[jmoak]

While residencies have existed since well before Medicare was passed, they were mostly something elites pursued. Overall, residency wasn't an absolutely necessary practice until the mid-late 20th century. By the 70s, with the tailwind of the baby boom, the practice became normalized.

https://en.wikipedia.org/wiki/Residency_(medicine)#:~:text=B...

Our demographic makeup means we have more elderly in need of care and fewer to care for them, which means we will need to revert our requirements. The UK is already discussing/planning-for this in their healthcare system: https://www.independent.co.uk/news/health/nurses-doctors-deg...

I understand that it's scary that care quality may be lower, but that argument is similar to demanding that every road worker and civil engineer have a PhD. Our bridges and roads would likely be better if all participants were so educated and qualified, at least for the horrifically expensive and few roads/bridges we would be able to build.

[nradov]

What will probably happen in most US states is that physician education will continue to require residency. But routine primary care will increasingly shift to Physician Assistants and Nurse Practitioners. Real physicians should be reserved for the more complex cases.

[jmoak]

I agree with this as a possibility for general doctor visits.

I already mostly see NPs for my checkups. If they aren't sure, then I can jump through the hoops to get a Physician.

It works well and I get plenty of time to discuss things during my appointments.

EDIT: I still think my original point may stand for specialists however, we'll have to see how it shakes out and what healthcare systems under more stress than ours decide to do in the near future.

[s1artibartfast]

Exactly. If you create a regulatory system so strict that you cant make doctors, you end up with a shortage, and creating a new class of professionals that do what doctors did before.

I think there are parallels to nursing as well, with increasing credentialism and then creation of new classes. 30 years ago nurses entered the workforce with a 2 year associates from a junior college. Heck, my highschool had a nursing occupational program.