Obamacare Means 1/3 Fewer MDs [Archive]

Upchurch

15th March 2010, 06:25 AM

Ready for rationing?

A total of 1,195 physicians from various specialties and career levels in locations nationally were surveyed. Nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.

This combined with the expected increase in demand could result in 50% reduction in available physicians.

http://www.nejmjobs.org/rpt/health-reform-may-reduce-physician-workforce.aspx
So, where does the rationing come in?

You may or may not be familiar with this, but there is an economic theory out there called "capitalism". It deals a lot with a concept called "supply and demand". When the supply of doctors goes down, the demand goes up. With the rise in demand, the compensation for doctors will go up. This will entice more people to enter (or stay in) the field, thus equalizing the supply and demand.

If someone wanted to game the system, they could tell others they planned to quit and encourage others to do the same. Then, they could (get this) not leave the workforce and watch the big bucks start rolling in. Just sayin'.

In all seriousness, I really doubt that many doctors will follow through on an ideological stance, especially a stupid one like "I'll quit if any health care reform is enacted, so :p". I would be interested to see those number juxtapose against those doctors who are considering leaving the profession over the current exorbitant insurance premiums.

WildCat

15th March 2010, 06:30 AM

You may or may not be familiar with this, but there is an economic theory out there called "capitalism". It deals a lot with a concept called "supply and demand". When the supply of doctors goes down, the demand goes up. With the rise in demand, the compensation for doctors will go up. This will entice more people to enter (or stay in) the field, thus equalizing the supply and demand.
You're forgetting that the AMA limits the number of medical school slots in order to keepn the number of doctors artificially low and their prices high. It's not a free market, it's a cartel.

ponderingturtle

15th March 2010, 06:38 AM

You're forgetting that the AMA limits the number of medical school slots in order to keepn the number of doctors artificially low and their prices high. It's not a free market, it's a cartel.

But medicine is a funny thing, more doctors can just as easily increase demand for their services. IF the doctor is not all that busy and so says that you should come back for review in 3 months instead of 6 months, they have just increased the demand for their services right there.

There was an adage about this relating to cataract surgery.

If there is one doctor in town this is done at 20/200
If there are two doctors in town this is done at 20/80
If there are three doctors in town this is done at 20/40

There are all kinds of ways under worked doctors can increase the amount of work they have by telling patients they need more work that they might if they had sufficient work.

Neally

15th March 2010, 07:57 AM

With the rise in demand, the compensation for doctors will go up. This will entice more people to enter (or stay in) the field, thus equalizing the supply and demand.
I see, therefore Obamacare will result in the loss of MDs which will cause prices to go up. Great thing this Obamacare. Oh, and you don't think that it's possible that insurance companies will put a cap on allowed costs for procedures, thus negating your idea that remaining physicians will just jack up prices?
There are all kinds of ways under worked doctors can increase the amount of work they have by telling patients they need more work that they might if they had sufficient work.The point here is that MDs won't have to make work, they will be overworked, to the point where demand will exceed supply, thus the possibility of rationing.

drkitten

15th March 2010, 08:02 AM

You're forgetting that the AMA limits the number of medical school slots in order to keepn the number of doctors artificially low and their prices high. It's not a free market, it's a cartel.

It's a good thing that he's forgetting it. It would be better if he never learned it in the first place, because it's simply not true.

Medical school slots are controlled by state boards of education, as are medical licensing; the AMA has nothing to do with them.

daenku32

15th March 2010, 08:07 AM

You're forgetting that the AMA limits the number of medical school slots in order to keepn the number of doctors artificially low and their prices high. It's not a free market, it's a cartel.

No they do not. The only references I have seen to this are more than a decade old. AMA current policy is for increasing the number of doctors because of the shortage.

ponderingturtle

15th March 2010, 08:07 AM

The point here is that MDs won't have to make work, they will be overworked, to the point where demand will exceed supply, thus the possibility of rationing.

Evidence? We have a lot of structural issues that can be the cause of this as well. The systems that increase work for doctors might be increasing it more than they should.

Alferd_Packer

15th March 2010, 08:12 AM

What do you call someone who graduated last in his class at medical school?

Doctor

thaiboxerken

15th March 2010, 08:23 AM

As to the OP, right......and Rush Limbaugh is really going to leave the country as well.

Neally

15th March 2010, 08:25 AM

Evidence? We have a lot of structural issues that can be the cause of this as well. The systems that increase work for doctors might be increasing it more than they should.Are you saying that a 50% reduction in the number of MDs will not lead to rationing? A shortage is already happening without Obamacare. http://www.examiner.com/x-5968-DC-Public-Policy-Examiner~y2010m1d29-Medical-college-associations-predict-physician-shortage-of-up-to-160000-by-2025

Medical school slots are controlled by state boards of education, as are medical licensing; the AMA has nothing to do with them. While true, the supply of MDs is in a large part dependent on Congress due to Medicare funding. http://www.examiner.com/x-5968-DC-Public-Policy-Examiner~y2010m1d29-Medical-college-associations-predict-physician-shortage-of-up-to-160000-by-2025

ponderingturtle

15th March 2010, 08:28 AM

Are you saying that a 50% reduction in the number of MDs will not lead to rationing? A shortage is already happening without Obamacare.

I don't see a 50% reduction in the number of doctors happening. What jobs are they taking, or what countries are they going to to practice medicine?

I am unconvinced that there is a general shortage in doctors. There are some structural issues regarding primary care but that isn't being addressed by our current system either.

drkitten

15th March 2010, 08:29 AM

While true, the supply of MDs is in a large part dependent on Congress due to Medicare funding. http://www.examiner.com/x-5968-DC-Public-Policy-Examiner~y2010m1d29-Medical-college-associations-predict-physician-shortage-of-up-to-160000-by-2025

So now you're telling me that Congress and the AMA are the same thing?

Beerina

15th March 2010, 08:40 AM

There was an adage about this relating to cataract surgery.

If there is one doctor in town this is done at 20/200
If there are two doctors in town this is done at 20/80
If there are three doctors in town this is done at 20/40

Studies have flat-out shown that adding doctors does not reduce costs, and in fact can increase costs while not increasing outcomes one iota.

So something is going awry with the capitalist competition here. Of course, the most likely culprit is more people attaching themselves to some payment teat, and probably private insurance.

I don't have a full analysis, but it's clear something is odd in this situation.

ponderingturtle

15th March 2010, 08:44 AM

Studies have flat-out shown that adding doctors does not reduce costs, and in fact can increase costs while not increasing outcomes one iota.

Sure, but it means we can't say that fewer doctors than we have couldn't do as good or better job

So something is going awry with the capitalist competition here. Of course, the most likely culprit is more people attaching themselves to some payment teat, and probably private insurance.

Knew you would say that.

Magyar

15th March 2010, 12:03 PM

Oh WAIT! NOW it's FIFTY percent of doctors :)

Could you AT LEAST be consistant about the number you pull out of your John Brown parts!?

Really WHAT evidence have you you that this kind of reduction has EVER happened in ANY industry in ANY time frame in the workd ofr ANY reason.

Your assertions are so patently looney they aren't even really worth commenting on!

Upchurch

15th March 2010, 12:28 PM

I see, therefore Obamacare will result in the loss of MDs which will cause prices to go up. Great thing this Obamacare.
Mmmmm... cherry-picking. :homersimp

Oh, and you don't think that it's possible that insurance companies will put a cap on allowed costs for procedures, thus negating your idea that remaining physicians will just jack up prices?
What prevents them from doing that now (assuming they don't)?

When you finish reading my post, let me know.

Beeyon

15th March 2010, 12:34 PM

It's a good thing that he's forgetting it. It would be better if he never learned it in the first place, because it's simply not true.

Medical school slots are controlled by state boards of education, as are medical licensing; the AMA has nothing to do with them.Medical school accreditation comes from The Liaison Committee on Medical Education, which is sponsored by the AMA. So it's not quite fair to say they have nothing to do with how many schools there are.

I understand that there are other factors like the government's funding for residency positions. But is there any evidence of the AMA trying to increase the supply of doctors?

I know that they talk about wanting more doctors, but it seems like they want to make sure the available positions for doctors increases first, before pushing for more schools/doctors. That seems to indicate that they are acting like a cartel.

Edited to Add:

I found the evidence I asked for.

The United States stopped opening medical schools in the 1980s because of the predicted surplus of doctors. The Association of American Medical Colleges dropped this long-standing view in 2002 with the statement: "It now appears that those predictions may be in error." Last month, it recommended increasing the number of U.S. medical students by 15%.http://www.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm

Though that (old) article does make it look like the AMA was trying to restrict the supply of doctors up until the 2000s. So. Semi-Cartel, I guess.

mhaze

15th March 2010, 12:39 PM

joobz

15th March 2010, 12:42 PM

Lurker

15th March 2010, 12:47 PM

drkitten

15th March 2010, 12:50 PM

1,195 physicians more interested in money then patients leave the field?
Sounds like a net gain to me.

Especially since my bet is approximately 0% of those physicians would actually leave the field.

After spending 10+ years to get a medical licence, the idea of walking away from it in a political snit-fit seems "unlikely."

Remember all those idiots who threatened to move to Canada if Bush won in 2004? Remember all those other idiots who threatened to move to Canada if Obama won in 2008? How many of them actually carried out that threat?

joobz

15th March 2010, 12:56 PM

Especially since my bet is approximately 0% of those physicians would actually leave the field.

After spending 10+ years to get a medical licence, the idea of walking away from it in a political snit-fit seems "unlikely."

Remember all those idiots who threatened to move to Canada if Bush won in 2004? Remember all those other idiots who threatened to move to Canada if Obama won in 2008? How many of them actually carried out that threat?

I can see some of the doctor's who are close to retirement leaving earlier and making a big show of it as protest. Unless, of course, their retirement portfolio was a bit too heavy in real estate over the past couple years.

