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by ZeroGravitas 1540 days ago
No, it's like saying all programmers should be replaced by certified programmers who are all from good families and have 10 years of intense training at top schools and massive debt.

You wouldn't trust some young immigrant or a long haired hippy kid who dropped out of college and started a business in his garage to provide your tech would you? Computers are complicated, we can't let amateurs in hoodies start doing things without some central control.

1 comments

NP/PA education is far less rigorous And requires far less hours than MD. Many more NP/PA schools have far more lax standards, and are probably better called diploma mills than MD schools.

It is all probabilities, and I would rather bet on an MD. At least compared to the current incarnation of NP/PA.

MD education in the US takes so long because students are required to spend four of those eight years studying something other than medicine.

Nurses actually study medicine as undergraduates before graduate NP education, so one could argue that NPs have more education in medicine.

The problem of NP/PA is not in the design or scalar length of education. It is in the credentialing. MDs have to take MCAT and step exams, which I know weed out many people. From my understanding, there is a relatively very low barrier to entry for NP/PA.

As a side note, the physician credentialing process of the US is far too long.

I doubt those exams select for skilled medical practitioners any more than leetcode interviews select for productive programmers.

In my own experience, I've seen several very good NPs and several very bad MDs.

> the physician credentialing process of the US is far too long.

Also too expensive and too abusive. It tends to select for people who are willing to put up with almost anything in exchange for the status of being an MD, not for people who are motivated to provide quality care for their patients.

NP/PA programs have entry requirements of 80-90% A’s (3.7 avg), GRE, 1000+ patient care hours and like 4% acceptance rates…
I don’t know that you can use the acceptance rate as a direct comparison to med school, you have different populations applying to each.

I remember there was a PA that did end up going to med school and took the PA boards (forget what they call it) just for kicks and ended up scoring in the 99th percentile.

What's the probability you are optimising though? That you as a rich person can get access to the artificially limited supply of <good thing>? Or that society in general gets access to <good thing>?

America has a stereotype that British people have bad teeth. They also have a stereotype that poor American "hillbillies" have even worse teeth. The stats suggest that on average the Brits have better teeth but I'd guess Dentists can make more money by moving from there to the country with the worse teeth on average and helping the Americans with good teeth have even better teeth.

> What's the probability you are optimising though?

The probably of me or my kids receiving a correct diagnosis.

To clarify, my intention was to specifically respond to

> Why the assumption that they're worse?

I have others views on healthcare credentialing on a societal scale.

Likewise: Boot camps and self-teaching are far less rigorous than CS degree programs, which I think is GP’s point.