Yesterday Jim McDermott introduced a bill aimed at making sure America has enough primary care doctors in the future. From his press release:
Modeled after the successful ROTC program, RDOCS offers full scholarships to medical students in exchange for a 5-year service commitment in a medically underserved area. RDOCS will be administered by the states, which will send RDOCS scholars to their state-operated medical schools. RDOCS officers (as they are known after graduation) will then become licensed and serve as primary-care doctors in their state of residence. The program is authorized to start immediately and begin graduating its first additional 4,000 new primary-care doctors in 2020, and 20,000 new doctors by 2024.
McDermott added, “Thanks to the Affordable Care Act, we are going to get close to universal health coverage in the United States. But universal coverage will not be meaningful if we don’t have enough doctors to serve our population. I am optimistic that Congress can demonstrate leadership in restoring our doctor workforce for the next generation.”
Fantastic. This is yet another way we’re going to have to make sure the Affordable Care Act works. We’re going to have to make sure there are enough doctors in the country. But, of course, the Republicans control the House of Representatives, so Joel Connelly isn’t sure about its ability to pass.
McDermott is a senior member of the tax-writing House Ways & Means Committee. When Democrats held a majority, he co-authored (with Republican Rep. Jerry Weller of Illinois) legislation that enacted a sweeping overhaul of foster care in America.
The fate of RDOCs, in a polarized House, is less certain. The House is spending less than one-third of 2012 in session.
Sure, that too. I don’t have anything like a whip count, but it seems like a worthy thing.
The nation might be able to do much more with nurse practitioners who today are allowed to practice independently in only 16 or so states. Removing the barriers and allowing more NP to establish independent practices would be a big help. Secondly the regulations that restrict direct entry midwives needs to be repealed so that mothers have a choice in birth attendants nationwide. In Europe midwives deliver 75% of infants. Thanks to regulations in the U.S. they deliver about 10%.
This will only see the light of day in the Republican controlled House if it includes mandatory training of these new docs in mandatory, unnecessary vaginal ultrasound exams.
@1
My experience is that NPs can be valuable adjuncts, particularly with people who are basically well, but they can very easily get out of their depth when dealing with patients with multiple interacting problems, like combined heart and kidney disease, heart and lung disease, or severe diabetes with multiple end-organ complications – problems that are growing in frequency as the populations ages, and gets more obese.
They are not a panacea, as much as ‘freeing’ them is appealing in a doctor-bashing kind of way.
WRT midwives, the same concerns apply. Most deliveries are uncomplicated, but there is a reason that birth-related mortality was reduced with medical intervention. I am reminded of an anecdote – a neighbor had both kids at home, very disdainful of doctors. The second kid had shoulder dystocia – an obstetric emergency that can result in both fetus and mother dead. The midwife’s response – she “gave herself permission to just pull harder” was exactly wrong and it’s a wonder there was not a horrid tragedy as a result. Just sayin’.
I’m looking forward to my future vascular surgery performed by former B+ student who got into some newly created doc-in-the-box medical school with lowered admissions requirements because we needed bodies in positions to meet the demand.
Eventually the pool will expand with competent people to meet demand.
Eventually.
Meanwhile, let’s all recall how the Tampa Bay Buccaneers did during their first two seasons as an expansion team. All those extra physicians hurried through the system will probably perform very similarly.
Hopenchange, baby.
“The House is spending less than one-third of 2012 in session.”
Are House GOPers trying to beat Chimp’s pre-9/11 vacation record?
@4 Explain how this program changes medical school entrance or academic requirements. Failure to do so will get you nominated for a Golden Goat Award.
@6
Yup. Thank you, RR.
re 4: Well, at least we won’t have to spend money invading Grenada again to save some American medical students from Ricky Ricardo.
It was really humorous to see conservatives ‘struttin’ their stuff’ following that idiotic little adventure.
re 4: Come to think of it, the Cubans could probably train all of our new doctors — and they’d learn Spanish in the process. It would make treating all of the illegal aliens for free much easier.
I can’t wait for Obama to get reelected so that we can just start giving away the store. I’ve been planning for this for a long time.
It’s in the blood.
re 4: Speaking of incompetents, how about all of those lawyers from Regis University that Bush put into the Federal system? And don’t forget all of the 22 year old fiery-eyed little Bushistas put into the foreign service by Bush (remember when ‘ideological purity’ was considered more important than brains and experience?
