• But no one will want to be a doctor!

    Did you hear how all doctors hate Obamacare and how they are all going to quit and that no one will want to be a doctor anymore cause it’s gonna suck and they won’t make any money and that even though being a physician is the most common profession in the top 1% of earners in America that we’re gonna see the supply dry up and the competition won’t be as fierce and no one who is smart will want to be a doctor and it’s all gonna suck?!?!?!?!

    A record number of students applied to and enrolled in the nation’s medical schools in 2013, according to data released today by the AAMC (Association of American Medical Colleges).

    The total number of applicants to medical school grew by 6.1 percent to 48,014, surpassing the previous record set in 1996 by 1,049 students. First-time applicants, another important indicator of interest in medicine, increased by 5.8 percent to 35,727. The number of students enrolled in their first year of medical school exceeded 20,000 for the first time (20,055), a 2.8 percent increase over 2012.

    “At a time when the nation faces a shortage of more than 90,000 doctors by the end of the decade and millions are gaining access to health insurance, we are very glad that more students than ever want to become physicians. However, unless Congress lifts the 16-year-old cap on federal support for residency training, we will still face a shortfall of physicians across dozens of specialties,” said AAMC President and CEO Darrell G. Kirch, M.D. “Students are doing their part by applying to medical school in record numbers. Medical schools are doing their part by expanding enrollment. Now Congress needs to do its part and act without delay to expand residency training to ensure that everyone who needs a doctor has access to one.”

    Oh, and by the way, three quarters of applicants had research experience. They had an average GPA of 3.54 and a median MCAT score of 29. Since lots of these applicants won’t get in, the stats for those accepted will almost certainly be better.

    @aaronecarroll

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    • The number of potential applicants to medical school increases in times of economic difficulty such as difficult employment opportunities and wartime. It is not surprising that more people are applying today.

      The question of quality remains despite the 3.54 GPA. One has to question the comparative quality of the schools where that 3.54 average was attained in and the types of courses taken. For example one school I happen to know years ago required a minimum of a 3.5 average to remain in the pre med program and premed students could not compete with non majors in the major sciences. Thus they had to compete with chemistry majors in their chemistry courses, physics majors in the physics courses, etc. They had little choice in the courses they took so they were always competing with the best. Today many are competing for slots after completing liberal arts programs and taking easier science courses.

      MCAT’s are a difficult comparison and I wouldn’t want to draw any conclusions based upon MCAT scores which over time will reflect the population being tested instead of a year to year comparison.

      Having said all that I don’t know that it is bad for the nation to reduce the quality standards of future doctors entering medical school. The very high standards of at least the past might be overkill and means that many that could provide benefit in fields of science will be lost treating patients despite the fact that treating patients is a noble endeavor.

      • You have literally no evidence whatsoever for the things you’re stating. You’re just assuming that somehow things have changed and gotten less competitive.

        For the record, I went to a liberal arts college.

        • Lord Jeffery Amherst was a soldier of the king

        • My first paragraph was the only one where I stated what I believe to be known true facts. Example: The Vietnam War led to a surge of applications to medical schools. The grade point average for acceptance to medical school increased.

          There is no proof that one can compare quality over a long period of time based upon MCAT scores.

          The rest of what I said did not draw any conclusions, but it asks questions that have been asked for decades. People are smart in different ways. The practice of medicine exacts certain demands that might be better fulfilled when students are able to deal with more intense scientific training. Logic and scientific ability are two such things. Liberal Arts might offer other benefits. As I inferred we do not necessarily require overkill in the sciences. We do not need the potential best rocket scientist to practice clinical medicine.

        • If Mitch McConnell told her, wouldn’t that be incontrovertible proof?

          • “If Mitch McConnell told her, wouldn’t that be incontrovertible proof?”

            After a snarky comment of that nature a question rightfully asked is not posted. I wonder why?

            The question was: “A bit of ideological temper?”

      • “For example one school I happen to know…”

        Which school?

    • I for one never bought the “Doctors hat Obamacare” rants…

      Doctors, Insurance companies, Drug companies, Med Equipment companies all LOVE the ACA…

      It guarantees the transfer to them of the 20% of GDP or so they are already getting – and should actually increase that percentage over time…

      Of course their riches and rewards – Mercedes and BMWs, Ski trips to Vail all come at our expense.

      Fix the cost side
      Fix the supply side
      THEN reform the insurance side..

      Otherwise it is a true train wreck.

      • And all the uninsured people who die in the wait for the fixes in the cost side and supply side?

      • “It guarantees the transfer to them [doctors et al] of the 20% of GDP or so they are already getting – and should actually increase that percentage over time…”

        You mean just like in Canada?

    • Anecdotally, all the doctors I know are worried about Obamacare. While many of them supported it because they think it is best for the country they are very concerned about what it will do to their individual incomes and to their ability to practice independently. They are also concerned about the ramifications of a lot of new patients that have been historically under-insured. They are worried these patients will be less familiar with health insurance and will cause time consuming costumer service issues since they are unlikely to have experience with co-pays, co-insurance, and deductibles. An extension of this is that they are concerned these patients will be more non-compliant than existing patients potentially leading to more frivolous medical lawsuits and other problems.

      A last concern for younger doctors is that reform will eventually lead to lower pay as well as reform of to medical school costs. Right now many of them justify the high income they receive by the medical school debt they incur. If costs are brought down, both at the aggregate medical spending level and then the medical school costs, they are worried about being the last group saddled with high medical debt and that reform will leave them unable to recoup these high costs due to lower reimbursements.

