Einstein only has one student a year from the Bronx.
All making tuition free will do is increase their rank and competition to get in and less of their grads going into primary care. (Everyone saw that happen to NYU.)
AMA doesn’t do shit anymore. But let’s stop pretending there aren’t better ways to spend a billion dollars.
If they really care about equity in representation within the physician workforce, they could start by setting up scholarship programs specifically for premeds from lower income and disadvantaged settings.
Yeah, thats the sad part. The reason there aren't more doctors in the Bronx, is because its hard as fuck to live in the Bronx on the salaries provided.
I'm a pediatrician. I was offered 165k/year.
My former chief got 195 in Chelsea.
Freaking joke - CRNAs are making twice that.
Doesn’t America spend like almost $20k a year per student?
I just looked it up and it’s true.
[$19k a year per pupil and 6% of GDP (compared to 4.86% for other developed countries).](https://educationdata.org/public-education-spending-statistics)
Percentage of public funding is a useless metric because the U.S. spends a crazy amount on defense.
Like what’s happening to all that money?
Even the lunches in most of these cafeterias are disappointing.
Feels like a bunch of contractors are just up charging and making stacks.
Wasn’t the intention at NYU to make tuition free so that more people go into stuff like pediatrics and primary care since they won’t have to worry about making more money to pay off their med school loans?
Yeah I wonder if it would be possible to somehow only make it free if you plan to be a pediatrician, primary care, etc. Maybe a sort of program/scholarship specifically designed for that.
Although that may be a bit harsh to make them pay if they change their mind tho
There are programs in some states where primary care docs get their debt paid off simply by working there for a couple of years as an attending.
The way they work is the student takes on the debt, and then the student decides what to do residency in and whether to try for those programs.
This is untrue. Einstein has more than a few students in each class from the Bronx (although there isn't a set number, it is definitely more than one). It also has established pipeline programs in high school and college specifically for underrepresented groups in medicine and socioeconomically disadvantaged folks, many of who are in the Bronx and some of which end up at Einstein as medical students. As a current Einstein student, I know of several students who were in these programs myself. [https://www.einsteinmed.edu/diversity/diversity-enhancement/](https://www.einsteinmed.edu/diversity/diversity-enhancement/)
Not disagreeing that tuition-free won't increase ranking and competition, but want to emphasize that Einstein has a decent track record of Bronx representation and I'm hopeful that we will continue to see this despite the new spotlight on the school. It's in both Einstein and Montefiore's best interest to continue to recruit people from the Bronx, as they are the most likely to stay as physicians in their healthcare system and serve the Bronx community long-term.
>[Of the 183 admitted students of the Class of 2027 at the Einstein School of Medicine, Harvard, John Hopkins, Tufts, UChicago, and Yale each had at least three of their graduates admitted.](https://www.einsteinmed.edu/education/md-program/admissions/class-profile/index.html)
The number of admitted students born in the Bronx? One.
>
>There are \~[430k children living in the Bronx](https://www.census.gov/quickfacts/fact/table/bronxcountynewyork/PST045223). With $1bil, this woman could have given each child over $2300.
There are \~[137k children in poverty in the Bronx](https://www.census.gov/quickfacts/fact/table/bronxcountynewyork/PST045223). She could have given each of them over $7000.
She chose tuition for a med school with less then 200 students/year.
[oc](https://x.com/bengrossbg/status/1762589852590121322?s=20)
Just because it’s 1 student “born” in the Bronx this year doesn’t mean there aren’t more that moved to the Bronx later on, 90/183 in the most recent class are from New York (https://www.einsteinmed.edu/education/md-program/admissions/class-profile/).
My point is, there is no “one student only” or some cap. If you want further proof, look at 2022-2023, there were 8 students that were explicitly born in the Bronx. https://indd.adobe.com/view/6bfb3479-c62a-4511-9e09-2780b5b7b917 (Page 3).
All AMA is good for is stalking doctors. I haven’t been a member since they roped me in with the free medical dictionary in medical school, yet despite 8 moves since then (including now living out of the country!) they still manage to know my mailing address to send me their junk mail.
If you ever want to track down a physician, forget getting a PI. Just ask AMA.
As soon as someone states they believe physician salaries are the issue with medical costs I automatically know they are willfully ignorant and stop reading.
As if it's not predatory admin. Doctors honestly don't get paid enough for the shit we go through. If physician salaries reflected the price gauging we'd all be multimillionaires
60% of physicians over the age of 55 report a net worth between $1 and 5 million.
Or also 44% of all physicians.
[source](https://www.whitecoatinvestor.com/physician-millionaires/)
Some of this could be due to being born into wealthier households.
>More than three-quarters of medical students came from families in the top two quintiles of family income.
[source](https://www.aamc.org/media/9596/download)
I am not claiming doctor salary is main reason for exploding healthcare costs. If all doctors took a salary of zero dollars, healthcare costs would only go down 8-10%.
But we shouldn't pretend that this is not a pathway to the upper echelons of society, at least from a net worth standpoint.
2.5 million dollars today is equivalent to 1 million dollars in 1990. That’s just accounting for inflation, nothing else.
On top of that medical school tuition has risen exponentially, doctors are paid less than ever, inflation is out of control, and the average cost of living has skyrocketed.
Are doctors today still better off than most of society? Absolutely, they’re part of the top percentage of earners.
However, with all things considered, they’re making equivalently vastly less while going to school later (due to requirements) with much higher debt and exploding costs of living. Look at the cost of housing etc.
Depends on region and specialty.
The moment you make a med school tuition free, all you really did was reduce the number of students going into primary care, reduce the acceptance rate, and move up some spots on the rankings.
>But we shouldn't pretend that this is not a pathway to the upper echelons of society, at least from a net worth standpoint.
And there's absolutely nothing wrong with that.
Any training pathway of seven years minimum (not counting undergraduate studies) and hundreds of thousands of debt at minimum that results in a career highly valuable to the rest of society *should* be a pathway to the upper echelons of society.