You have a lot of chutzpa (not a kosher dish) worrying about someone else’s competence.
@ 4 @ 6
Good question(s) and I should have been more clear. The program listed above shouldn’t have that affect.
However, if you look at the upcoming increase in those eligible for coverage and our current staffing, the only way to meet that increased demand is to either create a Canada-style waiting list for services or expand the pool of service providers, which current educational programs can’t meet. Do we:
1. Create new schools (with what money, with what faculty, and with what qualifications?)
2. Overburden current schools with additional students (the ones who wouldn’t be good enough to get in otherwise)
3. Bring in foreign graduates (same issue about questionable qualifications as with larger numbers of US-trained individuals)
I don’t think we can meet the need with our current staffing. The additional staffing has to come from somewhere and that likely will entail lowered standards.
If we’re going to cover another 30 million people, how many more medical staff will that require and where will they come from?
I suppose I could say we can make doctors work longer, but since Obama says we’re going to take away $716B from their compensation, making them work longer for less compensation isn’t going to fly. Of course, we could nationalize health care, couldn’t we?
(It’s not a bug, it’s a feature.)
We’ll get Regis University to start a medical school and the criteria for graduation will be loyalty to the Republican Party and Sweet Bleedin’ Jaysuz.
News to me that insurance companies performed vascular surgery..
I’ll be taking that former B+ student over a hack from United Health, Wellpoint, CIGNA, etc. thank you very much.
@4
One of biggest screwballs that I went to Jr. High with is now a doctor. A very good doctor. His dad died of a heart attack very young and all of the sudden he got very serious and very interested in medicine.
One of the biggest screwballs I went to high school with is now the head RN in a large ER. After high school she went up to Alaska & worked in canneries for a couple of years. After two or three years in the canneries she realized that if she didn’t change her ways that this would all she would ever do. She got an LPN from a community college and then an RN degree from the UW.
That’s the great thing about America, you can always start over and make something of your self.
re 12: We’ll just privatize the schools and the invisible hand will make everything OK.
Don’t you read your own propaganda?
@ 14
You’re real good at taking stuff from others, aren’t you, YLB? Lots of experience.
You make the unsupported, and very likely wrong, assumption that qualified applicants are rate-limiting.
More ideology-driven specious points. See #18.
What a nasty, petty, pointless thing to say, bub. Something making you sad these days?
@ 18
You make the unsupported, and very likely wrong, assumption that qualified applicants are rate-limiting.
That’s right, everyone can be a doctor just like everyone can play major league (fill in the sport here).
I know it hurt when it took three applications for you to get accepted, Lib Despair. It probably made you a better professional, though.
Even if there are plenty of qualified applicants, if the training program sucks or if their facilities/equipment are subpar, it will affect the quality of the finished product, won’t it?
LMAO! Not at all. Neither are you Bob.
We’d be in banking otherwise. On second thought, you’re not a bankster are you Bob?
@ 20
What a nasty, petty, pointless thing to say, bub. Something making you sad these days?
Cry me a river, Lib Sci. How much nasty, petty, pointless shit on this site do I get thrown my way on a daily basis? Start with goatfucker and go on from there. Grow the fuck up. If there’s a niceness requirement under ToS it’s violated pretty much hourly.
re 21: Yep. Keep whacking away at all those straw men and when you’re finished, you can clean the barn and lay down some fresh bedding.
Do something useful for a change. You’ll see life differently.
Heh it’s really funny that Bob still makes a stink about that 716 billion and points the finger at Obama and neglects to mention that Paul Ryan duplicated those cuts in his vaunted “Path to Prosperity”…
Sure sucks to be a right wing troll these days.
Last I looked not enough people were buying his 5 non-existent reasons for the ascension to the White House of one Dullard (R-Money).
That must really hurt.
@ 25
You clearly are not following. Obama plans to replace that $716B by savings from payments that would go to providers, which was the context in which I brought it up @ 12 in this thread.
You do follow the money beyond the left-wing talking points, don’t you, YLB? Obama did say he was going to put back the money he took, and I addressed the source from which he was going to re-acquire those funds.
Still waiting for Lib Despair to tell me how that excess of qualified applicants he says exists will be trained without expanding or building new facilities, which we don’t have the money for and which would take years longer to accomplish than the short amount of time until the new health care beneficiaries start receiving that care even if we did have the money.
