Let’s get some facts straight here, as I woefully live in NJ. Aside from the misnaming of the state medical society in NJ (it’s actually the Medical Society of NJ), the president of MSNJ never at any time made any such statement that you claim he made. The work slowdown, NOT stoppage (there was coverage by ER docs, some offices were open for emergent care, and some docs actually blew off the slowdown) was a grassroots effort not organized or even sanctioned by MSNJ. It was intended to alert the legislature to the deterioration in access to care, and the need for caps (yep, I brought it up).

But your point is still well taken (and you forgot DPM’s!) Dentists, podiatrists, nurse practitioners and physician assistants have no restrictions on the scope of their prescribing privileges. In very few places (I know Georgia is one) a mid-level can’t script for narcotics but that’s about it.

The statement to the contrary is clue number four thousand seventy six that a certain anon around here has very little practical knowledge about the delivery of health care…

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16249293&dopt=Abstract

In February 2005, the FSU College of Medicine received full accreditation from the Liaison Committee on Medical Education.

The good old CME again. On the other two schools… if you have information that the CME has kept their mits off… please let me know”

Yes, the LCME sets accreditation standards. So what. Most of the 30 new planned med schools have already met provisional accreditation standards. Are you trying to claim that the LCME standards are too high? Where is your evidence of that?

“In 2000, the Florida State University (FSU) College of Medicine was founded, becoming the first new allopathic medical school in the United States in over 20 years.”

The key word here is “allopathic.” Osteopathic medical schools have nothing at all to do with the LCME, which totally bashes your claim that the AMA holds monopolistic control over the doctor supply. Osteopathic schools have been increasing like wildfire over the past 20 years. In addition allopathics have been greatly increasing their enrollment sizes over that same time period. Since FSU Med was created, a literal flood of new allopathic med schools have been in development.

Here’s a list of them:

NEW MEDICAL SCHOOLS/BRANCH CAMPUSES THAT HAVE OFFICIALLY OPENED

MD – University of Hawaii-Kakaako – 2006
DO – Touro/Las Vegas – 2005
DO – PCOM/Atlanta – 2005
MD – University of Miami/FAU joint program – 2004
MD – Cleveland Clinic/Lerner – 2004
DO – LECOM/Bradenton – 2004
MD – Florida State University – 2002
DO – VCOM – 2002

NEW MEDICAL SCHOOLS THAT WILL OPEN SOON

MD – Florida International Univ – 2008
MD – Univ Central Florida – 2008
MD – Touro/NJ – 2008
DO – Touro/Harlem – 2008
DO – Pacific Northwest/Yakima – 2007
MD – Michigan State University/Grand Rapids – 2008
MD – University of Arizona/Phoenix – 2007

NEW MEDICAL SCHOOLS/BRANCH CAMPUSES THAT ARE IN PLANNING

MD – University of Cal Merced
MD – University of Cal Riverside
MD – University of Texas El Paso
DO – Vista/Colorado (for-profit)
MD – OHSU/Eugene
DO – MSUCOM/Detroit
DO – Barry University/Miami FL

3. Outside of MD and DOs, the prescription writing capabilities of the other professions is heavily limited. You aren’t suggesting that the prescription writing capabilities are the same for all of these professions.”

Heavily limited my ass. PAs and NPs can script for anything an MD can. Psychologists can also script drugs. Of course you wouldnt want a psychologist scripting a beta blocker. DCs can script drugs, pharmacists can script drugs

“5, 7, 9, 10, 11 – Let us try this again… it is not a difficult concept to understand. We have a 90 year history of undersupply. This has to be made up for prior to seeing any effects of sufficient or oversupply. The current supply of providers, regardless of regional concentration, is still not sufficient.”

Again, USA ranks #5 out of 35 in the industrialized world for number of docs per capita. We have plenty of docs.

“The healthcare market is not a free market system… however it is not a fixed price market as you are suggesting.”

Of course its a fixed price market. All insurance carriers base their reimbursements to what Medicare pays. When Medicare changes its billing, insurance companies immediately revise their reimbursement schedule accordingly. Thats ABSOLUTELY a fixed price market.

Remind to file that in the same place as I would an intellectually vacant response on race issues starting with “racist.” The good ol’ cirucular file.