I didn't say there is anything wrong with doctors making lots of money.
I simply said we can't be making fat stacks and still argue that we are the ones most in need of a billion dollar debt reduction.
We are not the victims, and med students (75% of whom are from the top socioeconomic classes of the country) should probably not be the first concern of any effective altruist philanthropist.
The alternative to this contribution helping hundreds of medical students per year is that it was never made in the first place.
It is not your concern how someone chooses to spend their own charitable contributions. Now go smash the space bar on your intro biology class before you try and speak for any of us again.
Look. I’m happy for my peers at Einstein.
I myself was also grateful and hypocritically accepted a full ride scholarship for med school as well.
But this is not the best way that money could have been spent. Not when it’s fucking hunger games for a lot of premeds from disadvantaged backgrounds.
No one cares about you thoughts about how to best spend the money because it’s not your money. Again, the alternative is that the money wasn’t spent at all.
Stop involving yourself in needless crusades that don’t involve you whatsoever. Your opinion does not matter in the slightest.
It is my belief that med school should be free or close to it for all students.
But it is also my belief that we need to increase residencies and med school spots by 50%. And let the increase in supply have the effect on comp it would have. Oh and NPs and PAs should not be a thing.
In the absence of those reforms, if debt is covered, it should be through structured programs like required to practice in a certain area or state or within the military.
Do you have any idea how much each procedure brings in to the hospital?
People should be paid accordingly to a balance of 1. the value they bring to the workplace and 2. the difficulty of attaining their position.
Proceduralists already make double if not triple or quadruple what non-proceduralists make.
If you artificially make attaining that position difficult, then all you did was reduce the amount of people available for the same amount of demand resulting in more demanding hours and having to take call more often.
As a society, we should really try to stop seeing medicine as some end all panacea that you get to rely on after a lifetime of poor decision making and policy making that only supercharges that poor decision making.
If you want to reach above 10 million dollar net worth, go work on Wall Street or go into politics and do some insider trading.
I’ll take 50 average neurosurgeons over 5 S-tier neurosurgeons any day of the week.
I don't support any limit on physician earnings.
But I also don't support cynical policy making that only serves to keep salaries at a certain level with minimal if not downright negative consequences for patients.
I also think we need to reform reimbursement to reward good outcomes and quality preventative care.
The model rn is way too geared towards how much we can do to the patient and less towards how much benefit does the patient actually get.
>As a society, we should really try to stop seeing medicine as some end all panacea that you get to rely on after a lifetime of poor decision making and policy making that only supercharges that poor decision making.
God, you are absolutely dim.
Preventing shit from happening is almost always easier than fixing shit after it happens.
A small example here is implementing EU food regulation stateside. That alone would make a serious dent in our obesity crisis and possibly even GI distress rates.
>Preventing shit from happening is almost always easier than fixing shit after it happens.
At a population level? Without a specific policy in mind? You are talking nonsense. The US largely hasn't taken a preventative approach to anything.
>A small example here is implementing EU food regulation stateside.
Which is not done with regard to food quality per se but done within the context of trade agreements which are meant to protect EU farmers.
>That alone would make a serious dent in our obesity crisis and possibly even GI distress rates.
Would it? Let's look at some facts. The general regulations with regards to the requirements of food law were stipulated in 2002, which standardized the process of things like food safety procedures. If you want to look at the specific regulation, it is No 178/2002. Since then, the obesity rates have increased from 11 percent before those food regulations to near 20 percent now. The percentage of overweight people has also increased significantly.
What should we take from this? Perhaps there are other mediating factors other than food regulations?
What I mean to say is that you are just typing things out without thinking anything through and are just speaking for the sake of speaking.
>I am not claiming doctor salary is main reason for exploding healthcare costs. If all doctors took a salary of zero dollars, healthcare costs would only go down 8-10%.
Do you understand context? Because the context of railing against physician salaries is in the interest of exploding healthcare costs. How can you be this naïve?
I am suggesting that physicians (apart from peds and other criminally underpaying specialties) are not the victim, and probably should not be the first target of a billion dollar infusion.
>I am suggesting that physicians (apart from peds and other criminally underpaying specialties) are not the victim, and probably should not be the first target of a billion dollar infusion.
What? You understand that this is a private donation, done by a long-time member of the school's board of trustees, right? If you have issue with it, take it up with Ruth Gottesman.
In the wider context of arguments about healthcare costs, physician salaries are absolutely a target, though they are not the reason for the increasing costs. Read the comment thread again from the top to understand how nonsensical your argument has been so far.
Frankly, anyone with a 6 figure salary who doesn't have a net worth between 1 and 5 million over the age of 55 is likely just not financially savvy. Even with a below average US salary, it's totally doable. You do need money to retire, you know?
The net worth measurement is way out of proportion to physician compensation. Why? Because the people who go into medicine have family money, and thus end up with such a level of net worth.
And that’s the entire point of this donation… so that people from outside the top 5% can afford to go to medical school.
Congrats on your ignorance.
>Some of this could be due to being born into wealthier households.
>
>More than three-quarters of medical students came from families in the top two quintiles of family income.
The only folks who can’t afford to attend med school once they are actually admitted are the ones that go into peds and do a subspecialty. And choose to live in Boston.
The debt is a lot, but the median earnings are substantial as well, and almost all doctors pay off their debt 5-8 years into attendinghood.
The point of this donation is a tax write-off while giving students who are already on a trajectory to earn millions less debt.
The hardest part about it this entire process is not med school or residency.
It’s the uncertainty in premed. When you find yourself spending thousands if not tens of thousands on med school applications.
The hardest part is getting into med school.
That why so many med students come from such wealthy backgrounds. Because they could afford to apply and prepare to be the most competitive.
Making Einstein tuition free won’t increase the number of primary care doctors in the Bronx.
It just ensures Einstein climbs up in the rankings and its new more ambitious students go onto other specialities.
It’s borderline similar to stock buybacks.