      I don’t believe that all of these concerns are that well grounded but I’ve had a few heated discussions with doctors I know on all of these subjects. To get back on topic, the point I’m trying to make is that doctors, even supporters of reform, are very worried about the ACA. I’m not that surprised that this doesn’t translate into low medical school applications, however. Even in a worst case scenario being a doctor is still a great deal. But if you have an established interest in medicine you’re likely to fall victim to the sunk cost fallacy and have an emotional feeling that you’re being cheated if reform makes your investment pay off less; even if the investment would still have been the most rational one to make given your individual preferences and aptitudes. Students, not having made these investments yet, are less likely to have the emotional investments to feel the same degree of concern that practicing doctors do.

      • I think many of the alleged concerns of listed above occurred in Canada at the introduction of the single payer system.

        Fifty years on doctors are now amongst the most vociferous supporters of the system.

        (Yes, I know that some who comment here will cherry pick a doctor or three who don’t like the system or who want changes and then claim that’s proof that doctors in Canada hate the system.)

      • Anecdata. The doctors that I know — and being a doctor, I know a lot of them — aren’t worried about Obamacare unless Republicanism is their pre-existing condition (possibly treatable with anti-psychotics).

    • Simple solutions to medical cost and quality problems are:

      1. Force physicians and healthcare facilities to publish prices for procedures as a percentage (like 150%) of Medicare allowances for that same procedure or facility.

      2. Allow Medicare, Medicaid and insurance dollars to be spent overseas and drugs to be purchased overseas.

      3. Imprison physicians for failure to wash their hands.

      4. Require nurses and physicians to take real science and math courses that are not the “baby math” and “baby physics” they now take, not to learn anything, but to avoid getting a B or worse.

    • I don’t totally understand why the cap on federal support for registry training is causing a “shortage” of doctors. I get that more subsidies=more doctors, but in what sense does failing to subsidize cause a “shortage?” What prevents hospitals and med students from financing their own residencies?

      • Lack of money.

        The question you would be asking if you had delved deeply into the subject matter was why medical school should cost so much?

    • Very true. I agree with this post and I would add that we do not need our MD’s to be such superbly qualified students. Licensing has gotten way beyond where is it beneficial. That goes for MD’s, PA’s, RN’s, LPN’s CNA’s and various other medical technicians. Heck some plenty smart enough people can’t get to physical therapist which lets face it is not that demanding.

    • Which is worse–having a doctor with a 3.54 GPA or not having a doctor at all?

      • It could go either way. A dumb doctor has dangerous tools matched with the ability to do dumb things. He could even kill you even though the problem was minor.

      • That’s what is called a “false dichotomy.” Rejecting a poorly educated doc still leaves you the option of being treated by a nurse-practitioner, a foreign doc educated in the USSA, or a doc in Thailand who charges 1/4 the price you pay to the typically poorly educated Amerikan doc with a 3.54 who has never mastered math or physics.

        • I’m not convinced that the ability to get a 4.0 in math or physics has all that strong of a relationship with being a good doctor. I admit to writing from ignorance, but my gut reaction is that beyond a necessary minimum of math, physics, and other science skills that there wouldn’t be much of a correlation between these skills and the successful ability to diagnose ailments and keep up with the literature. Is there any hard evidence to the contrary?

      • An idiot doctor can do a lot more damage than than no doctor at all. There is a reason why most people most of the time get better and when they don’t, it is usually complicated enough that we want someone with better than a mediocre 3.54 GPA treating them.

        Most of my med school classmates were better than the stats cited above and many of them were still duds. My solution would be to tighten the standards and allow more quality control (medical malpractice is a real problem and I am willing to admit that despite being a tort reform supporter in theory).

        For those worried about health care costs with this policy of lower and better supply, use our price caps on doctor incomes (RVU system) more aggressively and subsidize med school education more (like the UK and France do).

        For those worried about access, let’s either deregulate the lower end of drug supply (easier access to prescriptions is relatively low risk and one would argue better than adding an extra layer of cost through an NP who bills the same as a doc thanks to the ACA)

    • We could get the doctors without changing the cap by allowing doctors who did their residencies abroad to work in the U.S. Or do you support protectionism? Other issues: more doctors does not necessarily mean cheaper health care; when supply increases, so does utilization. Also, there needs to be a tax on foreign-trained doctors to support medical programs in their home countries as a measure to counter brain drain.

    • I’ve been teaching medical students for almost 20 years. I’ve also been involved in teaching in a couple of allied health professions.

      Lately I have never been more impressed by their quality or by their commitment to learning the professions.

      I think the future is very bright on the care-giver side.

      Now, if we can just hand them a health care system that actually works properly….

      • I’ve been involved for a lot longer than that. I haven’t concluded that one group is better than another, but I’ll bet the newer group might have better verbal skills since many are coming from Liberal Arts departments while the older group might have better science skills. It’s hard to compare the two, but it is something to consider.

        What I have noted over the years is that the Internists seem to rely more and more on testing and scans worried when they don’t obtain them. On the surgical front after multiple discussions with a number of surgeons I spoke to a specialist in a narrow surgical field. He told me that he had done more cases as a resident before completing his specialty training than his young equivalent had after being in practice for 5 years. Considering the fact that practice makes perfect that worries me.

        Another interesting thing I note is that the younger doctors don’t want to work as hard so they are happier with a normal work week. Women physicians were like that even years ago, understandable because frequently they are also mothers. Without commenting whether this is good or bad, one should take note that a shorter work week means that the total number of physicians required is greater.