Vitaliy Katsenelson writes worthwhile content for those interested in investing, art, classical music, and philosophical thoughts about life in general. See his recent post about coveting and envy.
Doggedness, canine and human.
A piece about skateboarding and flying, with thoughts from St-Exupery.
Speaking about flying, TxRed the Cat Rotator writes about some of her aerobatic experiences.
The article on state licensing, by a friend, is interesting. I have a California license which cost over $800 each two years to renew. They have finally come up with a retired license to allow docs to do charity clinic work without the big fees. It’s interesting that the feds allows docs with any state license to practice in a federal facility (VA, prisons, Indian clinics) in any state. I did H&Ps for military recruits in AZ for a couple of years with my CA license. I used to have Washington and Alaska licenses. WA I dropped because of the cost to renew once I decided I was not going to retire there.
The latest big push is to require medical schools to accept and graduate (!) POC applicants with lower MCAT scores. The state license thing seems peanuts compared to that mass dilution of standards.
As far as I can tell we’re moving close to a system like apparently they have in the UK where a large fraction of doctors are imported, because no one wants to go through the training process anymore, just to end up as an employee of an HMO or other big medical provider.
Brian, the big problem is the student debt. Before Obamacare destroyed the existing system, I thought there was a real opportunity to waive tuition for medical students who agreed to care for the poor. The military will pay tuition in return for a period of service. When I was starting medical school, I had no idea how I would pay tuition and would have taken such a deal but the doctor draft was still in effect and I got a scholarship. Student loans were not available, even though tuition was much lower.
Each year I would ask my students how many were using student loans for tuition and all would raise their hands. I would ask how many would consider the military deal and none would. They will be paying student loans until they are 50. I have not kept track of how applications are going. I do know that the primary care docs I knew were not happy with their practices.
Yes, I know. But isn’t that because the training system, and its financing especially, is lagging the changes that have been made in how doctors practice? The large debt was viable because you were being trained to be an independent businessman who could pay it off relatively easily. Now the debt is still there, but you’re training to be an employee of a large corporation, which makes much less financial sense. But of course it is still attractive for foreign-trained doctors to come to America, so that’s what we are getting, and will continue to get more and more of, because the home-grown supply isn’t meeting demand. In my small town the only pediatrician taking patients is from Syria.
I don’t think the military option is going to be there much longer. They’re really slicing out more and more of their medical staff.
I agree but you should differentiate between foreign students trained here and foreign trained. Many medical schools in other countries, including Mexico, have no clinical exposure to patients. It’s all book learning. I did know some Americans who went to foreign medical schools and they were required to spend a year of clinical experience before being licensed. I expect that will not last. American medical schools are also under attack by the “equity” crowd and standards will slip. Most of my black medical students were from outside the US. West Indies or Africa. My wife’s internist is from Jamaica. She had an infectious disease doc from Africa a few years ago. Both were good.
I have a question. Why are American lives so short, compared to other advanced nations? In both Infant Mortality and Age the US is at the back of the pack compared to other advanced nations.
I have a question. Why are American lives so short, compared to other advanced nations? In both Infant Mortality and Age the US is at the back of the pack compared to other advanced nations.
They aren’t. Different ethnic and racial groups have different health outcomes. Different countries collect medical statistics differently. Some countries (Hint: USA) invest a great deal of resources in saving at-risk infants who would be written off in other countries. Pengun, why don’t you research the specifics of, say, who gets counted in US vs. Cuban infant-mortality statistics and get back to us?
Sorry Jonathan, Penny doesn’t do research. It is above his pay grade.
“Some countries (Hint: USA) invest a great deal of resources in saving at-risk infants who would be written off in other countries”
This is simply not true. The Infant Mortality rate is the percentage of children born, that die. It has nothing to do with some imagined virtue.
Jonathan is of course 100% correct, and the troll is as usual completely wrong. It is very, very, very well documented.
https://www.healthsystemtracker.org/brief/u-s-s-high-infant-mortality-may-be-explained-by-differences-in-data-as-well-as-health/
“A major finding of the study was that 43% of the apparent infant mortality gap between the U.S. and Finland and 39% of the gap relative to Austria can be explained by differences in the way the U.S. reports this data. These reporting differences are largely due to how countries consider births near the “threshold of viability” – very preterm or very low-weight births are reported as live births more often in the U.S. than they are in other countries, thus contributing to the higher mortality count.”
Exchanges with the troll are a waste of time and pixels. He is here to denigrate this country and is often hilariously wrong about simple matters.