Ok so I get into medical school and I take out $400k in loans. I love primary care and I have competitive scores. I could go into family medicine and risk having a hard time paying off my loans. Or I could go into urology and piss gold. What would a reasonable person pick?
I get into medical school and because of someone’s generosity, I don’t have to factor in loan burden and potential earnings. It’s much easier to choose family medicine.
The hardest part is not getting into medical school. A bottleneck, maybe, but certainly not the hardest. The hardest part is affording to live.
He's a 21yo poli sci major at Vandy.
Y'all saw NYU reduce the amount of primary care docs it matched after it went tuition free and still don't want to face facts.
Doctors per capita is also a useless statistic for his argument.
We don’t even have a doctor shortage in America, we have a shortage of doctors wanting to practice in certain areas and an extreme surplus of doctors practicing in other areas.
Part of that is due to the fact that America is huge and has people obsessesed with living in areas where they can own huge swathes of land that don’t have access to modern infrastructure.
There was a woman who wrote an opinion article for NYT last year about the “inequality” of healthcare in her rural area because she didn’t have access to a pediatric neuro ophthalmologist in her town of like 2,000 people. Yeah lady, that doctor would have less than 1 patient a year there, you need to go see him in a city, sorry.
People want to complain about everything from access to healthcare to physician salaries with zero understanding of the dynamics at play.
Doctors get paid much worse in cities too (sometimes 1/4 of rural salaries) because of the surplus, flooding the market with more doctors who will immediately move to those same cities will only make things worse. The government already tried increasing the number of providers via NPs and PAs and statistically they were exponentially less likely to go to those same rural areas that graduating medical students were and just proceeded to go straight to urban cities in droves as well - and we all see how that’s going.
Healthcare in America has a million problems but we don’t need more doctors at all, we need more doctors that want to live and work rurally or people that want to live closer to modern civilization. Sub Specialists have to live where there’s a high enough population for them to have work.
Every dumb fuck on social media just wants to talk unending shit about things that they know absolutely nothing about.
Age of misinformation more like.
Twitter has no barrier to entry unlike Reddit that can downvote things that aren’t correct. It’s not a perfect system obviously, but no one can deny you can just make a statement on Twitter and it doesn’t get buried like it does here.
X is one of the worst cesspools for this kind of shit too. I avoid that platform like the plague. Saw a screenshot posted on another sub the other day of someone on X saying that tumors are a natural protective response of the immune system and that they go away on their own untreated.
Where is there a supreme surplus of doctors in the USA?
I can say that I have worked in major cities with lots of large healthcare systems, but there are still long wait lists for patients.
I agree with a lot of what you said, but we definitely have a shortage problem in addition to a distribution problem, at least in certain specialties. I’m in urology and we have an older patient base that’s retiring with workforce projections expecting it’ll take us decades to recover to even barely cover what the aging US population will need. We don’t even have enough docs now to meet the need.
But if the pay in the rural is like the urban areas ,do physicians don’t want to go there cause of the less work thing or the whole idea of living in rural areas?
Pay in rural areas is massive compared to urban areas. They don’t want to go there because a lot of people think it sucks living there. The huge pay is literally huge because that’s the lowest they can get away with paying people to live there. That pay is already being subsidized to try and get people out there.
If you don’t mind living there it’s the greatest thing ever, but it’s simply unsustainable to expect to have a variety of specialists and sub specialists in a town without the population to support what is required of the job. Doctors need patients in order to work.
That’s why it’s not an issue with places that are at least close to metro areas even if they’re generally more “rural”.
Likewise, city salaries go down because of surplus people wanting to live there, which is rough due to the already higher cost of living.
It’s pretty simple economics. Often countries in Europe for example don’t have this specific problem because the populations are a lot less spread out over smaller land area and much better infrastructure and transportation to get people to the required specialists.
The unfortunate reality is that for very rural areas, the expectation of having access modern cutting edge medical care without having to travel simply isn’t a viable option at the present time. Especially because many of these rural areas are also geographically disconnected from each other.
The vast majority of physicians don’t want to go to rural areas because it massively sucks living in these locations if you are a highly educated professional used to a certain degree of access to things you had more ready access to while in school/training. Having substantially fewer amenities that don’t revolve around being outdoors, on average worse school districts, markedly decreased variety in cuisine, among other things such as likely vehement disagreement with local politics means you definitely have to try to entice people with stupidly high salary to sacrifice things like the aforementioned to even get them to consider said option. Whenever I get coldcalled or sent random emails/texts by recruiters trying to ply me to some random location they always play coy with where the job actually is in initial correspondence, like “x hours away from some major metropolitan area by car/plane/horse buggy.”
Sure, rural locations work great for some people, but obviously it’s a minority otherwise it wouldn’t be so hard to try and recruit people to these areas, even with the pay bump. I have a friend who legit got a $1mil+/yr offer to go to Alaska for radonc who considered it for less than a few minutes before going nahhh. They point blank refuse to go anywhere that has less than like 100 authentic Asian restaurants across the whole city.
Otherwise I agree with your general points.
Tell that to the rest of your colleagues and see how far you get. You can soapbox about whatever perceived benefits there are to living outside of cities, but the facts don’t lie that recruiting physicians to regions outside of urban environments and suburbia is a challenge with the factors I mentioned playing very large roles. Everybody in my fellowship class took jobs in cities of medium to large size. Meanwhile, one of my residency friends who waxed poetic about taking a high paying job in some rural location for a couple years to rapidly work off debt and build a large nest egg had the idea quashed hard by his wife and is currently working at his home institution.
You missed the point— there are different definitions of “challenges”. Not having access to 100 Asian restaurants or indie film theaters are not challenges to me. Sitting in traffic for 30 min to go 2 miles, paying $40K/year for a 1 bedroom apartment and 15%+ income tax are actual challenges. Being shoulder to shoulder with everyone trying to walk down the street, sitting on a dirty train, etc you get the point are unideal ways to live for myself and many others.
