The article states rural areas tend to be served by a higher proportion of immigrant doctors. The densely populated coasts will probably be fine - the higher salaries will continue to attract US-born and limited immigrant doctors.
$200k urban vs $205k rural median offers to new doctors overall. But, in surgical practices, that flips well in favor of urban offers. But, that's just for new MDs. Career numbers skew even more to rural doctors
I think the issue is US _culture_, not education (although the two are intertwined). We had too many easy years where you could take a Jack Kerouac road trip for 5 years to find yourself and then settle down to the equivalent of a cushy 6 figure job just for being a man with a pulse. Now if you do that, you will come back to find all the cushy jobs filled, and you are unqualified for anything except bottom of barrel service industry jobs.
Today there is a lot more prerequisite grind to become a doctor that parents don't feel good about forcing on their kids. Five decades of movies villifying parents for pushing their kids too hard will do that.
Meanwhile, parents in/from China and India and Nigeria and many other places are more than willing to force their kids to grind to move up the economic ladder.
US health care continues to fall behind other Industrial Countries.
Can you provide evidence of this? The services are top notch, and over 90% of people have health insurance. Moreover, in other single payer systems (Canada, Poland) I keep hearing about months long wait for procedures until you go private/out-of-pocket.
The unique thing about the US healthcare system is that care is directly proportional to how much money you can spend on it. So as a top spender, yes the care is great. Though realistically we should look at the system as a whole for all people it "covers". Looking at infant mortality rate, life expectancy, etc, for the average person, the picture is bleak; the US is shockingly bad.
Sorry, but as an outsider from one of those other countries you mention, I don't get what you mean by top notch? Top notch for whom? The people who can afford to pay out of pocket? Or those willing to do into debt to just get treatment? Whenever I see news from places like PBS News Hour, it's about some low wage or senior person struggling to just care for their medical needs or prescriptions.
I don't know my guy, your system isn't exactly top notch for most people - I don't think you need to look very hard to see that if you try.
I suppose they could expand medical school admissions for Americans, why don’t they? It’s not for lack of talented people, the class size quotas are an archaic classist and partly racist way of thinking that have nothing to do with meritocracy, but instead are imposed to make sure that more undesirables don’t join the “elites” of society.
Some quick Googling surfaces the number of residency slots as being another limiting factor to medical school admissions. Apparently, federal funding caps the maximum number of residency slots which creates a bottleneck in the system.
It's most likely the case that there are multiple different bottlenecks. It's not just 1 person in a room somewhere saying "we need to make protect the elite!" - it's more likely just a lot of people continuing the status quo and few people fighting the change it.
The AMA pushed for limited residency slots ~20 years ago, as they feared too many doctors would cut their own incomes.
For some reason, residencies are paid by the federal government. Not sure of the history there - I find it hard to believe a resident doctor is a net-loss for the hospital system. Either way, I can't find any legal cap on number of residents - only a cap on funded slots (ie, a hospital could hire more residents and pay them out of pocket).
Sounds good to me. May be a bit painful in the interim (avoiding short term pain is just burdening future generations), but training and raising our own doctors is undeniably better than importing them. I don’t want a doctor who has another country they call home. I want a doctor who feels some blood and soil attachment to their patients.
That being said, Trump is not the leader to actually put Americans first so I’m sure he’ll cave when the donor class complains about their access to cheaper labor (importing trained doctors lets companies skip that training cost).
And, while it’s anecdotal, my personal experience with immigrant doctors is I’m just a line on a spreadsheet to them. I’ve had much better results taking care of my own health and avoided some even harmful advice.
We won't train any more doctors - there's a cap on the number of funded residency slots in the US (as lobbied for by the AMA back during the Clinton admin, IIRC). Hospitals have little to gain by self-funding slots (assuming that's even allowed).
> I want a doctor who feels some blood and soil attachment to their patients.
"Blood and soil (German: Blut und Boden) is a nationalist phrase and concept of a racially defined national body ("Blood") united with a settlement area ("Soil"). Originating in the German völkisch movement, it was used extensively by Nazi Germany, ...
North American white supremacists, white nationalists, Neo-Nazis and members of the alt-right have adopted the slogan. It gained widespread public prominence as a result of the August 2017 Unite the Right rally in Charlottesville, Virginia, when participants carrying torches marched on the University of Virginia campus on the night of 11 August 2017 and were recorded chanting the slogan, among others."
Great news for Canada. Thanks we'll keep our doctors.
Bad news for New York, New Jersey, California, Maryland; or more aptly labelled democrat controlled states.
Probably the only republican state impacted will be florida, but they often buck trends like this. they'll keep their immigrant doctors.
The article states rural areas tend to be served by a higher proportion of immigrant doctors. The densely populated coasts will probably be fine - the higher salaries will continue to attract US-born and limited immigrant doctors.
Doctors are paid more in rural areas than in big cities, a reverse of most other professions.
Huh, true enough. I linked one summary.
$200k urban vs $205k rural median offers to new doctors overall. But, in surgical practices, that flips well in favor of urban offers. But, that's just for new MDs. Career numbers skew even more to rural doctors
https://resources.nejmcareercenter.org/article/demystifying-...
