What the U.S. actually has is a group of people intent on keeping their doctor wages high by limiting supply through regulation and bottleneck creation.
As a med school dropout (best decision of my life), were I to "go back" to early college: I would have instead pursued a BSN (which my college offered!), to set myself up into eventually becoming a nurse practitioner. That way, if I decided to not complete graduate school, I'd still have an applicable role/job within medicine. Were I to have graduated that program, I also would have been able to practice much earlier (albeit limited scope, per US State).
Instead, what does an uncredentialled Chemistry Bachelor do after dropping out of medical school? ...I became an electrician, which allowed me to help people without sacrificing my lifestyle.
If your goal also includes "make substantial sums of money," I always recommend to preMeds they consider all the different ways someone can make money helping people without having to sacrifice your entire early adulthood.
The majority of my medschool classmates refer to me as "the dumbest smart guy they know," but in confidence several have expressed jealousy at not having to work so much (for IMHO so little, as physicians). Just cogs in an overly-complex, wealth-extracting machine...
Nurse practitioners are the overused. If you are on medicaid, at least in my state, you are almost guranteed to be seen by a nurse practitioner rather than an actual pyschiatrist. Even if you aren't on medicaid, which medicaid is usually better than any other marketplace insurance for selection of providers and service, getting seen by a nurse practitioner is very common.
Additionally, while many may be knowledgable about the medications they prescribe, I have had nurse practitioners prescribe me medication they didn't even know existed, as in during my session I asked for a specific medication based on a personal recomendation from a freind in the field, they didn't know what the medication was and looked up on google and then prescribed it to me.
There are good nurse practitioners, but they simply should not be prescribing long term pyschiatric medication with the level of schooling they have.
It takes 2 years to become a nurse, and 3 years to become a nurse practitioner. Additional certification is required to prescribe certain medications, but even then the amount of training and classes a nurse practitioner will take to understamd medications is very small compared to a psychiatrist.
It's absurd. NP's have been the solution to psychiatist shortage and it seems no one cares. Most likely, because anyone who knows is zombified by SSRIs by shit NPs or is in the medical field so their vision is already clouded by bias. Nurse takeover is a joke. Anybody with 2-3 years of schooling should be relagated to changing bedpans and putting in IVs. Not functioning as psuedo doctors.
>they didn't know what the medication was and looked up on google and then prescribed it to me.
How human that this practitioner admitted to not knowing something; then took the time to look up the drug's factsheet; and then trusted you enough to take your friend's personal recommendation.
>There are good nurse practitioners
Agreed. And terrible physicians, as well as good.
>...but they simply should not be prescribing long term pyschiatric medication with the level of schooling they have.
Agreed – with the additional thought that even physicians overprescribe these mind-altering substances in far-too-abundance.
>NP's have been the solution to psychiatist shortage and it seems no one cares...Nurse takeover is a joke.
I think most people "on psych meds" really just need better friends / families / societies / healthcare . It is most unfortunate that we are our own worst enemies, sometimes; particularly in allowing US healthcare expenditures to be highest with no obvious benefit (to patients).
It all made me so sick decades ago that I quit before even starting.
You are right in the context of the power NP's have compared to regular doctors. The primary difference in an NP and a doctor practically is pay. They do so much similar stuff, even though they shouldn' be allowed to. NP's prescribing meds, like a child with bazooka shooting at mentally ill people.
Out of curiosity, why cannot hospitals fund residency slots on their own with some riders (the resident should work in the same hospital for x years)?
It seems odd that the medical profession is not willing to invest in the training of the next generation of professionals without government help.
They do sometimes. People don’t realize how much of medicine, generally, is funded through the government. Additionally, society gives medicine a lot of leeway to act selfishly because the core practice of healing is so altruistic.
Broadly, it’s the same issue that all jobs have: it’s cheaper to hire pre-trained professionals than to hire and train.
Because they need to support their executives and capital projects / debt service. That’s the discretionary budget… training doctors doesn’t improve the bottom line.
Hospitals are really quasi-government entities. Their pricing structures have price controls based on Medicare reimbursements. A third of hospital revenue is Medicare and Medicaid.
Both programs have been slowing rate growth, which in turn impacts private insurance as well. The institutions haven’t been successful in reducing cost growth. ACA built out regional cartels^H provider networks, essentially eliminating competition.
I was trying to keep my comment short. Such a regulatory regime would be expected to close such obvious loopholes.
In much the same way that a doctor in $FOREIGN_COUNTRY cannot practice telemedicine in the USA, I would expect the regulations to make a distinction between software (and services provided by software) developed by foreign and licensed programmers.
>much the same way that a doctor in $FOREIGN_COUNTRY cannot practice telemedicine in the USA...
U.S. retired doctor here. This is a fascinating possibility that never occurred to me until I read your comment. Could a foreign doctor not set up a system whereby she/he could appear to be in the U.S. while being in a country that's essentially unreachable by U.S. authorities? And take payment in cryptocurrency?
> Lobby the government to prohibit anyone from practicing programming without a license.
No way you're getting consensus on this one, but even if you could, it's too hard to stop. If you charge for compilers, and only provide them to licensed developers, hippies will make and distribute compilers for free.
Also, the vast majority of software bugs are annoying at worst, with no death potential. Powers that be would react a lot more aggressively if stack overflows routinely led to bodies on the pavement.
Considering the number of ransomware attacks and other viruses that infect hospitals, it wouldn't surprise me if stack overflows had quite a large body count.
Why not both? Even better if you have to obtain accreditation as a professional in every different market because EU software is different from US software is different from Indian software...
Let's do note that on that graph which mapped a variety of increased costs, the only thing that increased faster than college costs was the cost of medical. That's connected to the shortage of doctors. Regulatory capture isn't just an issue with higher ed.
This is really a weird requirement and most other places in the world don't have it, without suffering any setbacks when it comes to outcomes of treatments.
Imagine that every programmer would have to study, say, Latin for 4 years before being allowed to code.
Agreed. It might make some sense to require undergrad chemistry and biology for med school applicants but presumably that could be squeezed into 2 years of undergrad. Possibly a customized curriculum could teach it faster or as part of med school.
That's a pipeline problem. What the U.S. actually has is a severe bottleneck in available places at medical schools and for residency training.