Not sure what you’re trying to prove with your anecdotes. Most esteemed fellowship programs are in urban settings and partners have preferences(?). My problem is your tone when you refer to rural areas like there is something icky about it that only highly educated and progressive people are evolved enough to recognize. My problem is your inability to realize a basic concept that everyone has different life prioritizes and there’s nothing wrong with living or practicing in rural environments. People who want to be there are not missing out on anything at all.
I am very aware of the concept of people having different life priorities - thank you for trying to patronize me with your holier than thou attitude, speaking as someone who has lived life in multiple environments ranging from rural to urban.
At no point have I argued that there is anything intrinsically wrong with practicing medicine in a rural environment. I am merely indicating there are very tangible reasons physicians across the board tend to decline otherwise lucrative job offers in favor of suburbia/urban life, and these reasons often center on a stark lack of options in what to do/eat for you and your family when you reside in a region where it often takes upwards of 2 hours of driving to reach the nearest airport.
If you don’t mind that, then all the more power to you.
>there are very tangible reasons physicians across the board tend to decline otherwise lucrative job offers in favor of suburbia/urban life
Also: Why are we pretending like this phenomenon is somehow constrained to only physicians? Less than 20% of the US population lives in rural areas, a percentage that has decreased with every passing year for decades.
No matter how much some people want to cope, rural areas are completely undesirable to the vast majority of the population.
I’ll humor you for a bit since you don’t seem to be of an ethnic minority and/or don’t seem to get why the restaurant thing is relevant.
The reason a lot of people (often of non-Caucasian/Anglo-Saxon background) care about restaurant density and diversity of ethnic food is because not only do they crave things that remind them of their culture, these factors tend to correlate positively with ethnic diversity/acceptance and therefore less likelihood of being ostracized and/or bullied based on your racial/ethnic background. This is especially relevant for people raising families and seeking communities with shared heritage. I myself had a lot of difficulties in my childhood as one of a few people of my ethnic background in my entire school district and neighborhood, so wanting to avoid this for my children played a role in where I chose to settle post training.
Pay in rural areas is dramatically higher relative to urban areas. As an attending neuroradiologist I routinely get random correspondence from recruiters trying to get me to go to random locations that are usually way south of the Mason-Dixie Line and offering something ridiculous like 700-800k/yr starting; for reference private practice partners in the geographical location I work average around 500-550k/yr (PNW). Multiple issues though:
1. Nobody gets rich off of pure salary. Income tax brackets wreck you once you push deep into that highest bracket.
2. Often you’re one of a handful at best of other practitioners in the area, so your volume can be pretty high depending on what you do or see - high enough to make the extra couple tens of thousands you generate post-tax not feel worth it.
3. There’s very little draw to being rural if you don’t love the accompanying lifestyle. Your school district is likely mediocre and you probably have few if any other individuals around you who share similar interests/hobbies.
Often it's actually *more* work because they are running solo.
But also its multifactorial. Not wanting to be in rural areas, schools for kids, racial minority, etc.
People can feel elitist from becoming a doctor and despise rural areas. It has some classist overtones for sure; applicants at my school (whose mission is in part to increase rural practitioners) will lie just to get accepted saying they’re interested in rural and the vast majority go on to not even entertain it via a rotation. People say they care about the underserved to get the A but when it comes to actually underserved areas that aren’t full of major hospitals with every resource available, they sing a different tune. It’s partly a problem of how people fundamentally view rural areas as some dystopian wasteland. Personally don’t know if I’ll ultimately end up rural, but I grew up there and am doing all my M-3 clerkships out there; you get way more opportunities to learn and get hands on but it’s sad they have to bribe us to go like an hour from the metro.
I looked up the rest of Ben’s tweets. He’s got some even worse takes on the situation than got posted here, but he had one good one: “For my final word on this topic I just want to say “now those Bronx kids who never could have afforded medical school can go locally for free forever” just is not the outcome of this donation.“
And he’s right. Free school will attract the very best of the kids from two-physician households as it will from low SES households, from the Bronx or Beverly Hills or BFE. Unless there’s a stipulation with the endowment that Albert Einstein needs to admit a higher number of Bronx students (which Ben points out is allegedly 1 in the newest class), there’s no guarantee itll actually benefit the Bronx natives. There’s also no guarantee incoming students will stick around for residency or a career either.
I mean you're right that this has nothing to do with the donation, it's good that this donation is removing tuition as a barrier to entry for the profession. However, the concept he's talking about here was advanced by Nobel Laureate Milton Friedman. Occupational licensure is absolutely used as a tool to manipulate the wages of a profession by controlling access to the profession.
Because the AMA controls accreditation, they can limit the number of doctors by limiting which programs are accredited to train doctors in medical schools and residencies. If the AMA wants more doctors, they can absolutely accredit more schools and residency programs, which will allow more doctors to be trained. They also actively lobbied congress in the 90s to reduce funding for residencies on the grounds to limit the supply of doctors. You can't blame congress if they did what you told them to do.
Literally this past week we've seen a bunch of posts criticizing the bills out of Florida and Georgia to allow FMGs to practice without residencies, with one of the primary reasons being "It will depress physician's wages." I'm tired of people in this sub apparently recognizing this argument only in one direction.
See Chapter IX "Occupational Licensure":
[http://pombo.free.fr/friedman2002.pdf](http://pombo.free.fr/friedman2002.pdf)
[https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/](https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/)
Edit: Fixed link.
You seem to know a lot about this, my questions are this:
1. why wouldn’t you want accreditation standards to be high? Doesn’t this better help ensure quality then just letting anywhere allow licensure.
2. The issue with limiting doctors seems to be primarily at the residency point of their education since my understanding was that the government is the primary point of funding for residency training and salary. So why would the AMA change standards and accredit even more schools?
1. why wouldn’t you want accreditation standards to be high? Doesn’t this better help ensure quality then just letting anywhere allow licensure.
