Slam Dunk?/ Politics/Residency
Too many medical students, yet not enough residency slots. Impending doctor shortage, yet “discarding” fully educated doctor grads. Why isn’t the solution to this dilemma a “slam dunk”? Because nothing is ever that simple. There are the “politics” involved that complicate the solution to this deficit.
Is there really going to be a physician shortage, or are the VA, The Affordable Care Act, and some states planning to utilize less expensive physician assistants and nurse practitioners to administer healthcare? Josanne Page of the Cleveland Clinic said, “P.A.s generally make about half a physician salary or less, depending on specialty (an ER doctor makes an average $270,000, an emergency-room P.A. $112,000).” (1)
“ And several states, such as
Is a PA or NP qualified to see patients as effectively as a doctor? A PA curriculum typically requires 1 year of classroom learning and 1 year clinical work. A NP requires a 1-3 year program post graduate after obtaining a nursing degree. Doctor training requires a minimum of 7 years after college. The 3 doctors in my family had 7 years, 10 years, and 11 years of post college training. The further depths of knowledge and medical experience afford a doctor a level of synthesis not attainable with lesser years of study.
A dermatologist I know recommended that a patient obtain a consult regarding a skin ailment, sometimes associated with pancreatic cancer( The patient returned to thank the doctor for the early diagnosis of pancreatic cancer which might have been missed under normal circumstances.) Would a PA have known that correlation?
An OB/GYN doctor told a patient to obtain further diagnostics for continued lactation after cessation of breast feeding. There is an association with pituitary tumors with uncharacteristic lactation. The patient did end up having a pituitary tumor. Would this have been noticed by a PA? Often, a doctor never enters the room when a PA is seeing a patient.
Ironically, PAs who by “definition” are “supervised” by a doctor, are allowed to work immediately after graduation. A doctor with 4 years of medical school cannot work at all, until obtaining a license upon completion of a residency. They can’t even work as a PA due to the stringent PA licensure rules!