Upchurch

15th March 2010, 01:03 PM

You're forgetting that the AMA limits the number of medical school slots in order to keepn the number of doctors artificially low and their prices high. It's not a free market, it's a cartel.I believe this was debunked by mhaze or BAC, I can't remember which.

Really? mhaze or BAC debunked it?

Maybe WildCat is correct after all....

GreyICE

15th March 2010, 01:57 PM

Loss Leader

15th March 2010, 02:02 PM

A total of 1,195 physicians from various specialties and career levels in locations nationally were surveyed. Nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.

This assumes that the doctors actually understand the new health care law and are able to correctly predict how it will affect the market.

I find that amazing as the new health care legislation isn't in any sort of final form that allows for this kind of analysis.

Perhaps the doctors were responding irrationally based upon a lack of information.

Delscottio

15th March 2010, 02:45 PM

First, are you familiar with a phenomena called 'lying?' It's where people... don't tell the truth.
[snip]

What, like this lot? http://news.bbc.co.uk/news/vote2001/hi/english/features/newsid_1320000/1320850.stm

Shame they didn't keep to their promises....

Neally

15th March 2010, 02:57 PM

First, are you familiar with a phenomena called 'lying?' It's where people... don't tell the truth.

I guess Gallup should just close up shop then, after all, everyone that is polled could be lying.

Architect

15th March 2010, 03:13 PM

Neally,how familiar are you with the actual operation of universal health care systems in comparable Western countries and to what extent do you believe that the outcomes of said systems are applicable to the US?

GreyICE

15th March 2010, 03:18 PM

I guess Gallup should just close up shop then, after all, everyone that is polled could be lying.

Guess you're just going to ignore the fact that the poll was run by a Murdoch shop, after all, that's not relevant. I guess you're just going to misrepresent me and lie, after all, honesty is overrated. I guess you're going to weasel around the point, after all, it's about spin and misrepresentation, not truth and skepticism.

Do you have an answer for what I asked, or is it going to be more of the same next post?

Neally

15th March 2010, 04:23 PM

With no data on the original poll or how it was conducted, no data on the methodology, and the sourcing coming from an organization known for producing complete bull, I call nonsense poll. Provide data, or get off the pot.

"The survey sample was randomly selected from a physician database of thousands. The database has been built over the past eight years by The Medicus Firm (formerly Medicus Partners and The MD Firm) from a variety of sources including, but not limited to, public directories, purchased lists, practice inquiries, training programs, and direct mail responses. The survey was conducted via emails sent directly to physicians."

This article was written in January 2010. The survey was conducted by The Medicus Firm (http://www.themedicusfirm.com/), a nationally retained physician search firm, based on the health reform legislation in process at that time.

Guess you're just going to ignore the fact that the poll was run by a Murdoch shopDo provide the connection with the Medicus Firm to "a Murdoch shop".

Neally,how familiar are you with the actual operation of universal health care systems in comparable Western countries and to what extent do you believe that the outcomes of said systems are applicable to the US?Topic here isn't so much about a comparison of UHC and the proposal in Congress, but about the possibility of a severe MD shortage and resulting rationing should Obamacare pass.

Architect

15th March 2010, 04:26 PM

Neally, no one said that it was; I asked how familiar you were with comparable systems as - by your reasoning - we should all be facing some sort of terrible doctor shortage.

theprestige

15th March 2010, 04:29 PM

Good luck in their new careers!
Why would they need a new career?

A part-time job to pay for food and shelter, and if they can't afford healthcare, the government will pay for it!

joobz

15th March 2010, 04:30 PM

Topic here isn't so much about a comparison of UHC and the proposal in Congress, but about the possibility of a severe MD shortage and resulting rationing should Obamacare pass.
Well, I guess we can close the thread, then since the topic is done.

The majority of Doctor's won't actually quit. (As Drkitten explained)
The doctors who would quit are likely not to be missed.

GreyICE

15th March 2010, 04:34 PM

"The survey sample was randomly selected from a physician database of thousands. The database has been built over the past eight years by The Medicus Firm (formerly Medicus Partners and The MD Firm) from a variety of sources including, but not limited to, public directories, purchased lists, practice inquiries, training programs, and direct mail responses. The survey was conducted via emails sent directly to physicians."

This article was written in January 2010. The survey was conducted by The Medicus Firm (http://www.themedicusfirm.com/), a nationally retained physician search firm, based on the health reform legislation in process at that time.

Do provide the connection with the Medicus Firm to "a Murdoch shop". It's right there under where the information was reported, in the article you linked to - Market Watch. A murdoch shop. Now stop being disingenuous, if there was no connection, find the original survey and point to it. Let us see methodology, questions asked, who funded the survey, etc.

A headhunting firm (which is all they are) got paid to do a hack job poll is the only thing I see going on here. And you really, really want it to be true.

The True Scotsman

15th March 2010, 05:18 PM

Gangularis

15th March 2010, 05:19 PM

Really? mhaze or BAC debunked it?

Maybe WildCat is correct after all....

LOL! I was about to say that... Like seriously? BaC?

The True Scotsman

15th March 2010, 05:25 PM

So, where does the rationing come in?

You may or may not be familiar with this, but there is an economic theory out there called "capitalism". It deals a lot with a concept called "supply and demand". When the supply of doctors goes down, the demand goes up. With the rise in demand, the compensation for doctors will go up. This will entice more people to enter (or stay in) the field, thus equalizing the supply and demand.

That works when you're discussing the free market, but government programs and policies don't necessarily follow the same rules. If the final bill contains a fixed wage for medical practitioners, then no matter how many practitioners leave or enter the field, the wages of these practitioners will remain the same.

fullflavormenthol

15th March 2010, 05:29 PM

Let me go out on a limb and declare 3/4s of that 1/3 are talking out their backsides. Sure they are going to quit being doctors, but when the time comes to put up or shut up they will stay in the medical profession.

Funny thing about "going Galt" is that you soon realize that there is always someone better looking for the chance to overtake you.

joobz

15th March 2010, 05:30 PM

That works when you're discussing the free market, but government programs and policies don't necessarily follow the same rules. If the final bill contains a fixed wage for medical practitioners, then no matter how many practitioners leave or enter the field, the wages of these practitioners will remain the same.
True, but I haven't heard that being proposed. From what I can tell, the health care bill only deals with requirements for everyone to carry health care. This would have the effect of potentially more patients for doctors to see. Hence the greater need for health care practitioners. This would likely mean more screening, and more diseases caught early, meaning cheaper to treat and a healthier populous.

Of course, I could be wrong however.

MikeMangum

15th March 2010, 05:33 PM

Especially since my bet is approximately 0% of those physicians would actually leave the field.

After spending 10+ years to get a medical licence, the idea of walking away from it in a political snit-fit seems "unlikely."

I seriously doubt that a full 1/3 of doctors would stop practicing, but a smaller fraction could indeed stop practicing and still put their medical degrees to work and make good pay by working for a pharmaceutical company. Another small fraction could very easily be family practice doctors who just change fields to become specialists.

WildCat

15th March 2010, 06:13 PM

Really? mhaze or BAC debunked it?

Maybe WildCat is correct after all....
You're very clever!

The Liaison Committee on Medical Education (http://www.lcme.org/faqlcme.htm), ever heard of them?

Who accredits medical schools? What standards are used to accredit schools?
In the United States, the accreditation status of programs leading to the M.D. degree is determined solely by the Liaison Committee on Medical Education (LCME). In cooperation with the Committee on Accreditation of Canadian Medical Schools (CACMS), the LCME also accredits M.D. programs in Canada. To be accredited, programs must meet the national standards described in the document, Functions and Structure of a Medical School (http://www.lcme.org/pubs.htm#f and s). For further information, refer to the Overview (http://www.lcme.org/overview.htm)and Accreditation Procedures (http://www.lcme.org/procedur.htm) sections of this site.

And who sponsors the LCME?

Why are there two LCME offices? Which one should I contact?
The LCME is jointly sponsored by the Association of American Medical Colleges (AAMC) (http://www.aamc.org/) and the Council on Medical Education of the American Medical Association (AMA) (http://www.ama-assn.org/). The AAMC and the AMA each appoint an LCME Secretary and maintain accreditation offices in Washington, D.C. and Chicago, respectively. Primary responsibility for coordinating survey visits, hosting LCME meetings, and serving as LCME spokesman (the "principal Secretary") alternates between the offices each academic year. In even-numbered years beginning each July 1, the principal Secretary is at the AAMC. In odd-numbered years beginning each July 1, the principal Secretary is at the AMA. Contacts (http://www.lcme.org/contacts.htm) to either office should provide answers to any questions.

This is self-explanatory I assume?

tyr_13

15th March 2010, 06:29 PM

You're very clever!

The Liaison Committee on Medical Education (http://www.lcme.org/faqlcme.htm), ever heard of them?

And who sponsors the LCME?

This is self-explanatory I assume?

No, it isn't. How does the lcme determining accreditation mean that the AAMC sets student numbers low?

WildCat

15th March 2010, 06:39 PM

No, it isn't. How does the lcme determining accreditation mean that the AAMC sets student numbers low?
Tell me how to increase the slots without requiring the accreditation of new schools or new programs in existing schools?

Anyone (such as Congress) wishing to markedly expand the number of medical school graduates will need the backing of the AMA. Even when the AMA approves Congress would be foolish not to consult with them in drafting any legislation aimed at affecting the number of medical school graduates.

lionking

15th March 2010, 06:45 PM

I wonder why nothing like this happened when the universal health system was introduced in Australia?

tyr_13

15th March 2010, 06:54 PM

Tell me how to increase the slots without requiring the accreditation of new schools or new programs in existing schools?

Duplicate classes. Increase class sizes. Expand existing programs.

