The context is some interpretations of Baumol effect, as discussed here for the very parallel case of childcare
There's a nursing shortage because the work is brutal, under appreciated, and under compensated aside from travel nursing gigs, for those who can maintain that sort of lifestyle. Nurses are a cost center, so management is constantly running floors understaffed. It's to the point that they receive bonuses for running the floor as thin as possible, despite the worsening of patient outcomes and nurses' sanity.
Don't get me wrong, there are some good gigs for sure, but there are lots of terrible ones.
On the physician side, there's definitely big changes coming, and I'm banking on a move to up-front APPs and a few remote physicians overseeing things. But I'm actually also seeing a number of entities that hired a bunch of APPs and are now moving back to physicians only and saving money doing do (think urgent care, ED, inpatient), though some specialties work very efficiently with a primary APP or co-management model, particularly the procedural ones.
Why? As you said, hospitals have a hard time finding nurses (undersupply), so more nurses would be better for patients and hospitals. An influx of more nurses could ease the undersupply, but I don't see why it would necessary overcome it completely and even lead to the impeding oversupply.
They make more than I do with over 25 years as a software engineer. If that’s not professional, what is?
Congress, at the behest of AMA lobbying, had kept the number of Medicare funded residency slots capped at the same number since 1997 until the Consolidated Appropriations Act of 2021 which added 1000 new residence slots[0]. Starting in FY 2023 (October 1 2022) no more than 200 new positions would be added each FY meaning the full 1000 could be created no sooner than FY 2028 (October 1 2027). Given the medical school timeline of 7-10 years training (school, residency, fellowship) we won't see any meaningful impact from that until the mid 2030s.
The US already has a much lower physician to patient ratio than Nordic countries (as a comparison between wealthy, western countries). The us has 2.97 active physicians per 1000 population, of which 2.52 are actual direct patient care physicians[2]. For comparison Sweden is ~5 per 1,000, Norway 4.5 per 1,000, Denmark 4.45 per 1,000, and Finland at 3.8 per 1000. Extra Bonus (Russian Federation reports 4.0 per 1,000)[3]. Note these numbers are as of 2020.
In America, most people interface with doctors in order to get tests run and medicine prescribed. Reducing the incentive for RNs to move into NP by removing it's professional degree status will likely lower the amount of prescribing individuals a patient can interface with, increasing bottleneck and time to care.
[0] - https://www.sgu.edu/news-and-events/new-residency-slots-appr... [1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC8370355/ [2] - https://www.aamc.org/data-reports/data/2023-key-findings-and... [3] - https://www.worldatlas.com/articles/countries-with-the-most-...
Unfortunately, healthcare is probably the most glaring example of this. It's already K-shaped based on the insurance you have (or don't have). In addition, most americans just aren't educated enough about their own bodies and medicine to accurately convey their problems to their care team, and that's before how likely they are to believe you.
I have a great PPO plan and spend a large amount of time each year researching care for longevity and curating a care team, or cash-only practices for things. If i lost that, then i'd be hosed. I can't imagine how people on HMO or medicare plans work.
NPs fulfil a very useful niche, even if that niche is "you tested positive for strep, here's your antibiotics" keeping physcians and PAs able to care on more severe persons.
In my experience, NPs already carry a lot of this load, especially in non medical speciality cases (i.e., what a GP or PCP would do).
Another example of self-harm to protect a wealthy segment of the population (doctors) at the expense of those who need medical care. It's not just time to care that's the problem. Scarcity drives up prices as well.
>Women should remain silent in the churches, They are not allowed to speak, but must be in submission, as the law says. If they want to inquire about something, they should ask their own husbands at home; for it is disgraceful for a woman to speak in the church (St Paul, https://en.wikipedia.org/wiki/Paul_the_Apostle_and_women)
though I think that stuff is a bit outdated even if it's in the Bible.
"a bit"? like 2000 years outdated
> even if it's in the Bible
the Bible also says you get stoned to death for adultery; we bring that back, starting with Trump and all rich bozos who cheat on their wives, and then we can talk about women keeping silent in the church
(not to mention that stoning is a very slow and painful death)
blinded•2mo ago
kace91•2mo ago
wahnfrieden•2mo ago
jeffbee•2mo ago
gscott•2mo ago
wahnfrieden•2mo ago
drivebyhooting•2mo ago
But when Ramanujan says 1 + 2 + 3 + … = -1/12 because god told him we accept that as a reasonable explanation.
davorak•2mo ago
What community accepts that as reasonable explanation?
