subsidies has also succeeded in developing an industry whose products are unmatched in quality, quantity, and variety–reform is rarely straightforward.

So HCFA has settled on a convoluted solution: continuing the subsidies for the residents that are trained, but paying the hospitals additional amounts not to train as many. This, the agency calculates, will save it some $300 million over the six years of the “demonstration.” “Brilliant and bizarre” is how experts characterized the scheme in the New York Times.

Where will it all end? HCFA’s Vladeck has already entertained extending the program, noting that if jealous congressmen from other jurisdictions “think this is a good deal, they have the power to make it more available.” Really? How widely? Surely, most of us can take credit for not having trained a legion of doctors?

And why limit payments to the medical sector? Many will feel that the case for subsidizing the nonproduction of doctors is weak when law schools are still cranking out lawyers by the caseload. Others may feel that the money would be better spent in paying the defense industry not to produce the latest round of high-tech weaponry, thus saving us the expense of generating still more lethal weapons when the current crop inevitably falls into the hands of our enemies. Why not pay poor people not to be poor? Come to think of it, that’s what the welfare system was meant to do.

Which may bring us to the moral of our story: When you start paying for nonproduction you are almost sure to reap a bumper crop.

LINK

---

quote:

---

The Effects of the Balanced Budget Act of 1997 on Graduate Medical Education
March 2000
...
The provisions that appear to have raised the most concern are the per-hospital cap on the number of residents and the reduction in the IME adjustment factor. The cap on the number of residents discourages facilities from adding or expanding residency programs. It is an across-the-board cap that limits the total numbers of residents, but in the 3 process, can hamper expansion of primary care specialties when hospitals do not make corresponding cuts in specialists. Although beneficial from the standpoint of curbing an oversupply of residents being trained and funded by Medicare, the limitation on primary care residents may conflict with the general goals of the Council on Graduate Medical Education (COGME) to promote the education and training of a mix of physicians consistent with current and future health care needs including in rural areas. Nevertheless, if the provisions lead to a slowdown in the growth rate of the physician workforce, while maintaining or increasing the number of primary care physicians, then the legislation is in line with COGME recommendations.

LINK

---

quote:

---

in holland they have twice the mds per capita as usa.
dutch mds make half what us doctors make

---

quote:

---

the number of residents is controlled by congress

---

quote:

---

AMA suppresses the amount by limiting medical school spots. Why do you think so many ( a lot of them bright) people end up in Caribbean medical schools?

---

quote:

---

Doctors regulate how many people they take into medical school for the purpose of preventing competition

---

quote:

---

they do what ama says.

---