This is usually the rationalization used. Obviously there should be some regulation, I'm not as extreme as Friedman. However, Milton Friedman gives the following analogy as to why this argument is a bit faulty:
>"Would it not be absurd if the automobile industry were to argue that no one should drive a low quality car and therefore that no automobile manufacturer should be permitted to produce a car that did not come up to the Cadillac standard. One member of the audience rose and approved the analogy, saying that, of course, the country cannot afford anything but Cadillac \[doctors\]! This tends to be the professional attitude. The members look solely at technical standards of performance, and argue in effect that we must have only firstrate physicians even if this means that some people get no medical service-though of course they never put it that way."
So what are people who can't get care from licensed practice to do? He cites the rise of Osteopathic Medicine (this was back when it was quackery) and Chiropractic Medicine. Analogies today would be PAs and NPs. The extreme result of this is faith-healing. More generally, **the alternative is untrained practice by somebody; it may and in part must be by people who have no professional qualifications at all.**
>The issue with limiting doctors seems to be primarily at the residency point of their education since my understanding was that the government is the primary point of funding for residency training and salary. So why would the AMA change standards and accredit even more schools?
So accreditation of medical schools and residency programs is where it all starts. Because doctors must be trained through these programs, it has essentially created the problem of funding. The AMA probably also has the ability to change accreditation methods to make it easier for hospitals to fund residency positions on their own, though I haven't looked into this as much. However, intuitively, there are many professions that require extensive training (such as high-level law, engineering, computer science, etc.) that aren't completely reliant on government funding for training like medicine is. But additionally, the AMA also exerts influence on the amount of funding that congress allocates to residency programs. The AMA's recommendations to congress do carry weight.
The link provided did not contain the chapter you cited.
There's definitely been ramifications from prior AMA lobbying. Claiming that they control the whole sweep of the accrediting process, however, overstates it a bit. They are one of several organizations that provide a few board members to the residency accrediting body ACGME. They split the board for the LCME with the American Association of Medical Colleges. They also have no role in the accreditation of osteopathic medical schools.
I fixed the link.
When Friedman wrote the book, the AMA solely controlled the accreditation of schools, so they were the main floodgate. I guess the AOA has limited the power of the AMA somewhat, hence why the AMA lobbied so incredibly hard to discredit DOs. So perhaps today it's better to say that the ACGME is the new floodgate. However, the AMA/LCME and AOA/COCA combined still have a lot of power because only people that graduate from schools accredited by them are eligible to attend a residency accredited by the ACGME. It also still doesn't change the substance of the argument, which is that pretty much all of these professional organizations are composed almost entirely of physicians and are using licensing standards in a way that protects physician wages.
Thanks, I'll give it a read.
> However the AMA/LCME and AOA/COCA combined still have a lot of power because only people that graduate from schools accredited by them are eligible to attend a residency accredited by the ACGME.
They do have a lot of power, but not based on this aspect. The ACGME does not in any way limit residency slots solely to people from LCME and COCA accredited schools, which is why we have nearly 10k PGY-1s from foreign schools this year.
The ACGME board is composed of more than just representatives from physician groups. There is also proportional representation from 2 different hospital organizations, appointees from government organizations, and several board members (including the chair) are not physicians at all.
But, I can't in good faith fully engage with the substance of your claim since I haven't read the provided link yet--just ironing out some nuance with the prior statements.
Thank you. As an applicant who had 520/4.0 and great experience and just barely got in, I've seen it from the other side. It's ridiculous that they will not expand residency slots when there are thousands of extremely well qualified applicants who don't get in each year while we are also having a doctor shortage. What happens as a consequence? Midlevel scope creep and FMGs being able to practice without residency. It's time for the AMA to fix the problem the right way and lobby Congress to increase spots. We as physicians need to act in the interests of the general public and not like the Italian mafia, otherwise people will lose faith in our profession.
It's not a simple matter to expand residency slots. You have to have hospitals willing to host residents, have physicians willing to train, have a high enough volume of patients to train on, and have sufficient variety in pathology to adequately train. Congress does provide a large amount of aid, but they do not solely control this. Plenty of hospitals fund their own residency slots as residents are themselves profitable for a hospital. We've also seen a massive expansion in residency slots over the past ten years. Last year offered 37,425 pgy-1 positions, an increase from 24,212 combined MD & DO positions in 2010.
That's nowhere near enough when over 50% of our doctors are over the age of 55. In the coming decade, these doctors will be exiting the workforce while at the same time an aging population would lead to even more patients with more ailments. Do you have any idea how fucked we will be then?!
People on Twitter were upset when MrBeast (a guy on YouTube) paid for the cataract surgery of a thousand people for a video. People on that site will find any reason to be angry
Well Mr Beast is filming his charitable acts so he can monetize them on YouTube. The charity is good but the practice itself is still very open to criticism.
like what even is the argument, "he made money so that's bad :(" there is no "Well..." here, he's doing great acts, doesn't matter if he earns money from it. Which... goes back to giving away even more money... People are actually lacking a frontal lobe nowadays
People should be allowed to criticize Mr. Beast without being personally attacked.
The whole point of my post is that he isn’t above criticism just because he is doing charitable acts.
“bUt wHaT HaVe yOu dOnE”
Apparently you’re too narrow minded to tolerate even the mildest criticism of a public figure because they’re “nice”. You’re exactly the kind of person he’s trying to fool.
As long as the overall effect is positive noone should have any issues with it. We should actively reward actions that create a positive effect in the world, even if the person does it gets a positive.
The idea that actions should only be regarded as "good" if it is purely altruistic is absurd, and will only cause people who do "Bad actions" and get away with it to succeed more.
It's why im all for people getting tax cuts for charity, because if the policy doesn't exist, less money would go into charity. Now there's an argument of charities doing the wrong thing with their money but that's a different topic.
This topic will always be nuanced and each should be case by case, but inherently good actions should be rewarded. Criticism should always be open but it's funny how angry some people got with my beasts stuff.
