In my opinion, we need to increase the number of admitted MDs and the number of residency spots. But more importantly, we need to also stop thinking of MDs as being necessary for a procedure or set of procedures, and focus instead on actual skill and experience for the procedure or service, and how one might get there.
I guess what I'm suggesting is that the solution is not "increasing the number of doctors" but rather "increasing the number and types of providers". Some of those could be more MDs, but some of them could be other types of providers. We need to create alternate paths to MDs, and also increase the number of degree endpoints that result in similar kinds of independent practice authority within a given medical field. Let other types of providers provide a wider range of services — maybe with increased scrutiny over training pre and post degree, like MDs have.
To prove your point, I believe the last time I went to an ENT to get my nose cauterized for bloody noses cost my insurance around $500 or so. That's for a 5 minute "procedure" I could easily do at home with the right equipment.
Yeah one of the benefits of the NHS, even with its problems, is that you can just roll up to a doctor/dentist whatever and if its something simple that requires slight medical intervention, or a cheap prescription for instance, there's no drama around insurance billing or bureaucracy. Now, on the other hand, you need to go to the ER, you need actual surgery?
A good analogy might be dentists - are there other spices of the medical profession that could be turned into more focused specialties with less total schooling?
I'm most familiar with pharmacy and psychology as examples, although I think there are probably many other fields as well, maybe diagnostic radiology for example. I'm also aware of research on surgical specialists in areas of the world where physicians are scarce, focused on relatively minor surgeries, showing that these procedures can be done with the same outcomes if the providers have the right training.
My guess is there is probably a way to encourage fields to come up with ideas that any given person out there outside the field wouldn't think of.
Ophthalmology? Maybe dermatology. Or at least you could lose part of the training for them. Probably need still a few specialized people with full schooling. But could lot be done there with less?
I guess what I'm suggesting is that the solution is not "increasing the number of doctors" but rather "increasing the number and types of providers". Some of those could be more MDs, but some of them could be other types of providers. We need to create alternate paths to MDs, and also increase the number of degree endpoints that result in similar kinds of independent practice authority within a given medical field. Let other types of providers provide a wider range of services — maybe with increased scrutiny over training pre and post degree, like MDs have.