drivebyhooting•2mo ago
They came to him from God. So apparently divine inspiration can indeed be valuable. Who is to say a Holy Ghost couldn’t divulge secrets of medicine to an anointed prophet.
wahnfrieden•2mo ago
cwillu•2mo ago
loeg•2mo ago
cjbgkagh•2mo ago
I dislike the quackery but traditional science isn’t free from it either. I wish everyone was rational, evidence based and disinterested (as in not having a particular interest on biasing an outcome). But the world we live in is far from that. Consider the percentage of ‘normal’ medical doctors in Germany who believe in homeopathy. A large part of that is due to the terrain school of thought in medicine which lost out to germ theory. An artifact of history rather than rational people and rational study. I’m still looking for a better way the phrase it; but it seems to me that the belief in the belief of science far exceeds the actual belief in science.
If doctors / medical researchers really were so good at research they wouldn’t have taken so long to rediscover the ancient practice of prolotherapy.
loeg•2mo ago
So they are not only quacks, but also grifters? The evidence for PRP is basically non-existent. It doesn't hold up in RCTs: https://www.jwatch.org/na54355/2021/12/27/evidence-against-p...
(To be fair, chiros are not unique in grifting PRP -- I've seen traditional doctors selling it too.)
> Consider the percentage of ‘normal’ medical doctors in Germany who believe in homeopathy.
I hadn't heard of this, but, yeah, that's also quackery. Wild. 32% of German GPs report "using" homeopathy once a week. The US medical system may have some problems, but at least believing in homeopathy isn't one of them.
cjbgkagh•2mo ago
kace91•2mo ago
Some of their techniques are also proven to be useful-ish for short term pain management (not for the reasons they claim, it’s similar to acupuncture). So someone who actually tells the patient that the treatment is exclusively for physical therapy and only short time benefits might be useful.
Few are that honest, but for some people that kind of short term help is vital.
It might be what gets you through the wait for a long term procedure, or what lets you rest and sleep to improve actual recovery, for example. Pain management is a need for some people.
drivebyhooting•2mo ago
* first see a GP, no real diagnosis.
* get an ultrasound - everyone already knows it won’t show anything of use but insurance companies require this escalation path
* get an xray - same as above
* maybe if you insist get an MRI.
* regardless the treatment is the same: go to a PT’s office.
the_af•2mo ago
Conflating medicine with how health systems work in some countries is a serious error.
yencabulator•2mo ago
kragen•2mo ago
Edit: please see https://en.wikipedia.org/wiki/Profession for the current undestanding of that category.
shermantanktop•2mo ago
kragen•2mo ago
yibg•2mo ago
kragen•2mo ago
Jensson•2mo ago
kragen•2mo ago
Moreover, the Department of Education is clearly using the term in the sense I am describing, about whose further historical development you can read more in https://en.wikipedia.org/wiki/Profession.
Jensson•2mo ago
But that change will confuse people since it has been a professional degree for a long time now. Using ancient definitions causes confusion, it doesn't resolve it.
kragen•2mo ago
yibg•2mo ago
asddubs•2mo ago
cpburns2009•2mo ago
Jensson•2mo ago
cpburns2009•2mo ago
jltsiren•2mo ago
RobRivera•2mo ago
BigTTYGothGF•2mo ago
RobRivera•2mo ago
Absolutely
Adore your handle
koakuma-chan•2mo ago
kragen•2mo ago
cpburns2009•2mo ago
yencabulator•2mo ago
api•2mo ago
johnisgood•2mo ago
Jcampuzano2•2mo ago
Why the hell does a large portion of this country give a rats ass about tradition, but also larp as caring about progress and effectiveness. These two are logically inconsistent.
If anything we should be removing more traditions than ever.
kragen•2mo ago
the_af•2mo ago
Besides, this bizarre tangent about tradition ignores that this has some very practical downsides for nurses, it's not just about preserving tradition or whatnot.
cwillu•2mo ago
sunkeeh•2mo ago
kragen•2mo ago
However, in this conversation, we are speaking English, whose words owe their meaning entirely to tradition.
Jensson•2mo ago
The meaning of words change over time, so you are wrong, words meaning are not entirely from tradition or else their meaning would not change.
Or if you agree that traditions can change, then what the word meant year 1300 doesn't matter, things has changed since then.
yencabulator•2mo ago
arthurcolle•2mo ago
dragonwriter•2mo ago
The list on the site has Theology, not Divinity (which is a bit ironic, because Divinity is traditionally the professional degree and Theology the academic one.)