But aside from that, your premise is that the AAMC won't accredit new schools. You've not presented evidence of that. Even if that were the case, you'd have to show that they were doing so in order to keep the number of doctors down, not to say, keep bad schools from receiving accreditation.

David Wong

15th March 2010, 07:04 PM

Fewer doctors won't matter, since there will be a smaller patient population due to the murderous death panels.

Neally

15th March 2010, 07:20 PM

It's right there under where the information was reported, in the article you linked to - Market Watch. A murdoch shop. The article says the survey results were mentioned "Market Watch". Other places have posted the results of the survey as well. Again do support your claim that it was bought and paid for by Murdoch, and therefore totally bogus.
A headhunting firm (which is all they are) got paid to do a hack job poll is the only thing I see going on here. Evidence? I know you desperately want to discount the results of the poll-either the physicians are all lying, or that it's all just a Murdoch scam, but without evidence you must be rather frustrated.

WildCat

15th March 2010, 07:24 PM

Duplicate classes. Increase class sizes. Expand existing programs.
All of which may require new accreditation. "Accreditation is a process of quality assurance in postsecondary education that determines whether an institution or program meets established standards for function, structure, and performance (http://www.lcme.org/overview.htm#purpose)." You can't just change the program using an existing accreditation.

But aside from that, your premise is that the AAMC won't accredit new schools. You've not presented evidence of that. Even if that were the case, you'd have to show that they were doing so in order to keep the number of doctors down, not to say, keep bad schools from receiving accreditation.
Evidences (http://www.endo.gr/cgi/content/full/350/17/1780#R1):

At the current time, questions about the supply of physicians are simply off the radar screens of most federal policymakers. Historically, the federal government has been slow to act on issues related to the supply of physicians and has waited for evidence of public distress, a firm professional consensus, or both before acting either to augment or to restrain the number of physicians. There is at present no indication that shortages of physicians have captured voters' attention, and experts and professional groups are far from a consensus on the adequacy of current or projected workforce numbers. In fact, according to Michael Whitcomb of the AAMC and Barbara Barzansky of the AMA, both these organizations seem to be admitting defeat in the effort to predict the required number of physicians, and, for now, neither plans to take a definite position on this issue. Despite the likely conclusion by the COGME that a physician deficit looms, the suddenness of the council's change in view, together with the reticence of the AAMC and the AMA, may well give policymakers pause. Therefore, it seems exceedingly unlikely that Congress or the executive branch will venture into the debate on the physician supply anytime soon.
Bold emphasis mine. The AMA plays a significant role in increasing the numbers of medical students.

tyr_13

15th March 2010, 07:30 PM

Funny, your own link shows that they do this to keep quality high.

Redtail

15th March 2010, 07:46 PM

I wonder why nothing like this happened when the universal health system was introduced in Australia?

I'm sure it did! You just didn't notice because... Umm... It was a secret! Yeah... That must be it...

Seriously, when you Aussies were heading toward UHC, did you have the same or similar ideological clashes as we are having in the USA now?

WildCat

15th March 2010, 07:48 PM

Funny, your own link shows that they do this to keep quality high.
Of course. All cartels/guilds will say that's why they do it.

But you now agree that the AMA has at least a very strong say in the number of medical school graduates?

tyr_13

15th March 2010, 08:26 PM

Of course. All cartels/guilds will say that's why they do it.

But you now agree that the AMA has at least a very strong say in the number of medical school graduates?

In a round about way they have a say in it.

I'll be back to comment more once I get my tin-foil hat on.

WildCat

15th March 2010, 09:45 PM

In a round about way they have a say in it.

I'll be back to comment more once I get my tin-foil hat on.
Sweet, a claim backed up by documentation by the only group authorized to accredit medical schools in the US and Canada and also an article published in the New England Journal of Medicine and it's tin-foil hat time?

bpesta22

15th March 2010, 09:49 PM

You may or may not be familiar with this, but there is an economic theory out there called "capitalism". It deals a lot with a concept called "supply and demand". When the supply of doctors goes down, the demand goes up. With the rise in demand, the compensation for doctors will go up. This will entice more people to enter (or stay in) the field, thus equalizing the supply and deman.

Would it be pedantic to point out the above is wrong? Decreased labor supply doesn't increase demand. The demand curve stays where it is, but now with fewer workers, wages go up, as the intersection of supply and demand is now higher up the old/unmoved demand curve?

The True Scotsman

15th March 2010, 09:52 PM

True, but I haven't heard that being proposed. From what I can tell, the health care bill only deals with requirements for everyone to carry health care. This would have the effect of potentially more patients for doctors to see. Hence the greater need for health care practitioners. This would likely mean more screening, and more diseases caught early, meaning cheaper to treat and a healthier populous.

Of course, I could be wrong however.

Yeah, I don't believe the bill is heading in this direction either. I was simply attempting to clear up an error I noticed in the person I quoted's economic theory. :D

lionking

15th March 2010, 09:52 PM

I'm sure it did! You just didn't notice because... Umm... It was a secret! Yeah... That must be it...

Seriously, when you Aussies were heading toward UHC, did you have the same or similar ideological clashes as we are having in the USA now?
Not at all. The vast majority saw it as a very good idea.

I should say that we do have a two-tiered system, with Medicare covering everyone, but only to a standard level. If you want private rooms and a doctor of your choice, you have to also have private insurance - which I have. And there are gaps - most GPs charge over the "scheduled fee" and you pay the difference.

But we were mercifully spared this socialism/communism/doctors will leave in droves crap.

GreyICE

15th March 2010, 09:58 PM

The article says the survey results were mentioned "Market Watch". Other places have posted the results of the survey as well. Again do support your claim that it was bought and paid for by Murdoch, and therefore totally bogus.
Evidence? I know you desperately want to discount the results of the poll-either the physicians are all lying, or that it's all just a Murdoch scam, but without evidence you must be rather frustrated.

Neally, your ability to trim two sentences from my posts and respond to them is so ***************** that I am giving you exactly two sentences to work with here.

Provide me the study right the hell now, or everything I said about it is correct, and since you are going to be unable to do that because it's a crappy study done by a crappy headhunting firm, with crappy methodology and crappy questions that you can't even locate and didn't even try to, because they're not publishing it for people with actual knowledge to dissect (and yes this sentence is long, but I don't trust you not to dishonestly trim my words again).

Edited, Breach of Rule 0.

The True Scotsman

15th March 2010, 09:59 PM

The article says the survey results were mentioned "Market Watch". Other places have posted the results of the survey as well. Again do support your claim that it was bought and paid for by Murdoch, and therefore totally bogus.
Evidence? I know you desperately want to discount the results of the poll-either the physicians are all lying, or that it's all just a Murdoch scam, but without evidence you must be rather frustrated.

If I may jump in for a second, I notice that this argument has come down to a question of burden of proof. As burden of proof necessarily falls on the person making a claim and seeing how you are both rejecting each other's arguments while simultaneously putting forth claims, I believe you both need to put forth proof of your claims. Ok, jumping back out now. :whistling

GreyICE

15th March 2010, 10:05 PM

If I may jump in for a second, I notice that this argument has come down to a question of burden of proof. As burden of proof necessarily falls on the person making a claim and seeing how you are both rejecting each other's arguments while simultaneously putting forth claims, I believe you both need to put forth proof of your claims. Ok, jumping back out now. :whistling

Lets see. I claim that a headhunting firm which doesn't normally do studies (duh?). I claim when the results of the 'study' appear in one news source with a known bias (and the study supports that bias) it is amazingly likely that the 'news source' paid the headhunting firm to do it.

I will defend the fact I have a rational basis for this belief, and since I've done a pretty thorough search for the study, which isn't showing up online, I'm going to guess that I'm right.

You can continue your naive belief that MurdochWorld doesn't pull these stunts :rolleyes:

Leif Roar

15th March 2010, 10:10 PM

Nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.

Good. We need more cab drivers.

ponderingturtle

16th March 2010, 03:09 AM

Tell me how to increase the slots without requiring the accreditation of new schools or new programs in existing schools?

Add slots to existing accredited programs. You seem to be of the opinion that a school that expands is threatening its accreditation. What is your basis for that idea?

Dancing David

16th March 2010, 04:53 AM

Neally

16th March 2010, 05:19 AM

If I may jump in for a second, I notice that this argument has come down to a question of burden of proof. As burden of proof necessarily falls on the person making a claim and seeing how you are both rejecting each other's arguments while simultaneously putting forth claims, I believe you both need to put forth proof of your claims.I'm saying I don't know who funded the study. GreyICE is claiming Murdoch funded it, simply because it was published on Market Watch, as well as other sites. Up to him to support his claim.
You can continue your naive belief that MurdochWorld doesn't pull these stuntsAnd you can continue your conspiracy theories and claim the respondents lied just because you don't like the results.

WildCat

16th March 2010, 05:34 AM

Add slots to existing accredited programs. You seem to be of the opinion that a school that expands is threatening its accreditation. What is your basis for that idea?
The statement that accreditation is for "structure, function, and performance".

You can't just change, say, double te size of the medical school. I'm not saying that you can't add a few students here or there (after all class sizes will vary from year to year) but any major change will require new accreditation.

ponderingturtle

16th March 2010, 05:46 AM

ponderingturtle

16th March 2010, 05:49 AM

Um, if there is a doctor shortage it is because people don't want the crappy hours, high work load and relatively low pay. Then there are those whow ant to be doctors but don't want to be Gps.

This has been about doctors in general. I remember hearing yesterday on the radio how pissed a cardiologist was that he might have to earn less than the 400k he was pulling down a year, due to cuts in medicare payment.

He can quit and feel what it is like earning 50k a year.

GreyICE

16th March 2010, 06:03 AM

I'm saying I don't know who funded the study. GreyICE is claiming Murdoch funded it, simply because it was published on Market Watch, as well as other sites. Up to him to support his claim.
And you can continue your conspiracy theories and claim the respondents lied just because you don't like the results.

