[wyldberry]

This applying to graduate degrees really does seem like the result of AMA lobbying to keep Nurse Practitioner numbers down. It is state and program dependent, but in some states NPs have prescribing authority, which cuts into the domain of MD/DO practice in the US. There are of course merits to the argument about NP training vs MD/DO training in Pharmacology, but overall this limits patient access in America to prescribed medicine.

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-...

[le-mark]

I haven’t seen a MD in years. I’ve only seen nurse practitioners, at least 5 years now. Health care in the US is deadly, expensive joke. But Fox and friends tell us how great it is compared to socialist countries! Yay!

[wyldberry]

My current working theory is that US systems are in general great, if you're smart and educated enough to not get scammed. There's a high level of knowledge you need to just exist in society without being preyed upon by some entity.

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.

[insane_dreamer]

> In America, most people interface with doctors in order to get tests run and medicine prescribed.

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.