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47 points bookofjoe | 10 comments | | HN request time: 0.001s | source | bottom
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amluto ◴[] No.42172284[source]
> Recently, her hospital’s dermatology program received more than 600 applications for four residency slots.

Perhaps if supply of dermatologists was not so strongly limited, prices and wait times would improve.

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wyldfire ◴[] No.42172320[source]
I doubt that limit is an artificial one. Hospitals don't need 600 dermatologists on staff. I think this is yet another factor of capitalism: selfish interests of individual corporations being in tension with the people's interests of having affordable healthcare. Other developed countries seem to have said "yeah, we recognize that nationalizing healthcare will result in insurance companies and hospitals making less money. But that's what has to happen for the people to be able to get the care they need."

Every time it comes up in the US, nationalized healthcare is demonized in some media. But it just feels like a facade perpetrated by the hospitals and insurance companies (and now private equity) who stand to lose the most. If it's good enough for veterans and retirees, why can't it be good enough for the rest of us? Maybe it's because when the government pays the bill, they don't just roll over and accept $EXORBITANT_FEE after $EXORBITANT_FEE - they negotiate and get some reasonable value.

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1. eppp ◴[] No.42172330[source]
They dont need 600 dermatologists on staff. They need residency slots. These people aren't asking to work for the hospital permanently, they just have to check the residency box that is artificially limited by gatekeepers.
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2. ninetyninenine ◴[] No.42172358[source]
It is a bit of a logistical issue shoving 600 dermatology interns into a hospital.

Make it a law that all doctor offices need one or two residency slots. That should alleviate the problem in time due to compounding growth.

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3. infecto ◴[] No.42172390[source]
Presumably a derm. resident is doing rounds related to dermatology. I am guessing this is similar to other specialized fields that don't have large volume in resident setting.
4. alistairSH ◴[] No.42172397[source]
Residencies are funded via Medicare. If you want more doctors, you need to convince Congress to fund those spots. Or, convince the industry to fund the slots itself, without the reliance on Uncle Sam's largess.
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5. nradov ◴[] No.42172426[source]
You've got to be kidding. There's no way that a regular doctor's office could provide adequate graduate medical education. Residents are taught in teaching hospitals.
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6. woooooo ◴[] No.42172489{3}[source]
On Medicare's time horizon, losing money funding those residencies for 10-20 years actually could be a great deal if it bends the cost curve.
7. ninetyninenine ◴[] No.42173883{3}[source]
I have no context. I’m just a layman.

Maybe force every doctor office by law to be a teaching hospital of some sort. They get paid 500K, seems to be a good form of taxation on an undeserved salary.

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8. ninetyninenine ◴[] No.42173991{4}[source]
Or maybe form a mentorship program. Every intern once they complete their training must train two other doctors to completion before they can genuinely practice. They must do this at the teaching hospital.

That hospital will then have enough support staff to maintain a large load of interns as the compounding growth continues. Of course the growth has to level off at some point. But yeah.

9. nradov ◴[] No.42174471{4}[source]
You've got to be kidding. Physician offices don't have the facilities or the breadth of practice to function effectively as teaching hospitals. Even most hospitals aren't teaching hospitals.

And as for conscripting physicians and forcing them to train residents, that's a completely bizarre and unrealistic suggestion. Forcing someone to teach and mentor who doesn't want to do it will guarantee bad results. And many practicing physicians don't live anywhere near a teaching hospital.

Who are you to decide how much salary someone deserves? I think you deserve $4 an hour. That seems fair to me. In the real world fairness to subjective. What actually matters is negotiating power. The most straightforward way to reduce physician negotiating power is for Congress to increase graduate medical education funding through Medicare. Income in the $500K range is already in the 35% tax bracket (plus any state income tax) so doctors are paying quite a bit; Congress just chooses to spend that money on other priorities.

https://savegme.org/

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10. ninetyninenine ◴[] No.42180896{5}[source]
It’s already unrealistic to get paid 500k. You want to become a doctor and earn that much? You need to actually take part of that 500k and turn your fucking office into a teaching facility.

I think it’s fucking disgusting the amount doctors get paid. It’s revolting and evil the way health is held hostage for money.

I don’t care if it’s a 35 percent tax bracket I have very little respect or appreciation for doctors who want to coast and get paid 500k while I have to pay 1000 just to get some uvb shined on my fucking skin. Like seriously some of these treatments are outta this world expensive and doctors charge an arm and leg just to have a goddamn intern shine a light on my skin.

Who am I to decide how much someone deserves? How about when all your patients are disgusted by you and your fucking money making tendencies then come talk to me about being entitled. The only reason why I’m not shining that light on myself is because the law forms a cartel and allows you to literally steal money from me. The AMA lobbies congress to limit the amount of residency spots. It’s a cartel. Don’t blame the government. Blame the business interests that limit the government.

People used to respect doctors. Now the majority of people I know fucking hate them. Your comment really pissed me off. I don’t think you’re aware at how much people in the US hate doctors. It’s like their life is in your hands so they don’t tell you first hand what they hate about you.

How about you cut your pay to 100k and increase the supply of doctors 10x so you have an easier time and can be more affective? Do you actually think what you do is so professional that only you can do it? The whole md degree is a gate keeping tool.