Neally, 1 sentence this time: where's the original study (third time I'm asking, too)?

tyr_13

16th March 2010, 06:24 AM

Sweet, a claim backed up by documentation by the only group authorized to accredit medical schools in the US and Canada and also an article published in the New England Journal of Medicine and it's tin-foil hat time?

No, the tin-foil comes from your assertion that they want to keep the number of doctors artificially low to make more money. Your claim is still tin-foil conspiracy theory. FEMA prison camps can be backed up with the exact same logic and documentation. They aren't happening either.

And no, you're still wrong because they can increase class sizes and 'copy-pasting' class "structure, function, and performance" requires a simple review of the teaching staff and facilities.

Your basic claim that the AMA is holding up costs and down the number of doctors is not proven because they have the authority to try to do so.

I know there are a bunch of people who become doctors to make money. However, ever single person I have ever spoken to who was in the process of becoming any type of medical professional, including administration, has expressed the primary motivation of helping people.

mhaze

16th March 2010, 07:59 AM

Of course. All cartels/guilds will say that's why they do it.

But you now agree that the AMA has at least a very strong say in the number of medical school graduates?What absolute nonsense.

MD's are licensed at the state level. Many are not even a member of the AMA. Schools could increase class sizes if they so chose.

Your argument about possible refusal of the AMA to accredit new schools is bunko. Show a case where they did so and I'll pay attention to it.

joobz

16th March 2010, 07:59 AM

The statement that accreditation is for "structure, function, and performance".

You can't just change, say, double te size of the medical school. I'm not saying that you can't add a few students here or there (after all class sizes will vary from year to year) but any major change will require new accreditation.
Sorry, wildcat, I call BS.

I'm going through an accreditation right now for ABET(engineering)....
it isn't so much that you can't double your class size. It's that you can provide the needed resources for the students you have. If you were to double your enrollment, the board is extremely happy, as long as you have enough faculty, class space, sufficient and updated laboratory resources...

Of course, it may be possible that med school accreditation is vastly different and that they are artificially keeping the numbers down but I suspect the limiting enrollment has more to do with financial success of the school rather than some evil cartel keeping the number of doctors low.

1.) School rankings matter. A marker of a school's success is the % of students who graduate and the % of those who become board certified.
2.) Any school wants to keep those numbers as high as possible. As such, they will only admit students they think will likely succeed.
3.) The lower you go down the GPA/MCAT scoring, the less likely this is going to happen.
4.) When all other schools keep entrance requirements high, you can't afford to go too low in your's, otherwise you look like the "easy school"
5.) If you have a reputation for being an easy school, residency programs will not consider your students, and the number of quality students further decreases.

The True Scotsman

16th March 2010, 08:02 AM

Lets see. I claim that a headhunting firm which doesn't normally do studies (duh?). I claim when the results of the 'study' appear in one news source with a known bias (and the study supports that bias) it is amazingly likely that the 'news source' paid the headhunting firm to do it.

I will defend the fact I have a rational basis for this belief, and since I've done a pretty thorough search for the study, which isn't showing up online, I'm going to guess that I'm right.

OK, just don't expect anyone else to believe your claims if you're not willing to or can't post evidence of them.

You can continue your naive belief that MurdochWorld doesn't pull these stunts :rolleyes:

It's funny how you jump to conclusions on the basis that I point out a structural flaw in your argument.

The True Scotsman

16th March 2010, 08:05 AM

I'm saying I don't know who funded the study. GreyICE is claiming Murdoch funded it, simply because it was published on Market Watch, as well as other sites. Up to him to support his claim.

True, but you are also putting forth a poll that's reliability has been put into question. It is up to you to find more information about it.

Mojo

16th March 2010, 08:07 AM

Upchurch

16th March 2010, 08:20 AM

Would it be pedantic to point out the above is wrong? Decreased labor supply doesn't increase demand.
You misunderstand me, or I worded it poorly not being a trained economist.

As the labor supply decreases the demand on the remaining labor supply would increase. Which, as you say...
with fewer workers, wages go up

GreyICE

16th March 2010, 08:40 AM

OK, just don't expect anyone else to believe your claims if you're not willing to or can't post evidence of them.

It's funny how you jump to conclusions on the basis that I point out a structural flaw in your argument.

I've posted all the evidence that exists. That alone should give you pause. This study wasn't published in any journal? The methodology isn't public? They didn't release the full paper?

Now those things are clearly irregular. Very irregular.

Now factor in the fact that the result is clearly anti-healthcare reform. And the results appeared in a Murdoch publication first and foremost. Without being publicly available.

Now maybe this headhunting firm did the study because they were curious, and like to do scientific studies. And maybe it was properly conducted and innocent, and they just haven't published the results because it's a confidential internal study for their own edification. And maybe they just happened to tell a reasonably obscure Murdoch publication about this - instead of the NYT, CBS, NBC, WaPo, USA Today, or even if we consider big name Murdoch publications, the WSJ, Fox News, or any one of a number of organizations (that people have heard of, and associate with Murdoch).

Holy crap man. Your hypothesis requires more weird things to happen then mine does. A headhunting firm just happens to conduct a study which just happens to be negative on Obama's agenda, which just happens to be private and they just happen to give the results to a Murdoch publication.

Or, y'know, a paper paid a publication to do a push poll using an obscure, neutral-sounding internet subsidiary. Because that's a radical hypothesis :rolleyes:

Skepticism does not mean we have to turn our brains off, or beat them against the wall until they are pudding.

ponderingturtle

16th March 2010, 08:55 AM

bpesta22

16th March 2010, 09:43 AM

You misunderstand me, or I worded it poorly not being a trained economist.

As the labor supply decreases the demand on the remaining labor supply would increase. Which, as you say...

I still think this is off-- it's easy to confuse a shift in demand with a decrease in demand.

I think as the supply curve shifts left hospitals should react by demanding fewer doctors (so demand actually decreases, though wages go up).

Maybe we can get our two resident economists to comment, whom are catfighting about econ (meow) in another thread which I find strangely arousing...:)

The True Scotsman

16th March 2010, 10:28 AM

I've posted all the evidence that exists. That alone should give you pause. This study wasn't published in any journal? The methodology isn't public? They didn't release the full paper?

Now those things are clearly irregular. Very irregular.

Now factor in the fact that the result is clearly anti-healthcare reform. And the results appeared in a Murdoch publication first and foremost. Without being publicly available.

Now maybe this headhunting firm did the study because they were curious, and like to do scientific studies. And maybe it was properly conducted and innocent, and they just haven't published the results because it's a confidential internal study for their own edification. And maybe they just happened to tell a reasonably obscure Murdoch publication about this - instead of the NYT, CBS, NBC, WaPo, USA Today, or even if we consider big name Murdoch publications, the WSJ, Fox News, or any one of a number of organizations (that people have heard of, and associate with Murdoch).

Holy crap man. Your hypothesis requires more weird things to happen then mine does. A headhunting firm just happens to conduct a study which just happens to be negative on Obama's agenda, which just happens to be private and they just happen to give the results to a Murdoch publication.

Or, y'know, a paper paid a publication to do a push poll using an obscure, neutral-sounding internet subsidiary. Because that's a radical hypothesis :rolleyes:

Skepticism does not mean we have to turn our brains off, or beat them against the wall until they are pudding.

I see you ignored the second half of my post that you quoted. You are jumping to the conclusion that because I don't entirely accept your argument then I must necessarily accept the argument you are arguing against. Not true. I accept neither that the poll was DEFINITELY done with good methodology (Neally's argument) or that it was DEFINITELY done with poor methodology (Your argument). I accept neither argument until more evidence is brought forth for either side. You are both presupposing and that is what I am arguing against.

Furthermore, you are making an ad homenim argument against a study possibly done by an organization that is probably untrustworthy. You are saying that since the organization performed the study, it is therefore useless.

daenku32

16th March 2010, 10:33 AM

joobz

16th March 2010, 10:45 AM

Basically, this isn't about Obamacare, it's about Doctors getting paid less than what they are today. So, any attempt to control costs, or dealing with the uninsured, will result in fewer doctors! Yay! What do I win?

Actually, there are at least three possible reasons for a doctor to threaten quitting:

1.) Are afraid the new system will result in a slower increase in salary or a reduction in salary
2.) Fear the new system would be too bureaucratic to deal with.
3.) Ideological hatred of all things smelling like socialism.

But all of these are rather non-issues for the following respective reasons
1. There is no legislation being discussed which limits salaries
2. Doctors already have to deal with multiple levels of bureaucracy thanks to multiple insurance systems, variable fee schedules, and hospital policies about handling of uninsured patients. I do not see how this will be any different, and could very likely remove a major bureaucratic obstacle in hospital care, insuring that coverage is met.
3. The Tinfoil hat community will welcome them into the fold.

thaiboxerken

16th March 2010, 05:36 PM

I believe this was debunked by mhaze or BAC.....

That's hilarious!! Nice one!

thaiboxerken

16th March 2010, 05:38 PM

Why would they need a new career?

A part-time job to pay for food and shelter, and if they can't afford healthcare, the government will pay for it!

Right, because those who want to become doctors only do it to barely survive........:rolleyes:

WildCat

16th March 2010, 05:39 PM

No, the tin-foil comes from your assertion that they want to keep the number of doctors artificially low to make more money.
Next you'll want me to prove that OPEC keeps supply low to make more money... :rolleyes:

WildCat

16th March 2010, 05:43 PM

What absolute nonsense.

MD's are licensed at the state level.
Explain to me how one gets a medical license without ever having been to an accredited medical school?

Many are not even a member of the AMA. Schools could increase class sizes if they so chose.

