[riahi]

The supply of doctors is not restricted by the AMA. The supply of doctors is determined by the number of residency spots available to new graduates; that number is entirely determined by the Centers for Medicare and Medicaid (CMS). Thanks to the Balance Budget Act of 1997, Graduate Medical Education (GME) was dramatically slowed due to decreases in Medicare funding of residency positions. [1]

As long as we require physicians to be US trained and to have completed a US residency, the bottleneck will be GME funding. To fix that, the AMA or any other concerned citizen can lobby Congress for an increase.

[1]: http://jama.jamanetwork.com/article.aspx?articleid=182532

[justincpollard]

If there's a shortage of doctors we could increase the supply or examine whether we need fully trained doctors for certain more basic services in the first place. There are plenty of beneficial/ necessary medical procedures that don't require an MD's expertise.

[bradleyjg]

Why should Medicare pay for every residency in the country?

If hospitals can afford to give their executives seven figure compensation packages, they can afford to fund a few residents.

[Bamafan]

I wasn't referring to residency spots at accredited medical schools.

I was referring to medical school accreditation itself.

[mbreese]

Medical schools are free to set their own limits on the number of students they admit. But they aren't going to admit more students than they predict can find a residency spot. It would look bad to have a high percentage of your students not be able to find a residency.

The real reason why there are fewer doctors is that it simply doesn't make any economic sense to be a doctor anymore. You need too much school, at too high a price, and you push off any real earning potential 6-9 years away from your peers. If you specialize, you can add an extra 2-4 years on top of that. And you really don't make enough over the long run to justify the lost opportunity costs.

So yes, there is a shortage of doctors, but that isn't going to change anytime soon.

[bradleyjg]

Sheer and utter nonsense. First there are a huge number of students who wish to go to medical school and don't get in. There's no shortage of applicants at all. Second the incredibly high compensation for speciality doctors quickly overcomes both opportunity cost and tuition costs as compared to almost any other profession.

I encourage you to run the numbers. You will find that $250k/year catches up very quickly to $100k/year even with a 10 year head start and $300,000 in extra debt.

[mbreese]

I encourage you to talk to some doctors. No one makes $250k per year, except maybe a few surgery specialists (and maybe ER). Primary care doctors (the ones that where there actually is a shortage) can can easily start at under $100k and the max can be below $200k. And if you are a pediatrician or a pediatric specialist, expect to take a cut in pay relative to your adult colleagues.

[bradleyjg]

Why would I solicit anecdotes, when there is data available?

Median compensation for all physicians is above $200,000/yr for every region of the country.[1] The highest averge earning speciality is not surgery but radiology at $315,000. [2]

Focusing on primary care doctors is a goalpost shift. Your original talking about the extensive opportunity costs for all doctors and specifically mentioned the additional time needed to specialize. Furthermore foreign born and educated doctors, who faced very different trade-offs, make up a disproportionate percentage of primary care physicians.[3] Finally, primary care is the area most suitable for less expensive medical professions, if only doctors quit engaging in anti-competitive lobbying.

In any event, medical school applications alone put lie to any sort of overall compensation-driven doctor shortage, which was your original complaint.

Maybe it's because I'm not a Christian, but I'm puzzled as to how a profession can be plagued simultaneously with God complexes and Martyr complexes.

[1] http://www.medscape.com/features/slideshow/compensation/2012... pg 5 [2] ibid pg 2 [3] http://www.nytimes.com/2010/08/12/health/12chen.html

[mbreese]

I'm replying to a comment days later, only because I didn't see this earlier.

Median compensation for all physicians. I encourage you to look at the actual distributions, based on age of the doctor and specialty. Early doctors make very little, and primary care doctors (GP, family practice, pediatrians), make the least. Oh, and while they are in training (residency, fellowhips), they wouldn't quality in the median compensation calculation, because even though they are MDs and treat patients, they are still considered students/trainees, and they make very little (~40K residency, ~60K fellowship, depending on area of the country). Those are the specialties that are in need - hence the reason to focus on those.

Really, I don't know why you're arguing this so much...

The cost of health care is a very complicated topic, and not one that is conducive to this type of forum.

My source: me, my wife, and a bunch of our friends. I almost became an MD, but left med school to get a PhD. I left for a variety of reasons, but once factor was the math didn't add up. My wife is an MD/PhD (pediatrics with a specialty). And we know many other doctors - all young, the category I was focusing on, and some make a lot, and others make very little.

Your data model is too simplistic to get a full grasp of the situation.

[sseveran]

Some specialties do. Its called the ROAD to success. Radiology, Ophthalmology, Anesthesiology and Dermatology. I know many radiologists who make between $500K and $1M. That being said residency spots in these specialties are extremely competitive.

[arethuza]

Out of interest, is there any good reason why medical degrees have to be done as second degrees in the US? Doesn't that add hugely to the cost of becoming a doctor?