Are you sure you can find that many more doctors? That they'll be any good?

Speaking from Romania: here medicine is prestigious. So many parents push their kids towards medicine. There's a glut of newly minted doctors every year, but rumour has it that the quality drops every year. Sure, they pass the exams and residency and what not, but... They're just not into medicine as much.

Do you want to get treated by such a person?

This year I had to go to a neurologist. I went to one locally, they dismissed me in 5 minutes, told me to take some vitamins basically. Went to another one in a much bigger city, they talked to me for an hour, ordered a ton of tests.

Would it help if we get a lot more of the first kind of doctors?

I think one issue is that the admissions for medicine are getting harder and harder. In many places you practically need a 4.0.GPA, volunteer work, great mcat scores, research experience, sometimes a post grad degree like an MSc and PhD etc. This selects for highly competitive and intense personalities that are not always suited for every medicine specialty. Most of them don't want to go into family medicine and pediatrics because it's more work, less money, less prestige etc. The friends I had who wanted to go into family medicine couldn't because of the admission requirements. Their only alternative was to have family money to pay for medical school in places like Ireland.

Edit: I should have mentioned that pediatrics and family medicine represent a large proportion of available residency spots each year and are rarely full.

We already have a system for cheaper doctors.

It’s called physicians assistants and nurse practitioners. They are essentially exactly what’s you’re talking about. They make less and they have less training.

The American Medical Association would sooner let the whole thing burn than allow that to happen

> Their salaries need to be lower, training needs to be cheaper and faster, and we need a lot more of them.

The quality of the average physician is already so low I am not sure what you are hoping to accomplish with lower salaries and faster training.

Doctoring isn't a matter of more warm bodies

AI. We need AI, period.

At least as first line docs.

But what the author describes - fuck no, this is absolute unsustainable madness. Race to the bottom. I’d rather fix plumbing at my own pace.

> (speaking from US): The reality is we need more doctors. A lot more.

[Doctors only spend around 18% of their time with patients in the U.S.](https://pubmed.ncbi.nlm.nih.gov/40500897/) The rest is spent on administration. I respectfully contend that the bigger issue is not the number of doctors per patient (though I admit that it could be a contributing factors), but rather that successive bureaucracy and compliance and laws and insurance requirements and policies have resulted in a system which forces doctors away from patients and towards ass covering. Remove the bureaucracy and you instantly have 5x as many doctors, effectively. Add more doctors to the machine and the machine will only find more creative ways to waste their time and talents.

I'm not sure about the salaries. Vocation-motivated people are already doing it. The rest needs a good reason to put their entire life, quite literally, into one single purpose. It's one of those professions that requires a complete dedication of free time, youth, health, mind, etc.

Nah you just need to unfuck your insurance system. It’s fine in other places without watering down the quality of medical professionals.

I don't think Dr salaries are even that high a percent of healthcare spending. Although, maybe better work life balance, lower salary escalation and less debt would help everyone.

I am willing. I just need someone to fund med school for me. If you won't do that you can't be that desperate :)

> There's no solution other than training a lot, lot, lot, lot more doctors.

Seems like having doctors emigrate from other countries would work as well.

True, but the other side of that is a lot of primary care will be taken over by lower licensed PA/NP. We can't possibly train enough new physicians to meet the demand imposed by an aging population. It doesn't take a real doctor to deal with routine scrapes and sniffles.

Probably better solution is to upskill nurses + AI to do handle all the simpler tasks like prescribing standard treatments, etc. There's already a concept of mid-level practitioner which can be expanded.

There's basically no need for GP to be a doctor.

Why do you think you're going to get more doctors by paying less?

For a lot of specialties, we just don't have enough caseload to train doctors well enough. There is this meme that there's a cap on residency positions, which is the main limiter, but caseload is a significant limiter as well, especially for anything procedural or less knowledge-based.

Would you say that people also need to be more responsible to be healthy themselves? Reducing pressure on the system and freeing capacity. E.g. healthy lifestyle to reduce diabetes.

Agree - one sensible start would be to at least hybridize the European model where students are a whole lot closer to getting there medical degree as an undergraduate.

In brazil, we imported doctors from Cuba

"There's no solution other than training"

Not true.. according to most around here, it will be AI and robots all the way.

If you want more doctors you need to find out what’s holding people back to become doctors.

I have no idea what this might be.

there is another solution that will be (and is) actually happening: diffusion of doctor responsibilities to other less regulated/trained workers

sucks but that's incentives for ya

> The reality is we need more doctors. A lot more.

No, the reality is we should be more healthy, so we need less doctors.

> The reality is we need more doctors. A lot more.

I think building a better prevention layer is more important.

Don't get me wrong, I agree that we need more doctors (and nurses, and physios, and dietetists, and ...), but it is much easier to scale a good prevention system than the number of workers in healthcare.

The reality is we need a lot more than just more doctors.The entire system needs to be revamped.

General practitioners make something like 150k on average in the US. Specialists tend to make a lot more (upwards of double) and also tend to skew perceptions of doctors’ pay.

You could argue specialists should make less but considering how long it takes to become a doctor, how much work it takes to get there, how long you’re putting off real earning potential, school debt, etc., I do not consider 150k overpaid.

From a more practical angle, I don’t know how you could possibly find more doctors by lowering their earning potential.

> Their salaries need to be lower, training needs to be cheaper and faster, and we need a lot more of them.

We need to reduce the requirements to be a doctor. I think general ability is way way way more important than the specialisation. I don't think the speciality that doctors spend money and time on add that much value..

[flagged]

The author: "Doctors are caught in a web of business, no longer a noble vocation. The altruism of young doctors have been replaced by the shackles of efficiency, productivity and key performance indicators."

The answer: here's some key performance indicator we can improve.

Sigh.