Your argument about possible refusal of the AMA to accredit new schools is bunko. Show a case where they did so and I'll pay attention to it.
The NEJM article I posted stated matter-of-fact that historically no action is taken to increase medical student class size without the support of the AMA.

joobz

16th March 2010, 06:03 PM

Explain to me how one gets a medical license without ever having been to an accredited medical school?
By going to a foreign medical school.

JoeTheJuggler

16th March 2010, 06:06 PM

So this AMA conspiracy to artificially limit the supply of MDs--it has nothing to do with current health insurance reform bills being considered in Congress (what the OP refers to as "Obamacare"), does it?

That is, there's nothing in the bills that will change this situation one way or the other, is there? (Well--except perhaps very indirectly, since the House is probably going to insist on passing a reform of federal student loan programs.)

ETA: So we can dismiss this "Obamacare Means 1/3 Fewer MDs" as yet another scare tactic? I think it belongs right up there with "death panels" and the "government takeover of healthcare" and "it's socialism!" claims.

MikeMangum

17th March 2010, 12:46 AM

Weird how the physics department I went to seemed to double the number of graduates in 10 years but med schools can't do anything like that.

Physics students don't work with real patients under the supervision of a doctor.

MikeMangum

17th March 2010, 01:11 AM

No, the tin-foil comes from your assertion that they want to keep the number of doctors artificially low to make more money. Your claim is still tin-foil conspiracy theory. FEMA prison camps can be backed up with the exact same logic and documentation. They aren't happening either.

The medical profession is controlled by a guild. To call it a tin foil conspiracy theory when someone refers to one of the purposes of a guild as limiting competition is roughly the same as calling it tin foil hat territory if someone says that one of the purposes of a union is to get higher wages.

And no, you're still wrong because they can increase class sizes and 'copy-pasting' class "structure, function, and performance" requires a simple review of the teaching staff and facilities.

How do they increase "structure, function, and performance" when doing so requires 1) a larger hospital, 2) more doctors as teaching staff, and 3) more patients? Medical school does not just require additional classroom space and texbooks. Adding another wing to a hospital is not the same as building more classrooms.

I know there are a bunch of people who become doctors to make money. However, ever single person I have ever spoken to who was in the process of becoming any type of medical professional, including administration, has expressed the primary motivation of helping people.

Almost noone enters a given profession for only one reason; it is usually a mix of different factors. There are not a "bunch of people who became doctors to make money"...EVERY doctor became a doctor to make money unless they are working for free. That might not have been their only motivation, but you can believe that it was one of their motivations; an important one. Many doctors who became doctors "to help people" might have chosen (or might choose) some other profession in which they could help people if doctors were paid significantly less. That should not be controversial.

ponderingturtle

17th March 2010, 03:03 AM

Physics students don't work with real patients under the supervision of a doctor.

And how does that change the ability for schools to expand? Yes they might need more staff, but so what?

Leif Roar

17th March 2010, 03:21 AM

How do they increase "structure, function, and performance" when doing so requires 1) a larger hospital, 2) more doctors as teaching staff, and 3) more patients?

If AMA was artificially limiting the number of medical students there would have to exist excess capacity of both 1, 2 and 3 for them to limit the number from.

McHrozni

17th March 2010, 03:40 AM

ponderingturtle

17th March 2010, 03:43 AM

I suspect the effect where people say they would do one thing and then do another is in play here. Heavily.

That being said, US needs at least 50%-100% increase in the number of physicians, so any decrease is very bad news.

McHrozni

Where are you pulling that number from?

thaiboxerken

17th March 2010, 03:56 AM

Where are you pulling that number from?

From a place, I suspect, that the numbers had to be wiped off before he posted them in here.

Dancing David

17th March 2010, 04:08 AM

This has been about doctors in general. I remember hearing yesterday on the radio how pissed a cardiologist was that he might have to earn less than the 400k he was pulling down a year, due to cuts in medicare payment.

He can quit and feel what it is like earning 50k a year.

Or 24K, :)

Dancing David

17th March 2010, 04:11 AM

Next you'll want me to prove that OPEC keeps supply low to make more money... :rolleyes:

Um evidence for a cartel that says it is a cartel and acts as a cartel does not mean you have demonstrated the same is true of the AMA.

joobz

17th March 2010, 06:03 AM

Actually,
I think I need to side with Wildcat on this one. looking deeper into the issue, it's clear that the AMA has actively sought to limit the number of doctors produced as a means of salary controls.
http://www.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm

For the past quarter-century, the American Medical Association and other industry groups have predicted a glut of doctors and worked to limit the number of new physicians. In 1994, the Journal of the American Medical Association predicted a surplus of 165,000 doctors by 2000.

"It didn't happen," says Harvard University medical professor David Blumenthal, author of a New England Journal of Medicinearticle on the doctor supply. "Physicians aren't driving taxis. In fact, we're all gainfully employed, earning good incomes, and new physicians are getting two, three or four job offers."

I've just lost a lot of respect for the profession.

Neally

17th March 2010, 08:11 AM

Actually, there are at least three possible reasons for a doctor to threaten quitting:

1.) Are afraid the new system will result in a slower increase in salary or a reduction in salary
2.) Fear the new system would be too bureaucratic to deal with.
3.) Ideological hatred of all things smelling like socialism.

But all of these are rather non-issues for the following respective reasons
1. There is no legislation being discussed which limits salaries
2. Doctors already have to deal with multiple levels of bureaucracy thanks to multiple insurance systems, variable fee schedules, and hospital policies about handling of uninsured patients. I do not see how this will be any different, and could very likely remove a major bureaucratic obstacle in hospital care, insuring that coverage is met.
3. The Tinfoil hat community will welcome them into the fold.

From the article:
"Skeptics may suspect that physicians exaggerate their intent to leave medicine due to health reform. Some experts point to the malpractice crisis of years ago, when many doctors also expressed a desire to leave medicine. Some did quit; many did not. However, health reform could be the proverbial “last straw” for physicians who are already demoralized, overloaded, and discouraged by multiple issues, combining to form the perfect storm of high malpractice insurance costs, decreasing reimbursements, increasing student loan debt, and more."

ponderingturtle

17th March 2010, 08:32 AM

From the article:
"Skeptics may suspect that physicians exaggerate their intent to leave medicine due to health reform. Some experts point to the malpractice crisis of years ago, when many doctors also expressed a desire to leave medicine. Some did quit; many did not. However, health reform could be the proverbial “last straw” for physicians who are already demoralized, overloaded, and discouraged by multiple issues, combining to form the perfect storm of high malpractice insurance costs, decreasing reimbursements, increasing student loan debt, and more."

Yea, $150,000 is a crushing debt when you only earn $400,000 a year.

daenku32

17th March 2010, 08:41 AM

Actually,
I think I need to side with Wildcat on this one. looking deeper into the issue, it's clear that the AMA has actively sought to limit the number of doctors produced as a means of salary controls.
http://www.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm

I've just lost a lot of respect for the profession.

Here is the current line from the article:
Even the American Medical Association (AMA), the influential lobbying group for physicians, has abandoned its long-standing position that an "oversupply exists or is immediately expected."

But this is really besides the point, because AMA doesn't actually control the number. Their power is mostly as advisory. And only 15% of doctors are members of the AMA (wiki).

Going back to the USAToday article about the real limits for having more doctors, you are looking at Government Subsidies. The lack of them is creating the shortage. Which is quite frankly a direct result of people not wanting to "throw money at the problem".

JoeTheJuggler

17th March 2010, 08:48 AM

The medical profession is controlled by a guild. To call it a tin foil conspiracy theory when someone refers to one of the purposes of a guild as limiting competition is roughly the same as calling it tin foil hat territory if someone says that one of the purposes of a union is to get higher wages.

Again, even if this conspiracy theory is true (and the AMA is conspiring with Congress to limit the number of MDs), this has nothing to do with "Obamacare", right?

The argument Neally is citing is that something about the proposed healthcare reform is going to cause doctors to quit the profession in droves.

JoeTheJuggler

17th March 2010, 08:50 AM

Here is the current line from the article:
Even the American Medical Association (AMA), the influential lobbying group for physicians, has abandoned its long-standing position that an "oversupply exists or is immediately expected."

If that's all the AMA conspiracy is based on, it sounds rather like the reverse of the Yogi Berra line: "Nobody goes there anymore; it's too crowded."

And again, that's not the argument this thread is really about anyway, since it has nothing to do with the current health insurance reform proposals.

Schrodinger's Cat

17th March 2010, 08:53 AM

First off, this statistic is contradicted by the fact that both the AMA and the new England Journal of Medicine states that 70% of health care providers are in favor of health care reform.

I work at one of the top hospitals in the world, in Boston. There are several other hospitals which are among the top hospitals in the world which are in boston as well, as we are a huge medical hub. Every top hospital in the city has been lobbying for health care reform for over a decade.

So yeah, maybe your stupid, barely passed medical school yokel doctors who got their MDs at a degree factory who don't know what they're talking about are against health care reform.

I think I'll stick with what the top hospitals and doctors in the country think, thanks.

**oh, also the fact that I've been working in hospital finance and think private health insurance companies are just simply the most evil institution on the planet. My concern isn't really with a public option, but it IS with healthcare reform and regulating the industry. Maybe if your job was listening to crying mothers on the phone who have paid thousands of dollars in health insurance premiums over the years who now is seeing their 7 year old getting denied cancer treatment as not medically necessary by Blue Cross Blue Shield, you'd understand.

further edit: **although, I have to say that I have little faith that our government is going to reform in a way that actually is relevent to the industry. Considering that the people who seem to have the loudest voice on health care reform are tea party members who have no experience in health care, while actual physicians and hospitals are hardly included in the debate at all, I have little faith. So I should say that I am in favor of reform which will actually regulate the industry in a way to protect health care providers and patients from the frankly evilness which is private insurance, not necessarily whatever reform is going to come out of this health care "debate." As for the public option...I like it in theory, but I can admit to myself that I just don't know enough about economics to know whether it is plausable to implement effectively, so on that I have little opinion.

willhaven

17th March 2010, 09:01 AM

Here's the survey: http://www.nejmjobs.org/rpt/physician-survey-health-reform-impact.aspx

Key Findings from The Medicus Firm Survey

Physician Support of Health Reform in General
• 62.7% of physicians feel that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation.
• 28.7% of physicians are in favor of a public option.
• 3.6% of physicians prefer the “status quo” and feel that the U.S. health care system is best “as is.

