correct all three... money, physical space and sufficient MD trainers...it's a daunting problem and it keeps coming back to money...
and as we discovered here after the initial resistance from MDs claiming they would all leave(they didn't) they discovered it worked and the MDs are still well paid....and now we have more applicants to become MDs than we have room for...
Pay them like they spent twelve years working their asses off, incurring debt, deferring income, giving up nights, weekends and holidays, continue to put in 60 hour work weeks and get out of bed at 3:00 am to save your life
Yes, but in the long-term isn't it an investment, an investment in human capital that will end up lowering prices decades from now? We often hear about public "investment in education", which is mostly a bunch of crap, but here's a situation where it may actually have some validity. Instead of wasting public money on handing out a bunch of useless degrees, divert it towards creating more positions in teaching hospitals.
If you want to make it less arduous we're going to have to talk about changes that would make it easier for them to go through the process, at every stage. I don't believe everything they have to go through right now is an inherently necessary thing. For example, because these teaching hospitals basically hold a monopoly, since there aren't enough slots, they can force new trainees to work very long hours for little pay. Imagine going through 8 years of school, then working insanely long hours and essentially being paid minimum wage for the next 3 or 4 years. Well of course they're going to demand huge sums of money when they can finally go out on their own.
There's alot to learn in a short time, and much of it is experiential. Shorten the hours and you'll need to train for twice as many years
There might have to be some sacrifice in quality to lower prices. At some point in quality levels there is such a thing as diminishing returns, so we have to question whether the current high standards of quality are truly worth it. In any case I'd question how much they are truly learning with such long hours and being so exhausted all the time. They're probably not remembering half of it.
Only if it's your bad outcome, then it's really worth it. You have to do it so many times and under extreme duress, that you could do it in your sleep
Better to take some small risk with lower quality than not being able to afford a doctor at all. It depends exactly what the cost-benefit trade-off would be, of course. Something I can't truly answer because I'm not an expert and don't have all the data to put together a proper analysis. (Maybe this would be the type of thing for health economists to try to figure out)
Oh, just so everyone is aware, high doctor incomes are not the primary reason for high healthcare costs in America. They are only a small part of the equation. That doesn't mean the issue should not be considered as a factor, but there are many other big issues as well.
absolutely I agree 110%...a healthy population is also a more economically productive population...overcoming the divisive wedge issue politcal rhetoric is the immediate battle here's where you lose me...there are no useless degrees, their use may not be readily apparent to someone on the outside but there is value everywhere...