When I went to medical school in the 80′s my buddies and I (who were all AOA) used to talk about our classmates a lot. We felt that 10% were just frankly stupid but somehow were able squeak by. Another 20% have severe personality disorders that are often advantageous as a coping mechanism for malignant hard core residencies. Regardless of all of anon 7:43′s rants I don’t see any advantage in lowering standards and letting more stupid people, or those with malignant personality disorders out to practice on the unsuspecting public.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16249293&dopt=Abstract

In February 2005, the FSU College of Medicine received full accreditation from the Liaison Committee on Medical Education.

The good old CME again. On the other two schools… if you have information that the CME has kept their mits off… please let me know.

2. Thirty new schools built in the last 5 or planned in the next 15?

“In 2000, the Florida State University (FSU) College of Medicine was founded, becoming the first new allopathic medical school in the United States in over 20 years.”

Outside of FSU, the two other schools in Florida that you have mentioned and the one in Arizona… where are the others?

3. Outside of MD and DOs, the prescription writing capabilities of the other professions is heavily limited. You aren’t suggesting that the prescription writing capabilities are the same for all of these professions.

4. Why do we take foreign doctors in… Hmmmm… Perhaps because we don’t produce enough of our own?

5, 7, 9, 10, 11 – Let us try this again… it is not a difficult concept to understand. We have a 90 year history of undersupply. This has to be made up for prior to seeing any effects of sufficient or oversupply. The current supply of providers, regardless of regional concentration, is still not sufficient.

8. There are still providers that take Medicare? I had heard a rumor that they Meicare patients were being dropped like hot potatoes because it did more harm to the provider to have to accept lower reimbursements? The healthcare market is not a free market system… however it is not a fixed price market as you are suggesting.

6. Point conceded. I should not judge the whole profession by those that gouge the most.

“Case closed. Healthcare is NOT a free market, therefore your analysis is BULLSHIT.”

How erudite and scholarly (particularly the all caps tantrum). Besides the medical errors and “bad outcomes” it is this type of attitude that causes people to sue those in your profession.

1) AMA does not control medical schools. Florida just recently opened up 3 new med schools and the AMA was neither consulted, nor did they “approve” any of them. The florida state legislature has sole purview to open up however many med schools they want, and the AMA has zero control over it.

2) There are currently 30 new MD and DO schools either built in the last 5 years or planned in the next 15 years. What were you saying about the AMA keeping an iron fist on med schools?

3) MDs, DOs, NPs, PAs, DDS/DMD, NDs, can all script medications. Thats at least 7 different training pathways, and the AMA is involved in only ONE of them. Again, where is this “monopoly” you speak of?

4) USA takes more foreign doctors than all other nations COMBINED. Again, where is this iron fist AMA approach you speak of?

5) USA per capita doctor ratio has risen by 50% in less than 20 years. Again, where is this lockbox you speak of that The AMA keeps on doctors?

6) Orthopods and neurosurgeons collectively make up less than 5% of all doctors. Thats not too smart to judge and entire profession by a 5% sampling. Neurosurgeons alone average 3 standard deviations above the median aggregate doctor income. Your comparison is similiar to me stating that business owners are overpaid because Bill GAtes makes X billions per year.

7) In terms of doctors per capita, USA ranks #5 in the world among 35 industrialized nations. If the US AMA has a lockbox on doctors, then the european nations have an even tighter monopoly than the USA does.

The study in teh original article proves that more doctors does NOT lead to lower costs. Thats because doctors dont compete against each other, because healthcare is NOT a free market. Medicare control ensures that healthcare will NEVER be a free market. The only way to create a free market in which doctors would compete against each other would be to remove government control. Medicare controls 60% of all healthcare dollars in the USA, making it a virtual monopolistic owner.

9) 20 years of increaseing doctors per capita in the USA has done NOTHING to change rural doctor shortages. More doctors just means more docs living in New York or Miami.

10) Boston and New York have more per capita docs than anywhere on the planet. According to your logic, that means Boston and NY docs should make the least amount of money, since they compete against each other. WRONG. Boston and NY docs make MORE money on average than their counterparts in less crowded markets.

11) Boston and NY have the highest per capita # of docs, therefore healthcare costs should be lower according to your logic. WRONG. NY and Boston routinely have the HIGHEST PER CAPITA HEALTHCARE EXPENDITURES IN THE UNITED STATES.

Case closed. Healthcare is NOT a free market, therefore your analysis is BULLSHIT.

http://jama.ama-assn.org/cgi/content/full/291/17/2139