Health Reform and Primary Care Physicians
• 46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.

Health Reform, Public Option, and Practice Revenue/Physician Income
• 41% of physicians feel that income and practice revenue will “decline or worsen dramatically” with a public option.
• 30% feel income will “decline or worsen somewhat” with a public option.
• 9% feel income will “improve somewhat” with a public option, and 0.8% feel income will “improve dramatically” with a public option.

Health Reform, Public Option, and Physician Supply
• 72% of physicians feel that a public option would have a negative impact on physician supply, with 45% feeling it will “decline or worsen dramatically” and 27% predicting it will “decline or worsen somewhat.
• 24% of physicians think they will try to retire early if a public option is implemented.
• 21% of physicians would try to leave medicine if a public option is implemented, even if not near retirement age at the time.

Health Reform and Recommending Medicine to Others as a Career
• 36% of physicians would not recommend medicine as a career, regardless of health reform.
• 27% would recommend medicine as a career but not if health reform passes.
• 25% of physicians would recommend medicine as a career regardless of health reform.
• 12% would not recommend medicine as a career now but feel that they would recommend it as a career if health reform passes

Ready for rationing?

A total of 1,195 physicians from various specialties and career levels in locations nationally were surveyed. Nearly one-third of physicians responding to the survey indicated that they will want to leave medical practice after health reform is implemented.

This combined with the expected increase in demand could result in 50% reduction in available physicians.

http://www.nejmjobs.org/rpt/health-reform-may-reduce-physician-workforce.aspxSo 46.3% feel like they'd be forced out or would want to quit. That doesn't make it a reality. Change to a longstanding system won't be welcomed with open arms, but the proof is in the pudding and this is a survey not a study of what will actually happen.

If there is increased demand, there will be doctors there ready to fulfill that demand. If we look at Switzerland, they've got no public option and they've got an individual mandate to buy private insurance. Their system is cheaper than ours and ranks more highly according to the WHO. I'm not aware of a mass exodus of doctors in 1994 when they adopted their new system. I'm also not aware of health rationing in Switzerland.

17th March 2010, 09:07 AM

Here's the survey: http://www.nejmjobs.org/rpt/physician-survey-health-reform-impact.aspx

So 46.3% feel like they'd be forced out or would want to quit. That doesn't make it a reality. Change to a longstanding system won't be welcomed with open arms, but the proof is in the pudding and this is a survey not a study of what will actually happen.

If there is increased demand, there will be doctors there ready to fulfill that demand. If we look at Switzerland, they've got no public option and they've got an individual mandate to buy private insurance. Their system is cheaper than ours and ranks more highly according to the WHO. I'm not aware of a mass exodus of doctors in 1994 when they adopted their new system. I'm also not aware of health rationing in Switzerland.

since the 80's the number of doctors / 1000 people is growing.

http://www.obsandaten.ch/indikatoren/5_1_1/2006/d/511.pdf

Neally

18th March 2010, 08:22 AM

Here's the survey: http://www.nejmjobs.org/rpt/physician-survey-health-reform-impact.aspx

So 46.3% feel like they'd be forced out or would want to quit. That doesn't make it a reality. Change to a longstanding system won't be welcomed with open arms, but the proof is in the pudding and this is a survey not a study of what will actually happen.

Thanks for the link. We will see what happens, and while no doubt saying and doing may not match, as mentioned in the original article, even if a fraction actually follow through in quitting, or retiring early, it could in fact cause wait times to increase.

Interestingly, there was no mention of funding of the survey by Murdoch or anyone else. Seems like a straight forward email survey. Ah well, conspiracy nuts are hard to crack.

GreyICE

18th March 2010, 08:27 AM

I see you ignored the second half of my post that you quoted. You are jumping to the conclusion that because I don't entirely accept your argument then I must necessarily accept the argument you are arguing against. Not true. I accept neither that the poll was DEFINITELY done with good methodology (Neally's argument) or that it was DEFINITELY done with poor methodology (Your argument). I accept neither argument until more evidence is brought forth for either side. You are both presupposing and that is what I am arguing against.

Furthermore, you are making an ad homenim argument against a study possibly done by an organization that is probably untrustworthy. You are saying that since the organization performed the study, it is therefore useless.
Reading comprehension fail. The fact that the study isn't findable, verifiable, or in any way testable makes it worthless. If the study is done well, it's worth something.

This is also an example of Murdoch's dishonest flavor of 'journalism,' but it's the fundamental flaw of the study not, well existing in any verifiable form that makes it useless.

GreyICE

18th March 2010, 08:28 AM

Neally, 1 sentence this time: where's the original study (third time I'm asking, too)?

Neally, take 4. I see you keep speculating with this study that you can't seem to find.

McHrozni

18th March 2010, 09:06 AM

Where are you pulling that number from?

It's my estimate, but it's founded in fact.
USA has 2.3 physicians per 1,000 people. France, Germany and Switzerland for example have about 3.5.
http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people

Considering how much the US doctors are paid, I find it very improbable that increasing their number wouldn't drive down their paychecks, which could easily reduce the overall medical costs in the US, seeing as the proportion of medical costs going towards their pays is over twice to that in, say, France and Germany. This would obviously take time, possibly as much as a generation. But the current health system in the US is suffering from major problems in part because the doctors are so expensive. Fixing that should be a priority, but expecting people to work the same for less isn't going to work, so the only other approach may be to force them to work less for less, because of increased competition and the resulting shared workload.

Even if you disagree with that, I'm sure we can agree that reducing their number further wouldn't be beneficial at all.

McHrozni

joobz

18th March 2010, 09:16 AM

The current health care system is specialist driven.

A Family practice physician can expect a salary of 135k/year (with 3+ years experience).
The next lowest grade is Podiatry, which gets paid ~40k more/year.
It goes up from there.
There's a disincentive to be a primary care physician and those are what we generally need most of.

Rolfe

18th March 2010, 10:39 AM

I don't know anything about the medical system in the USA, but I do know that in Britain the RCVS limits the number of places in veterinary schools to try to avoid over-supply. They have been known to get it terribly wrong though, but fortunately their advice to contract significantly in the mid-1980s wasn't followed. The main reason is that these university places are heavily subsidised, and the country doresn't want to subsidise training of personnel it doesn't need.

This has all gone a bit weird since we were obliged to accept any vet with a European degree to work in Britain, and some European countries definitely do have an over-supply. But somehow we survive, and I've made some lovely Spanish and Portuguese friends. (They report excellent universal healthcare in their home countries by the way.)

Recently one university opened a new veterinary school, because it was clear the influx of foreign graduates meant that we were under-supplying - even though the six existing schools have all markedly incrased the numbers graduating. That new school should be producing its first graduates this year, when it will have to pass the RCVS accreditation in order for the degree to be recognised. That's how standards are kept up.

Over and above all that though, all the schools can take extra students paying full fees, over and above their quotas, if they have the facilities for them. Most of these are foreign students, and some of these are funded by their home countries.

I have a feeling the medical schools have a somewhat similar system, with the NHS having a fairly big say in how many new graduates it thinks it's going to need. It's not at all unusual, and it's not at all unlikely that a similar quota system exists in the USA for medical schools. You don't want to subsidise more trainees than you need (if you are subsidising them), and you don't want to take high fees from students for a long and arduous course if there's not going to be work for them when they finish.

Rolfe.

Dancing David

18th March 2010, 10:39 AM

http://www.themedicusfirm.com/pages/survey

Specialists (all other) 65.7%

Rolfe

18th March 2010, 10:43 AM

Maybe if your job was listening to crying mothers on the phone who have paid thousands of dollars in health insurance premiums over the years who now is seeing their 7 year old getting denied cancer treatment as not medically necessary by Blue Cross Blue Shield, you'd understand.

Please tell me that doesn't really happen!

I mean, you're the people that keep telling us you don't want universal healthcare because you don't want "some bureaucrat" standing between you and your doctor! What's THAT, if it isn't "some bureaucrat standing between you and your doctor"?

Hint. Nobody but my doctor decides what treatment is medically necessary for me, under the NHS.

Rolfe.

joobz

18th March 2010, 11:34 AM

Please tell me that doesn't really happen!

I mean, you're the people that keep telling us you don't want universal healthcare because you don't want "some bureaucrat" standing between you and your doctor! What's THAT, if it isn't "some bureaucrat standing between you and your doctor"?

Hint. Nobody but my doctor decides what treatment is medically necessary for me, under the NHS.

Rolfe.

Oh, it's goofier than that.

Depending on who your insurance is with will dictate what medications get covered. If you have allergies, the insurance company may claim that allegra, singulaire, clarinex, Nasonex... are all equivalents and therefore only cover the generic allegra. All others you will have to pay for. In this case, if you are a patient who only responds to Nasonex, your insurance will not cover it.

These coverage agreements are decided between the insurance company, pharmaceutical supplier and pharmaceutical company. Your doctor has zero say in it.

In other words, doctors are forced to play drug matchmaker and determine which medications are covered by the plan and then prescribe that one. It doesn't matter if that is the one the doctor thinks is best.

ponderingturtle

18th March 2010, 11:37 AM

Delscottio

18th March 2010, 11:56 AM

Oh, it's goofier than that.

