←back to thread

How dermatology became the 'it' job in medicine

(www.wsj.com)
47 points bookofjoe | 1 comments | 18 Nov 24 12:56 UTC | HN request time: 0.001s | source
Show context
NameError ◴[18 Nov 24 14:40 UTC] No.42172647[source]▶
When my primary care doc referred me to a dermatologist for a suspicious mole, I could not find an actual dermatologist who would see me in less than ~8 months. I ended up seeing a physician's assistant, which I'm still uneasy about since there's been a study that shows that PA's seem to have a lower success rate vs. doctors [1], and the educational requirements are very different for PAs.

As a layperson, it seems like we (patients / society) would benefit from having more doctors, i.e. opening up more residency slots and admitting more people to med school, but there's probably a lot I don't understand about the issue. Not sure if it's a lack of political willpower to do this, or if there are other reasons why the number of doctors we train is so restricted.

[1] https://pubmed.ncbi.nlm.nih.gov/29710082/ ("PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists")

replies(6): >>42176229 #>>42176916 #>>42180277 #>>42180641 #>>42181426 #>>42181633 #
marxisttemp ◴[18 Nov 24 19:54 UTC] No.42176229[source]▶
> As a layperson, it seems like we (patients / society) would benefit from having more doctors, i.e. opening up more residency slots and admitting more people to med school, but there's probably a lot I don't understand about the issue. Not sure if it's a lack of political willpower to do this, or if there are other reasons why the number of doctors we train is so restricted.

Like so many of America’s issues, it’s due to lobbying based on entrenched greed.

> In 1997, the AMA lobbied Congress to restrict the number of doctors that could be trained in the United States, claiming that, "The United States is on the verge of a serious oversupply of physicians."

replies(1): >>42177316 #
1. freedomben ◴[18 Nov 24 21:33 UTC] No.42177316[source]▶
Yep. The requirements (and cost!) to become a physician are absolutely insane, and it's entirely intentional. As a society we seem to assume that people in certain trades are altruistic and moral, simply because of their job. For some reason, everyone assumes doctors wouldn't act self-interested. Teachers are often thought of the same way. I don't want to swing the pendulum to the other side and start thinking of them as selfish (though certainly some individuals are), but I do wish as a society we would remember that people are still people. Our systems need to be structured to overcome the natural and innate tendency of people to optimize for themselves or their groups. We don't let the cigarette companies do all the science and make all the laws/rules around tobacco sales, we probably shouldn't do that with medical stuff either. We don't need antagonistic people in charge, but they should be independent.