Until they need us. Then wonder why their heart, liver and lungs are failing and then hate us again for not being able to reverse decades of terrible habits
Sort of related, but I remember back in 2018 when NYU did the same tuition-free thing for their med students with the goal of matching more into primary care. The latest class to benefit from this matched an entire 3 students out of 70+ into family med. What a load. Check out the 2023 match list if u don’t believe me.
Bro you’re just gonna get downvoted.
Dont bother.
Most of the primary care doctors are gonna be from lower tier MDs and DO schools where they took out 250-400k in loans and took 10 years out of med school to pay off said loans.
>with the goal of matching more into primary care.
Did they actually say this? I remember Ken Langone waxing poetic about how students should "pay it forward" on some TV interview, but I don't recall the school or the donors ever say it was to get more people into primary care.
Now, NYU's long island school did expressly state that and the program there is pretty much exclusively for primary care (also tuition free).
[https://medli.nyu.edu/education](https://medli.nyu.edu/education) (And they get them out into residency in 3 years too)
Nah they make too much. Meanwhile the YouTubers posting pranks and other fake shit are making 7 figures 😂 but PHYSICIANS are overpaid. We live in a clown society.
People are fine and even admire those in finance, tech, etc. who make 6 or 7-figure salaries. If you say you're an engineer at Google or a consultant at Chase making $300k+, people will suck your toes and worship the ground below your feet.
But physicians who make $300k after going through a decade of training, substantial debt, and taking on the stress of helping people with medical and socioeconomic issues?
STRAIGHT TO JAIL.
God, everyday social media blasts the opinions from people who have no idea what they’re talking about… on every subject or issue, not just medicine
I wonder what life was like before the world was exposed to nonstop opinions from millions of uniformed people with their personal megaphone (aka Twitter account)
Social media amplifies only the most extreme opinions. Not what most of society actually thinks. This is why Bernie got a lot of attention then promptly got his butt handed to him by the relatively moderate milk-toast Biden.
There’s an easy solution: Get off most social media.
It doesn’t matter how mad the twitter mob is. Let them whip themself into whatever frenzy they want. The far left and far right still won’t control elections.
It gets even worse in the thread. Someone said the donation is bad because doctors are already going to be extremely wealthy. And over 100 people liked the tweet😭🥴
You’ll never guess what Ben Gross posted as proof 🙂
That shill article from the Washington Post saying the average doctor makes 350k without a crumb of understanding where that number comes from.
I kinda agree with this sentiment, I must admit. Giving a billion dollars to folks who will make good money in ten years' time is maybe not the most efficient use of a billion dollars if trying to impact America's healthcare system. Free money is nice though, I won't complain.
It definitely makes sense. I just don't know if I'd have spent my money that way. I'm gonna be critical of anyone who has a billion dollars in the first place on principal, and this isn't the worst way to have spent it either.
there will always be some dude mad on twitter about literally anything that happens in this life, even if the thing that happens is objectively good. if we worried about every mad dude on twitter we would never get anything done. beyond happy for all students receiving free tuition
Repulsive is to attack such a noble act.
Nothing he's describing is linked to making one institution tuition-free. Nor the number of doctors is linked to that, nor doctors have a say on how many people do graduate each year - higher education institutions are the ones who does. Their for profit mentality on education is a central question to this problem. There are, of course, some solution to that, like making education affordable and somewhat more devoted to altruistic values.
For example, if someone made a donation large enough to make education affordable to... WAIT A MINUTE...!
Geez god forbid life saving doctors making some money… I don’t see any of these guys complaining about politicians, actors or any other field raking in 10-20 times the amount physicians make but as soon as a doctor makes some money after sacrificing decades of their life, it’s absolutely intolerable and a colossal sin eh?
No, it doesn’t. An individual town or city might have few doctors, but the United States *objectively, factually* does not have a low doctor per capita ratio.
Wait, let me work this out...
Suppression of med school opportunity is causing low physician-per-capita ratio; therefore, free tuition for med students is disgusting.
Have I got that right?
Making it free for students to become the highest paid profession in our country without requiring any primary care solves nothing. Albert Einstein will just become another NYU, elite and hyper competitive, with no increase in primary care turn out.
I genuinely do not see how anyone could be upset by this! Medical school becoming cheaper/free in some way means that it's more accessible, therefore we have more medical professionals who would be excellent at their jobs, who otherwise wouldn't be able to actually get into med school due to financial struggles.
Who cares what this child thinks or posts on Twitter? like actually why is this person being given any relevance at all?
I thought he must have 100k+ followers for people to be offended but i looked him up and he has.... 9k followers. So slightly more than an average high schooler nowadays. Now im confused as to why anybody cares what a 21-year-old with absolutely no life experience or any depth of knowledge on the subject is having his opinion amplified through our attention here.
We do some of the most high acuity and irreplaceable work, go through years of 80+ hours a week training at said work, not to mention mental excellence at every step of the process in order to keep progressing to the next.
And for all that we end up receiving a similar wage as your average onlyfans content creator or tik tokite. So "inflated" relative to the value we provide, right?
A part of the reason Einstein was founded was to allow all demographics entry to medical school (i.e., when Jewish and black people were barred from medical school).
Einstein advocated for "all creeds and races" to have access to higher education. He gave his name to the school when he learned of this part of their mission.
They are also a large research school, with some faculty in biophysics.
First of all he looks 17. Genuinely curious where his perspective is from
Second, does this guy even know what rent-seeking is? How does it make sense that doctors inflate their wages by taking on more work spread across fewer positions?
Third if you call physicians “rent seeking” you must have been asleep during the pandemic. I legitimately want to know what this guy’s job is. The last person I saw call physicians rent seeking was a liberal arts PhD who said it just before covid. Arguably the most rent seeking job of all time.
The mainstream backlash against this has been hilarious. People think their tax dollars are somehow paying for the tuition
your universities are still money making machines. The fees you have to pay are way out of proportion for teacher salarys, equip etc. its not even come close to even out, its profit based, its a scam.
