That is Matthew Holt’s solution to cutting physician pay:
What’s the rational answer? Do what most other countries do and restrict the amount of specialty positions available. Instead insist that most physicians focus on primary care which is both cheaper to the system and more cost-effective. Of course, doing that would be better for the system overall, but it would be worse for individual physicians–or at least for their incomes. It would though of course be better for the taxpayer, who is funding the vast majority of that specialty training.
Related posts:
- Should specialists be re-trained as primary care physicians?
- Males = specialists, females = primary care physicians
- Why primary care doctors shouldn’t be pain specialists
- Primary care is damn cheap, and can solve our health care woes
- Should specialists spread the wealth to primary care?
- Are specialists preventing the government from spending more on primary care?
- When specialists provide primary care, and why patients aren’t complaining
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{ 4 comments }
Specialists are already limited to a great extent. One of the specialties that comes to mind is plastic surgery. There are 82 spots in the country that students can match into right out of med school. I think there are about 300 dermatology positions nationwide for 20,000 graduating doctors every year.
If you are going to start telling students what specialty or group of specialties they must choose, then communism is already here and the terrorists have won.
Yeah! Now that I have mine, lets limit any more comming in.
Oh the wonders of central planning. A series of five year plans produced by the illustrius seers of governmennt wisdom using their crytal balls.
The more rational way to govern things in a country that generally operates on the free market supply/demand principle is to follow the ‘pay for performance’ mantra. If you want people to perform generalist care, then the government needs to be prepared to pay for such services.
People cannot be strong armed into careers they don’t want by removing other options. Medical students are an academically bright lot and will find a way to earn a decent living in something that interests them. They will not cheerfully accept primary care merely because specialty training was limited by the government.
As others said, specialty training is already limited by the government. Those slots happen to be disproportionately preferred to primary care amongst U.S. graduates for obvious reasons, leaving more primary care residency training places for international medical graduates, which is the way things have been for many years.
If you want people to choose primary care over specialties, then primary care has to become more attractive to practice. It has to pay better. It really is that simple.
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