Depending on who your insurance is with will dictate what medications get covered. If you have allergies, the insurance company may claim that allegra, singulaire, clarinex, Nasonex... are all equivalents and therefore only cover the generic allegra. All others you will have to pay for. In this case, if you are a patient who only responds to Nasonex, your insurance will not cover it.

These coverage agreements are decided between the insurance company, pharmaceutical supplier and pharmaceutical company. Your doctor has zero say in it.

In other words, doctors are forced to play drug matchmaker and determine which medications are covered by the plan and then prescribe that one. It doesn't matter if that is the one the doctor thinks is best.

Is this a common thing? Are the patients aware of what the doctor is doing? It seems utterly bizarre on so many levels.

joobz

18th March 2010, 12:02 PM

Is this a common thing? Are the patients aware of what the doctor is doing? It seems utterly bizarre on so many levels.
Yes. Often times, they'll get patient input. Using the allergy example, the doctor will try the different meds to see which ones work with the patient.
they'll start at generics covered by the insurance company, then go to namebrands covered by insurance, then go to name brands not covered by insurance.

The True Scotsman

18th March 2010, 12:38 PM

Reading comprehension fail. The fact that the study isn't findable, verifiable, or in any way testable makes it worthless. If the study is done well, it's worth something.

Cool. I agree. (except for the first 3 words)

This is also an example of Murdoch's dishonest flavor of 'journalism,' but it's the fundamental flaw of the study not, well existing in any verifiable form that makes it useless.

Here comes my issue. You are assuming that it was done dishonestly, rather than simply with unintentionally poor methodology.

Debaser

18th March 2010, 03:27 PM

28.7% of physicians are in favo(u)r of a public option.

Wow!...Between a quarter and a third of your doctors are dirty, filthy Commies? How can you let them touch you...especially there :eek:

Must be that damnable Hippocratic Oath and vowing to help anyone in need of aid. You'll want to get rid of that, quick smart.

GreyICE

19th March 2010, 02:11 PM

Cool. I agree. (except for the first 3 words)

Here comes my issue. You are assuming that it was done dishonestly, rather than simply with unintentionally poor methodology.

Here's the thing. If someone unintentionally screws up, they tend to publish the results, get roundly kicked in the crotch, and drop it.

It's the fact that they're keeping it secret that leads me to call it dishonest. If your hypothesis is the study is unintentionally flawed, why would they keep it secret? Once again we're left hypothesizing strange things (the group does the study, decides to keep it secret because they think the results are private, then... publish a summary of the results...).

At every step, for this to be an innocent coincidence, the very strangest series of things must have happened.

The True Scotsman

19th March 2010, 03:36 PM

Here's the thing. If someone unintentionally screws up, they tend to publish the results, get roundly kicked in the crotch, and drop it.

It's the fact that they're keeping it secret that leads me to call it dishonest. If your hypothesis is the study is unintentionally flawed, why would they keep it secret? Once again we're left hypothesizing strange things (the group does the study, decides to keep it secret because they think the results are private, then... publish a summary of the results...).

At every step, for this to be an innocent coincidence, the very strangest series of things must have happened.

I believe this may be useful to the discussion, though may change the direction of our discussion.

http://www.themedicusfirm.com/pages/survey

The above link is a showing of the poll's methodology which was linked from the original article.

JoeTheJuggler

19th March 2010, 04:59 PM

I believe this may be useful to the discussion, though may change the direction of our discussion.

http://www.themedicusfirm.com/pages/survey

The above link is a showing of the poll's methodology which was linked from the original article.

It was an on-line survey. (They sent out the survey via e-mail.)

It says they used their own database of MDs, but doesn't mention at all how that database was compiled.

I wouldn't put much stock in it.

ETA: And beyond that, there's nothing in the survey that says what the net change in MDs might be. That is, some the 22% who replied that they would take early retirement, for example, might already have been planning to take early retirement, and nowhere does the survey address how many new doctors would be entering the field (to calculate what the net change might be).

Rolfe

19th March 2010, 05:11 PM

Look at the businessmen who said they'd leave the country if Scotland got a devolved parliament.

Still here.

Rolfe.

GreyICE

19th March 2010, 11:01 PM

I believe this may be useful to the discussion, though may change the direction of our discussion.

http://www.themedicusfirm.com/pages/survey

The above link is a showing of the poll's methodology which was linked from the original article.

This really fails to meet the criteria of 'enough information.' The following points represent things you need to know to know if you're looking at an accurate poll (and things that Gallup, Pew, etc. regularly publish and account for).

What percentage of US physicians does their database represent? It's clearly a nonrandom sample, but if its a nonrandom, small sample, that's its own pile of bias.
What were the opinions of the (nearly half) of all physicians who did not respond? What steps did they take to estimate and normalize for this?
When they say the survey is not targeted at any demographic, they lie (their demographic is people in the Medicus database, obviously. More specifically, it's the people in the database who responded to their query. As they should know). What does does this demographic look like, versus the general population of physicians?
As a followup, was this normalized by comparing the results of the non-political questions to the general population, and doing a demographic adjustment?
What other questions were asked to determine the demographic of people versus their responses? Was it primarily physicians with large amounts of experience who thought it would be negative, or inexperienced students (10% of respondents had never practiced medicine)

As you can see, I rightly dismissed this nonsense as completely insufficient and useless. Linking to it again doesn't make it less nonsensical.

Travis

20th March 2010, 12:47 AM

I seriously question the sanity of any doctor who looks at something that will bring in more patients (and thus more income) and just says, "to heck with that! I quit!"

I think it's safe to say that we would be better off without such people.

McHrozni

20th March 2010, 03:24 AM

I seriously question the sanity of any doctor who looks at something that will bring in more patients (and thus more income) and just says, "to heck with that! I quit!"

Well, there is a quite real possibility that the said doctor can't spend all the money he makes now, and is overworked to the point where he just can't take any more work. Evidence for that is mostly anecdotal, but I'm quite certain there are a few such doctors in the US.

The more you push somebody the more will you have to pay him. That much is clear, but at a certain point you'll need to increase his wage by proportionally greater amount that the amount of work you'll get from him. That's where you better hire somebody else so share that workload. If the US doctor paychecks are any indication, the US is way past that point already.

McHrozni

Dancing David

20th March 2010, 06:02 AM

I think the question of the Medicus data base is very relevant, as is the skew in the survey (of any sort)

http://www.themedicusfirm.com/pages/survey

Specialists (all other) 65.7%

Neally

20th March 2010, 07:05 AM

Reading comprehension fail. The fact that the study isn't findable, verifiable, or in any way testable makes it worthless. If the study is done well, it's worth something.

This is also an example of Murdoch's dishonest flavor of 'journalism,' but it's the fundamental flaw of the study not, well existing in any verifiable form that makes it useless.Typical truther argumentation tactics. First you claimed they were lying, then it was funded by Murdoch, on and on. Just like when when you provide an answer to a truther, then they say, but what about this, what about that...

We all see that you are desperate to discount the results and no amount of information will change that.

Architect

20th March 2010, 07:44 AM

And yet, strangely, you ignored the times where it was pointed out that in other UHC systems there didn't seem to be issues around doctor retention/recruitment.

GreyICE

20th March 2010, 08:07 AM

Typical truther argumentation tactics. First you claimed they were lying, then it was funded by Murdoch, on and on. Just like when when you provide an answer to a truther, then they say, but what about this, what about that...

We all see that you are desperate to discount the results and no amount of information will change that.
Well since you're still reading the thread, try five!
Neally, 1 sentence this time: where's the original study?

JoeTheJuggler

20th March 2010, 08:25 AM

Look at the businessmen who said they'd leave the country if Scotland got a devolved parliament.

Good point. The survey isn't a measure of doctors who will leave the profession if the healthcare bill passes; it's a measure of doctors who say they will leave.

Another way of looking at it is that these responses to the question are more a measure of who strongly the doctors from their database (that we still don't know how was compiled--and the skew Dancing David pointed out) who responded to their e-mail like or dislike a given proposal.

And again, some of the doctors who replied that they'll retire early if this passes might have already been planning to retire early.

And it's certainly not logical to say how many fewer doctors there might be overall since we have no idea of how many new doctors there will be. The claim made in the thread title is analogous to noting that some Americans emigrate to other countries and based on that figure alone claiming that the U.S. population is shrinking by the percentage that emigration represents.

Upchurch

22nd March 2010, 06:12 AM

Have 1/3 of doctors quit yet?

Neally

22nd March 2010, 07:41 AM

Have 1/3 of doctors quit yet?
Has the bill been implemented yet?

willhaven

22nd March 2010, 07:59 AM

When does Rush Limbaugh move to Costa Rica?

GreyICE

22nd March 2010, 08:05 AM

Has the bill been implemented yet?

Where's the original study, try 6? Does it not exist?

Upchurch

22nd March 2010, 08:21 AM

Has the bill been implemented yet?

Oh, okay. I'll check back later.

Incidentally, while we're waiting, will there be a point where we can declare the bill "implemented" and take a head count of doctors, or will there always be some obscure clause to point to where you could say "Well they didn't do X so the bill isn't fully implemented yet"?

Beerina

24th March 2010, 08:15 PM

Darat

25th March 2010, 01:27 AM

I don't understand. Why would they want to leave? People around here swore there was no direct legislation controlling profits, and that would include salaries.

Darat, you are a big proponent. Tell him there's nothing that's stopping free doctors from continuing to freely ply their trade.

Big proponent of what - "universal health care"?

Upchurch

25th March 2010, 04:38 AM

So, any count on how many doctors have quit so far?

thaiboxerken

25th March 2010, 07:18 AM

Rush Limbaugh has backed out of his promise to move to Costa Rica, saying that what he meant was that he'd go to Costa Rica for his health care.

Which is a silly thing.

Upchurch

25th March 2010, 07:33 AM

Rush Limbaugh has backed out of his promise to move to Costa Rica, saying that what he meant was that he'd go to Costa Rica for his health care.