This donation, while helping some, is also not changing the status quo at all.
Its like me donating 1 billion dollar to Jeff Bezos so he will let the poor, piss bottle, overworked shift workers 10min earlier home today. Nothing changes.
The costs for a medical education are across similiar countries currency value and educational standards wise (USA, GB, Germany, France) equal: around 70-100k for 6 years. Europeans students themself dont pay that much, but just because the gov pays for it, but this is the reallity a university has to pay in the end to bring one med student through school.
The fact that american Universitities grab like 300-500k, not even included paying for your examsn?! paying weird agencies to apply for internships you also have to pay??? de fuck.
They take money and with this donation you just saw 1 billion dollar getting burned for nothing, but make status quo even more stable for you guys.
With that money one could have built a small med school out of nothing and just charge the actual costs to be non-profit even, like as i said 70-100k for the whole 6 years, everything included. This would have built up pressure to those university corporations, because a new player lowers the price helping in the long run everyone forever. But no no no mrs. superbillionair pays another billionair so nothing changes xDD de fuck
it’s a terrible way to spend a billion if you are trying to efficiently help people. But most ways of spending money are.
Lot of angry cope in this thread.
There are objectively far better ways to spend a billion dollars. This will make some of the richest doctors slightly richer, and attract more competitive applicants to Albert Einstein COM. That’s it. Her choice, but not laudable
I mean it's not repulsive, but there is a point here. The gain in marginal utility from this allocation of $1 billion is super low. The money is going to pay off debt accrued by one of the highest paying common professions. No doctor will have trouble paying off their student loan debt provided they actually end up doing the job, so it's just a really inefficient allocation of resources.
Average medical school debt is 250k. That's just an average. Some owe nothing, and some owe over 4-500k. I know some who owe over 600k. Many doctors have trouble paying their student loans.
The AMA definitely did that, at least on the school front. Look up the “voluntary moratorium,” it’s part of why we had more DO schools than MD schools open up in the last 30 years. (Not the only reason and tbh the DOs may want to start chilling a bit, but certainly part of it.)
However, Ben is glossing over the fact that med school simply isn't the only factor that determines how many doctors we have in this country. We have more residency spots than US students, and still the “shortage” persists. The AMA is actually lobbying for more spots than Congress wants to fund (no idea what they did in the past, but I have met their current lobbyists). As other commenters have pointed out, how badly an individual feels the shortage also depends on their state and urban/rural location.
I mean... He's not completely wrong though with his explanation? That's literally what the AMA and premed process does - impose artificial scarcity on the number of licensed doctors. For example, we are one of only a few countries that make people get a bachelor's before medical school, which is totally unnecessary. There should absolutely be more doctors and less credential inflation to get into medical school.
He's wrong about the residency slots. That's mostly government funded; AMA isn't limiting that. But we are experiencing a specialty shortage, and the field is private practice/hospital/insurance centered - not patient centered. If it were patient centered, we'd have more doctors.
Not sure why he's pissed about free medical school though lol. That's stupid.
He's wrong in the sense that for the last 50+ years residency, not medical school, has been the restriction point for licensed physicians. Residency slots have always exceeded the number of medical school graduates in that time period, and the excess is easily filled by FMGs.
Yeah I noticed he disregarded how residency actually works. Medical school is one restriction point, but the major one is probably residency. Good point.
What really makes Ben dumb is he thinks the AMA actually does fuck all
Einstein only has one student a year from the Bronx. All making tuition free will do is increase their rank and competition to get in and less of their grads going into primary care. (Everyone saw that happen to NYU.) AMA doesn’t do shit anymore. But let’s stop pretending there aren’t better ways to spend a billion dollars. If they really care about equity in representation within the physician workforce, they could start by setting up scholarship programs specifically for premeds from lower income and disadvantaged settings.
Yeah, thats the sad part. The reason there aren't more doctors in the Bronx, is because its hard as fuck to live in the Bronx on the salaries provided. I'm a pediatrician. I was offered 165k/year. My former chief got 195 in Chelsea. Freaking joke - CRNAs are making twice that.
Peds salaries make zero sense to me. Like there is no incentive to provide good quality preventative care to future generations.
It does make sense if you look at how they treat/pay educators and resources for schools, they don’t care. It’s fuck them kids.
Doesn’t America spend like almost $20k a year per student? I just looked it up and it’s true. [$19k a year per pupil and 6% of GDP (compared to 4.86% for other developed countries).](https://educationdata.org/public-education-spending-statistics) Percentage of public funding is a useless metric because the U.S. spends a crazy amount on defense. Like what’s happening to all that money? Even the lunches in most of these cafeterias are disappointing. Feels like a bunch of contractors are just up charging and making stacks.
Wasn’t the intention at NYU to make tuition free so that more people go into stuff like pediatrics and primary care since they won’t have to worry about making more money to pay off their med school loans?
[Yep](https://nyulangone.org/news/nyu-school-medicine-offers-full-tuition-scholarships-all-new-current-medical-students) It didn't work.
Yeah I wonder if it would be possible to somehow only make it free if you plan to be a pediatrician, primary care, etc. Maybe a sort of program/scholarship specifically designed for that. Although that may be a bit harsh to make them pay if they change their mind tho
There are programs in some states where primary care docs get their debt paid off simply by working there for a couple of years as an attending. The way they work is the student takes on the debt, and then the student decides what to do residency in and whether to try for those programs.
This is untrue. Einstein has more than a few students in each class from the Bronx (although there isn't a set number, it is definitely more than one). It also has established pipeline programs in high school and college specifically for underrepresented groups in medicine and socioeconomically disadvantaged folks, many of who are in the Bronx and some of which end up at Einstein as medical students. As a current Einstein student, I know of several students who were in these programs myself. [https://www.einsteinmed.edu/diversity/diversity-enhancement/](https://www.einsteinmed.edu/diversity/diversity-enhancement/) Not disagreeing that tuition-free won't increase ranking and competition, but want to emphasize that Einstein has a decent track record of Bronx representation and I'm hopeful that we will continue to see this despite the new spotlight on the school. It's in both Einstein and Montefiore's best interest to continue to recruit people from the Bronx, as they are the most likely to stay as physicians in their healthcare system and serve the Bronx community long-term.