Don’t know about that but I believe in fact checking Bob.
http://www.politifact.com/trut.....16-billio/
and the fact checkers often find your beloved right wing politicians a bit truth challenged.
@ 29
YLB, we’re talking about the same thing. The spending reductions @ 29 you refer to are reduced payments to the providers, which is the reduced compensation @ 12 to the doctors (substitute hospital if you wish) I mentioned.
You had no reason to bring up Paul Ryan. He’s irrelevant unless he is successful in changing the ACA somehow. I’m pointing out the reduced payments to doctors in the law as it currently exists.
Stop thinking about Paul Ryan and start thinking about what the incentive will be for providers to provide care to a greater number of recipients at the same time as they are being told they will be paid less for the care they provide. What’s their incentive?
Uhhh.. Bob I thought I heard Bill Clinton say in his DNC speech that the 716 billion
1) Bolstered the health of the Medicare trust fund out some years to 2024.
2) Closed the doughnut hole in Medicare part D..
He’s just a politician of course but just sayin’…
30 – Again you’re cherry picking.. You LEAVE OUT Medicare Advantage which is a FAILED approach to cutting costs just like the old Guaranteed Student Loan which by the way Obama reformed and cut out the bankster middlemen saving billions.
LOL!! Every reason to bring up Paul Ryan.
We shouldn’t elect pathological liars to high office.
Their incentive is that if they want sufficient compensation, they’ll have to operate more efficiently.
What about a health care sector approaching 20 percent of GDP, more than any other country, screaming WASTE, FRAUD, ABUSE don’t you understand?
Why didn’t ObamaCare include this 3 years ago??
It was thrown together with no regard for the stress on the system. 3 years later, something that should have been addressed as part of the Bill, is now getting attention. Yet it was known 3 years ago that ObamaCare would worsen the shortage of doctors.
Ready, Fire, Aim
Why is the “free market” suddenly unable to meet this demand?
If Obama is truly a “socialist” like the idiot right wingers say he is then he would have included this.. Guess he’s not a socialist.
Yawwwn.. Another right wing lie exposed.
# 34: Because obstinate Republicans, insisting that nothing President Obama could take credit for would be allowed to pass the Senate, blocked the big changes (universal health care or lowering the age for Medicare to 55, for example). Instead, they had to settle for a Romney blueprint which had been proposed by Conservative think-tanks as a compromise measure. Like all compromises, it doesn’t do everything well. But it’s far better than what existed before that.
Perhaps we can get a better plan if a few more people become unemployed. For example, I can think of a hundred or so Republicans in the House of Representatives which need to be fired for incompetence and working on updating their resumes right now. That would improve just about everything- the budget, health care, the country’s credit rating, etc.
By the way, I assume that weasel Ryan is also up for re-election to the House. A good move by him – his odds of becoming V.P. aren’t real good right now. But that just means we will proabably see his weasily face on the TV proclaiming himself as the “real” leader of the House for the next two years.
I’d love to see Ryan primaried out in 2014 by a more “reasonable” Republican – if they can find one these days.
I like McDermot’s plan. But I think we need to go a bit further and deal with the issue of doctor’s residency. We need to also subsidize primary care residency in certain areas, as well.
Oh, bob. When I applied, I was flown around the country by various schools recruiting me. No shit.
No again, bub. You’re making completely specious arguments. I’ll try to use small words. Correcty, you point out that not everyone can be a doctor; however, many more people are perfectly capable of being doctors than the number who presently go to medical school.
That is, there are lots of qualified, intelligent people who could become doctors, if more slots were opened in medical schools.
I hope that clarifies things for you, bub.
No one aasked you to post drivel here, bub. That’s what happens what idiots post drivel, they get shit thrown at them.
“…there are lots of qualified, intelligent people who could become doctors, if more slots were opened in medical schools.”
Yes, that’s right. I beleive the AMA has managed to control the number of docs produced every year so as to keep salaries high. Somewhere along the line, pre-med sutudents were required to take Econ 101, and they realized that limiting the supply of docs means higher salaries for the docs that are already here. The AICPA has also done the same thing with the CPA field. They’re all just guys and gals protecting their wealth.
re 41: “They’re all just guys and gals protecting their wealth.” — While simultaneously spouting nonsense about healthy competition and the free market.
That’s the whole problem in a nutshell.
re 34: Are you the guy who invented the lightweight vacuum cleaner? All your comments indicate that you have a lot of expertise on being a lightweight.