...because they have universal health care?

thaiboxerken

25th March 2010, 07:42 AM

That's why I said it's silly.

willhaven

25th March 2010, 08:29 AM

So, any count on how many doctors have quit so far?Considering that the poll was conducted assuming a public option was in the bill, I figure zero doctors have quit so far.

Those poor doctors and insurance companies. Why won't anybody think of them?! :cry:

Neally

25th March 2010, 09:11 AM

Where's the original study, try 6? Does it not exist?All the details available as to the methodology and results has been linked to. Kill the messenger since you don't like the message. Demand another study like the truthers. Whatever.

Incidentally, while we're waiting, will there be a point where we can declare the bill "implemented" and take a head count of doctors, or will there always be some obscure clause to point to where you could say "Well they didn't do X so the bill isn't fully implemented yet"?It gets incrementally implemented over 10 years. Check back in 2020 and see how your wait times are doing compared to today. If the MD's stick to their responses, it will be longer.

joobz

25th March 2010, 10:24 AM

It gets incrementally implemented over 10 years. Check back in 2020 and see how your wait times are doing compared to today. If the MD's stick to their responses, it will be longer.
And of course, in 2020, if wait lines don't increase (wait times already exist for some), and health care is affordable, can I expect your apology?

Upchurch

25th March 2010, 11:15 AM

Actually, when you put it that way, I wouldn't be overly surprised if a decent number of those currently employed doctors did retire over the next decade.

Lame.

joobz

25th March 2010, 11:22 AM

Actually, when you put it that way, I wouldn't be overly surprised if a decent number of those currently employed doctors did retire over the next decade.

Lame.
Like I said on page 1:
I can see some of the doctor's who are close to retirement leaving earlier and making a big show of it as protest. Unless, of course, their retirement portfolio was a bit too heavy in real estate over the past couple years.

Upchurch

25th March 2010, 11:24 AM

Like I said on page 1:

Yeah, but you extend that from a couple of years to a decade, that possibility goes way up.

joobz

25th March 2010, 11:26 AM

Yeah, but you extend that from a couple of years to a decade, that possibility goes way up.

exactly. The funny thing is, they would be replaced by new doctors already accustomed to the changes in the healthcare system. So, it's still a net gain.

Leif Roar

25th March 2010, 11:26 AM

Yeah, but you extend that from a couple of years to a decade, that possibility goes way up.

The average career of a doctor is what? Forty, forty-five years? Out of a random selection of doctors, you'd expect 20+% of them to see the (natural) end of their career in the next decade.

Upchurch

25th March 2010, 11:36 AM

The average career of a doctor is what? Forty, forty-five years? Out of a random selection of doctors, you'd expect 20+% of them to see the (natural) end of their career in the next decade.

I have no data to support this, but isn't the medical community skewed older? Aren't we having trouble getting young people to go into medicine?

I can't find anything with a quick Google search.

ponderingturtle

25th March 2010, 11:39 AM

I have no data to support this, but isn't the medical community skewed older? Aren't we having trouble getting young people to go into medicine?

I can't find anything with a quick Google search.

The only area I have heard there are problems getting people are in primary care. And there are issues that need to be resolved around primary care vs specialists.

Upchurch

25th March 2010, 11:43 AM

The only area I have heard there are problems getting people are in primary care. And there are issues that need to be resolved around primary care vs specialists.

May be. I'm pulling this from the corners of my memory and may not be true. Since I can't support it, forget I mentioned it.

Leif Roar

25th March 2010, 11:49 AM

May be. I'm pulling this from the corners of my memory and may not be true. Since I can't support it, forget I mentioned it.

I found this document (http://www.health.state.mn.us/divs/orhpc/pubs/workforce/phys08.pdf), about physicians in Minnesota (so, rather limited, and I don't know how well it would translate to nationwide) It claims that "Overall, 19 percent of physicians active in 2008 said they expected to stop practicing within five years. More than 40 percent expect to leave the profession within 10 years."

Neally

25th March 2010, 11:55 AM

And of course, in 2020, if wait lines don't increase (wait times already exist for some), and health care is affordable, can I expect your apology?Apologize for what? I linked a survey showing a certain % of MDs would quit practicing if Obamacare passed. If they did what they said, there would be a shortage and longer wait times. If they don't, then they either lied or changed their mind.

Actually, when you put it that way, I wouldn't be overly surprised if a decent number of those currently employed doctors did retire over the next decade. Lame.
Yes, MD's are retiring all the time. Asking for a count as to how many have followed through 2 days after it was signed is what's lame. The survey didn't drill down to determine of the ones that said they would leave, exactly when they would leave and they probably wouldn't have any concrete idea on a time line anyway. Even those that were seriously committed to leaving wouldn't lock the door the next day and walk. They'd likely take several months to transition out.

It will take many years to see how the bill and future tweaks to it affect health care.

joobz

25th March 2010, 12:11 PM

Apologize for what?
For being stupidly wrong.

GreyICE

25th March 2010, 12:12 PM

All the details available as to the methodology and results has been linked to. Kill the messenger since you don't like the message. Demand another study like the truthers. Whatever.

The methodology is bullcrap, for the reasons I have outlined. Keep comparing me to the truthers, but there is a difference between being skeptical when:

You have multiple studies, footage, and evidence reviewed by hundreds or thousands of individuals
You have one set of really unusual results with crappy methodology, no explanation of anything, and no paper or supporting evidence

You would have me believe the UFOites because "look, they have one picture! And an anecdote! Picture AND Anecdote! Isn't that enough evidence, unless you're a truther or something?"

Yeah. So sayeth you.

It gets incrementally implemented over 10 years. Check back in 2020 and see how your wait times are doing compared to today. If the MD's stick to their responses, it will be longer.
Oh, so we can't fact check your crappy study for a decade? :rolleyes:

You have no link to the paper, no link to the methodology, no link to the specific adjustments, no link to how their survey population compares to the general population, no link to how they adjusted for nonrespondants (which was high), and absolutely no supporting evidence for any claim you have made here.

In short, you can spew insults and tell lies, but you cannot support them with facts and logic. As you would say, like a truther.

Upchurch

25th March 2010, 12:19 PM

Yes, MD's are retiring all the time. ...The survey didn't drill down to determine of the ones that said they would leave, exactly when they would leave and they probably wouldn't have any concrete idea on a time line anyway. Even those that were seriously committed to leaving wouldn't lock the door the next day and walk. They'd likely take several months to transition out.
So, the claim that "Obamacare Means 1/3 Fewer MDs" is both unsupported and un-provable. It's basically useless.

Asking for a count as to how many have followed through 2 days after it was signed is what's lame.
I was making a point.

Neally

25th March 2010, 05:13 PM

So, the claim that "Obamacare Means 1/3 Fewer MDs" is both unsupported and un-provable. It's basically useless.
Time will tell.
I was making a point.That being?

joobz

25th March 2010, 06:01 PM

Time will tell.
That being?

that you were...
being stupidly wrong.

Leif Roar

25th March 2010, 08:00 PM

Time will tell.

Uh, no. That's the point. Time won't tell, because the assertion can't be tested.

JoeTheJuggler

25th March 2010, 09:40 PM

Uh, no. That's the point. Time won't tell, because the assertion can't be tested.

Exactly. Not unless you can make a copy of the universe and try going the next ten years with "Obamacare" in one and without in the other, ceteris paribus, and then compare the number of MDs in the U.S. in each one.

Upchurch

26th March 2010, 04:40 AM

Exactly. Not unless you can make a copy of the universe and try going the next ten years with "Obamacare" in one and without in the other, ceteris paribus, and then compare the number of MDs in the U.S. in each one.

Alternatively, unless the number of MDs had dropped by 1/3 almost immediately after the bill had been passed (or at a specific point when it is "implemented"), there is no way to pinpoint the cause to this bill. There are too many other factors in a prolonged period of time to make that determination.

This is claim is just unsupportable fear mongering.

Neally

26th March 2010, 09:00 AM

Alternatively, unless the number of MDs had dropped by 1/3 almost immediately after the bill had been passed (or at a specific point when it is "implemented"), there is no way to pinpoint the cause to this bill. There are too many other factors in a prolonged period of time to make that determination.

This is claim is just unsupportable fear mongering.So in 5 or 10 years, if the number of MDs has dropped substantially, and polling the physicians that have quit practicing as to why they left, results in a substantial number saying it was due to Obamacare, that wouldn't pinpoint the cause to this bill?

Leif Roar

26th March 2010, 10:17 AM

So in 5 or 10 years, if the number of MDs has dropped substantially, and polling the physicians that have quit practicing as to why they left, results in a substantial number saying it was due to Obamacare, that wouldn't pinpoint the cause to this bill?

Well, not trivially, no. Ten years is too long after the fact (if you waited eight years before you quit "over Obamacare", it can hardly be said to have been the decisive factor,) but five might be workable. Still, you will have to account for the expected number of MDs to have quit over that period, check against the number of new MDs that have entered the field during the same period and you have to evaluate how accurate the MDs are in their self-appraisal of their reasons of quitting. People tend to overstate things like this. (A doctor who was 70 when the bill was passed and quit three years later ... well -- do we count him or do we not? Sure, he might have disliked the new system, but how much of his decision came down to age?)

willhaven

26th March 2010, 11:22 AM

Apologize for what? I linked a survey showing a certain % of MDs would quit practicing if Obamacare passed. If they did what they said, there would be a shortage and longer wait times. If they don't, then they either lied or changed their mind.The survey was presuming the passage of a public option... which is not in the law.

We can guess as to whether there will be more or fewer MDs in 5 years. We can guess whether there will be a shortage of MDs in 5 years. What we can't do is see if these numbers end up being accurate, because a major factor in arriving at those numbers in the survey (the public option) is not in the law.