Simple, US health care continues to fall behind other Industrial Countries.
But the big ask here is, what is wrong with the US educational System that forces people to avoid becoming medical professionals ?
Maybe when Trump is gone, this specific situation may revert back to pre-trump. But that does not mean education will be fixed.
I think the issue is US _culture_, not education (although the two are intertwined). We had too many easy years where you could take a Jack Kerouac road trip for 5 years to find yourself and then settle down to the equivalent of a cushy 6 figure job just for being a man with a pulse. Now if you do that, you will come back to find all the cushy jobs filled, and you are unqualified for anything except bottom of barrel service industry jobs.
Today there is a lot more prerequisite grind to become a doctor that parents don't feel good about forcing on their kids. Five decades of movies villifying parents for pushing their kids too hard will do that.
Meanwhile, parents in/from China and India and Nigeria and many other places are more than willing to force their kids to grind to move up the economic ladder.
US health care continues to fall behind other Industrial Countries.
Can you provide evidence of this? The services are top notch, and over 90% of people have health insurance. Moreover, in other single payer systems (Canada, Poland) I keep hearing about months long wait for procedures until you go private/out-of-pocket.
The unique thing about the US healthcare system is that care is directly proportional to how much money you can spend on it. So as a top spender, yes the care is great. Though realistically we should look at the system as a whole for all people it "covers". Looking at infant mortality rate, life expectancy, etc, for the average person, the picture is bleak; the US is shockingly bad.
Sorry, but as an outsider from one of those other countries you mention, I don't get what you mean by top notch? Top notch for whom? The people who can afford to pay out of pocket? Or those willing to do into debt to just get treatment? Whenever I see news from places like PBS News Hour, it's about some low wage or senior person struggling to just care for their medical needs or prescriptions.
I don't know my guy, your system isn't exactly top notch for most people - I don't think you need to look very hard to see that if you try.
Random examples:
- https://upload.wikimedia.org/wikipedia/commons/0/0b/OECD_hea... - https://upload.wikimedia.org/wikipedia/commons/d/d6/Life_exp...
There's something very very wrong here when your paying that much per capita and a lot of people are still struggling.
I suppose they could expand medical school admissions for Americans, why don’t they? It’s not for lack of talented people, the class size quotas are an archaic classist and partly racist way of thinking that have nothing to do with meritocracy, but instead are imposed to make sure that more undesirables don’t join the “elites” of society.
Some quick Googling surfaces the number of residency slots as being another limiting factor to medical school admissions. Apparently, federal funding caps the maximum number of residency slots which creates a bottleneck in the system.
It's most likely the case that there are multiple different bottlenecks. It's not just 1 person in a room somewhere saying "we need to make protect the elite!" - it's more likely just a lot of people continuing the status quo and few people fighting the change it.
The AMA pushed for limited residency slots ~20 years ago, as they feared too many doctors would cut their own incomes.
For some reason, residencies are paid by the federal government. Not sure of the history there - I find it hard to believe a resident doctor is a net-loss for the hospital system. Either way, I can't find any legal cap on number of residents - only a cap on funded slots (ie, a hospital could hire more residents and pay them out of pocket).
Sounds good to me. May be a bit painful in the interim (avoiding short term pain is just burdening future generations), but training and raising our own doctors is undeniably better than importing them. I don’t want a doctor who has another country they call home. I want a doctor who feels some blood and soil attachment to their patients.
That being said, Trump is not the leader to actually put Americans first so I’m sure he’ll cave when the donor class complains about their access to cheaper labor (importing trained doctors lets companies skip that training cost).
And, while it’s anecdotal, my personal experience with immigrant doctors is I’m just a line on a spreadsheet to them. I’ve had much better results taking care of my own health and avoided some even harmful advice.
We won't train any more doctors - there's a cap on the number of funded residency slots in the US (as lobbied for by the AMA back during the Clinton admin, IIRC). Hospitals have little to gain by self-funding slots (assuming that's even allowed).
> I don’t want a doctor who has another country they call home. I want a doctor who feels some blood and soil attachment to their patients.
But like... why? Why does that matter at all?
The same reason a parent cares for their child more than a random strangers? Cultures and people matter.
Nope, sorry, still not seeing it. You'll have to spell it out for me.
Because jingoism.
> I want a doctor who feels some blood and soil attachment to their patients.
"Blood and soil (German: Blut und Boden) is a nationalist phrase and concept of a racially defined national body ("Blood") united with a settlement area ("Soil"). Originating in the German völkisch movement, it was used extensively by Nazi Germany, ...
North American white supremacists, white nationalists, Neo-Nazis and members of the alt-right have adopted the slogan. It gained widespread public prominence as a result of the August 2017 Unite the Right rally in Charlottesville, Virginia, when participants carrying torches marched on the University of Virginia campus on the night of 11 August 2017 and were recorded chanting the slogan, among others."
https://en.wikipedia.org/wiki/Blood_and_soil
I’m not a nazi. There is nothing wrong with wanting to live and work with people of your culture.