UPDATE: A new analysis of Obamacare’s role in the conversion of American Medicine to an industry with corporate ethics.
The health system is now like a cocaine junkie hooked on federal payments.
This addiction explains why the insurance companies are lobbying furiously for these funds alongside their new found friends at left-wing interest groups like Center for American Progress. The irony of this alliance is that the left-wing allies the insurers have united with hate insurance companies and want to abolish them. The insurance lobby is selling rope to their hangman.
Hospital groups, the American Medical Association, the AARP and groups like them are on board too. They are joined by the Catholic Bishops and groups like the American Heart Association and the American Lung Association. (If you are donating money to any of these groups you might want to think again.) This multi-billion dollar health industrial complex has only one solution to every Obamacare crack-up: more regulation and more tax dollars.I practiced during what is more and more seen as a golden age of medical care. Certainly the poor had problems with access. Still, most got adequate care, either through Medicaid after 1965, or from public hospitals, many of which were wrecked by Medicaid rules and by the flood of illegal aliens the past 40 years.
Obamacare destroyed, probably on purpose, the healthcare system we had. It had been referred to by Teddy Kennedy, the saint of the Democrats Party as “a cottage industry.” As far as primary care was concerned, he was correct. What we have now is industrial type medicine for primary care and many primary care doctors are quitting.
So why is there waning interest in being a physician? A recent report from the Association of American Medical Colleges projected a shortage of 42,600 to 121,300 physicians by 2030, up from its 2017 projected shortage of 40,800 to 104,900 doctors.
There appear to be two main factors driving this anticipated doctor drought: First, young people are becoming less interested in pursuing medical careers with the rise of STEM jobs, a shift that Craig Fowler, regional VP of The Medicus Firm, a national physician search and consulting agency based in Dallas, has noticed.
“There are definitely fewer people going to [med school] and more going into careers like engineering,” Fowler told NBC News.
There are several reasons, I think. I have talked to younger physicians and have yet to find one that enjoys his or her practice if they are in primary care. That applies to both men and women. Women are now 60% of medical students. This has contributed to the doctor shortage as they tend to work fewer hours than male physicians.
Physicians are the most highly regulated profession on earth. The Electronic Health Record has been made mandatory for those treating Medicare patients and it has contributed a lot to the dissatisfaction of physicians.
THE MOUNTING BUREAUCRACY
This “bottleneck effect” doesn’t usually sour grads on staying the course, Fowler finds, but he does see plenty of doctors in the later stages of their careers hang up their stethoscopes earlier than expected. Some cite electronic health records (EHRs) as part of the reason — especially old school doctors who don’t pride themselves on their computer skills. New research by Stanford Medicine, conducted by The Harris Poll, found that 59 percent think EHRs “need a complete overhaul;” while 40 percent see “more challenges with EHRs than benefits.”
If I remember my arithmetic, that adds up to 99% unhappy with the EHR.
Most primary care physicians I know are on salary, employed by a hospital or a corporate firm. They are require to crank out the office visits and are held to a tight schedule that does not allow much personal relationships with patients. The job satisfaction that was once a big part of a medical career is gone.
Tags: health care
My original question was whether US med school seats were going empty, as they have been recently with law school seats. The big difference is that law schools are cash cows, and med schools the opposite. Also, decades ago, the ABA ran afoul of the antitrust laws for controlling law school class sizes (antitrust is something taught there), as was also being done with med schools. I remember one doctor friend of mine maybe 20 years ago bemoaning that they had blown their predictions of need badly, and the result was that they weren’t graduating enough doctors, and it would take at least a decade to catch up. But then I remembered that we do import both doctors and nurses, and wondered how that fit in to your analysis.
My guess is that Obamacare sped up retirements, more than cut med school admits. And with the corporatism that you point out, Millenuals seem to be mostly opting out of working more than 40 hours a week (and often less for mothers). The added paperwork burden, of course, just made it worse.
Admissions went way up after I graduated but are now declining as I read about it. I quit teaching three years ago, partly because of the EHR, and have not been around the school since moving to Arizona.