@35 & 36–
Not wait a second.
Obama jams thru Medicare with addressing the doctor shortage. Now the Doctor shortage is the Republicans fault?? Sorry, doesn’t wash at all. The same people that voted for ObamaCare could have voted for this. But at the time, Obama his shills were denying a doctor shortage.
Shell-game again.
INFRASTRUCTURE SPENDING!!
That was only partly tongue-in-cheek…the hospitals already exist, the patients already exist, the lecture halls already exist. I’m sure the present residents would love having more colleagues to do the work – patient numbers have been steadily increasing in the face of steady numbers of in-training doctors. You might need more professors to do the in-class teaching, but the actual requirements to generate substantially more doctors doesn’t seem too daunting, despite bub’s transparent and monotonous doom-and-gloom.
“While simultaneously spouting nonsense about healthy competition and the free market.”
Actually I think the docs are pretty much even split as to supporting free markets or having total government control over the medical industry. Some docs think the government should provide all health care under the single payer plan. Other docs think they should be able to charge what they want and make a profit.
It’s likely that just as many docs favor single payer as those that don’t support single payer. Producing more docs would be just the ticket to prove both opinions have their faults.
Wrong, again. Payments to doctors and payments to hospitals are two different things, bob. Medicare Advantae is yet another, and the biggie – a great big waste of our money going to poorly performing HMOs.
Thanks for playing!
My Medicare reimbursement has not gone down at all!
“…the hospitals already exist, the patients already exist, the lecture halls already exist.”
Yep, all that’s needed is to increase the class sizes. Surely we can at least increase class sizes by 15 or 20 percent without much stain???
A lightweight that sucks.
Or, dipshit, have more classes of the same size, which is why I said
@50,
It’s a good thing you’re bald. You definitely must save on K-Y Jelly when you stick your head up your ass. Not having any hair on you head means using less K-Y to get the job done, and you’re really good at the job of sticking your head up your ass. And you do it so often!!!
@51
You sound like you speak from experience.
“Meanwhile, let’s all recall how the Tampa Bay Buccaneers did during their first two seasons as an expansion team. All those extra physicians hurried through the system will probably perform very similarly.”
You somehow left out how, in their fourth season, Tampa Bay won the Central Division and went to the NFC Championship Game. The Seahawks took twice as long to accomplish something like that. They’ve won a Super Bowl, the Seahawks haven’t. In other words, you’re telling us that RDOCS is going to outperform anybody’s expectations.
“Lib Despair”
You’re an amateur at this. You come up with something like “Lib Despair” or “Doctor Steve” and, while it might give you some strange jolly, all you elicit from us are puzzled head scratches.
When I tagged “Mr. Cynical” as the Klynical Klown, the goatfucker, and, yes, I’m the one who introduced goatfucker, he went mad. He hates my fucking guts for it. I took his idiotic insult for us, “KLOWNS”, and turned it against him in a way that hurts. So many people have called him goatfucker and Klynical Klown for so long that who started it got lost. But the Klown knows. He’ll never forget who did this to him. That’s how effective it was. Hell, now there’s a Golden Goat Award and a Golden Goat Lifetime Acheivement Award. He’s so fucked up in the head with this now that he even denies that he’s “Mr. Cynical”.
There’s a reason why it works, Bob, why it’s like twisting a word-knife in his fucking gut. Why does it hurt him? It’s because he and everybody else here knows that he’s a dumber than a stump, goatfucking Klynical Klown.
Do you see how it works? This lesson is on the house, Bob. I’m trying to help you not to come off as being so damned pathetically stupid as you have been as you attempt to play this game in the future.
re 46: “Actually I think the docs are pretty much even split as to supporting free markets or having total government control over the medical industry.”
Why is it always either/or with you guys
re 49: Good tag line! I got a laugh out of that.
Easier to come up with straw man arguments, easier to demagogue, easier to conceal a self-serving agenda, easier to manipulate.
Nuance is very challenging to them. Reality has a well known liberal bias.
In Australia they had a system that paid your college tuition if you agreed to teach for two years. Not all were great teachers but at least they found out. Result schools had a constant influx of new blood. BTW they were members of the union and got paid as much as any starting teacher.
I really hope we get an open thread tomorrow. I feel like a Golden Goat Award might be forthcoming, if so. So many trolls, so much idiocy . . .