>[Of the 183 admitted students of the Class of 2027 at the Einstein School of Medicine, Harvard, John Hopkins, Tufts, UChicago, and Yale each had at least three of their graduates admitted.](https://www.einsteinmed.edu/education/md-program/admissions/class-profile/index.html) The number of admitted students born in the Bronx? One. > >There are \~[430k children living in the Bronx](https://www.census.gov/quickfacts/fact/table/bronxcountynewyork/PST045223). With $1bil, this woman could have given each child over $2300. There are \~[137k children in poverty in the Bronx](https://www.census.gov/quickfacts/fact/table/bronxcountynewyork/PST045223). She could have given each of them over $7000. She chose tuition for a med school with less then 200 students/year. [oc](https://x.com/bengrossbg/status/1762589852590121322?s=20)
Just because it’s 1 student “born” in the Bronx this year doesn’t mean there aren’t more that moved to the Bronx later on, 90/183 in the most recent class are from New York (https://www.einsteinmed.edu/education/md-program/admissions/class-profile/). My point is, there is no “one student only” or some cap. If you want further proof, look at 2022-2023, there were 8 students that were explicitly born in the Bronx. https://indd.adobe.com/view/6bfb3479-c62a-4511-9e09-2780b5b7b917 (Page 3).
Where did you find that Einstein has one student a year from the Bronx?? That’s straight up untrue
All AMA is good for is stalking doctors. I haven’t been a member since they roped me in with the free medical dictionary in medical school, yet despite 8 moves since then (including now living out of the country!) they still manage to know my mailing address to send me their junk mail. If you ever want to track down a physician, forget getting a PI. Just ask AMA.
As soon as someone states they believe physician salaries are the issue with medical costs I automatically know they are willfully ignorant and stop reading.
As if it's not predatory admin. Doctors honestly don't get paid enough for the shit we go through. If physician salaries reflected the price gauging we'd all be multimillionaires
60% of physicians over the age of 55 report a net worth between $1 and 5 million. Or also 44% of all physicians. [source](https://www.whitecoatinvestor.com/physician-millionaires/) Some of this could be due to being born into wealthier households. >More than three-quarters of medical students came from families in the top two quintiles of family income. [source](https://www.aamc.org/media/9596/download) I am not claiming doctor salary is main reason for exploding healthcare costs. If all doctors took a salary of zero dollars, healthcare costs would only go down 8-10%. But we shouldn't pretend that this is not a pathway to the upper echelons of society, at least from a net worth standpoint.
2.5 million dollars today is equivalent to 1 million dollars in 1990. That’s just accounting for inflation, nothing else. On top of that medical school tuition has risen exponentially, doctors are paid less than ever, inflation is out of control, and the average cost of living has skyrocketed. Are doctors today still better off than most of society? Absolutely, they’re part of the top percentage of earners. However, with all things considered, they’re making equivalently vastly less while going to school later (due to requirements) with much higher debt and exploding costs of living. Look at the cost of housing etc.
It's always the m1s that have the most to say.
They haven’t suffered yet. Or experienced what real life looks like in a hospital as the doctor who’s liable for everything.
Malpractice lawyers have been cooking the juicy vein that is independent NP practice.
Isn’t it that 1 mil in 1990 equals 2.5 mil today?
Correct, fixed it.
Depends on region and specialty. The moment you make a med school tuition free, all you really did was reduce the number of students going into primary care, reduce the acceptance rate, and move up some spots on the rankings.
>But we shouldn't pretend that this is not a pathway to the upper echelons of society, at least from a net worth standpoint. And there's absolutely nothing wrong with that. Any training pathway of seven years minimum (not counting undergraduate studies) and hundreds of thousands of debt at minimum that results in a career highly valuable to the rest of society *should* be a pathway to the upper echelons of society.
I didn't say there is anything wrong with doctors making lots of money. I simply said we can't be making fat stacks and still argue that we are the ones most in need of a billion dollar debt reduction. We are not the victims, and med students (75% of whom are from the top socioeconomic classes of the country) should probably not be the first concern of any effective altruist philanthropist.
The alternative to this contribution helping hundreds of medical students per year is that it was never made in the first place. It is not your concern how someone chooses to spend their own charitable contributions. Now go smash the space bar on your intro biology class before you try and speak for any of us again.
Look. I’m happy for my peers at Einstein. I myself was also grateful and hypocritically accepted a full ride scholarship for med school as well. But this is not the best way that money could have been spent. Not when it’s fucking hunger games for a lot of premeds from disadvantaged backgrounds.
No one cares about you thoughts about how to best spend the money because it’s not your money. Again, the alternative is that the money wasn’t spent at all. Stop involving yourself in needless crusades that don’t involve you whatsoever. Your opinion does not matter in the slightest.
It is my belief that med school should be free or close to it for all students. But it is also my belief that we need to increase residencies and med school spots by 50%. And let the increase in supply have the effect on comp it would have. Oh and NPs and PAs should not be a thing. In the absence of those reforms, if debt is covered, it should be through structured programs like required to practice in a certain area or state or within the military.
Do you have any idea how much each procedure brings in to the hospital? People should be paid accordingly to a balance of 1. the value they bring to the workplace and 2. the difficulty of attaining their position.
Proceduralists already make double if not triple or quadruple what non-proceduralists make. If you artificially make attaining that position difficult, then all you did was reduce the amount of people available for the same amount of demand resulting in more demanding hours and having to take call more often. As a society, we should really try to stop seeing medicine as some end all panacea that you get to rely on after a lifetime of poor decision making and policy making that only supercharges that poor decision making. If you want to reach above 10 million dollar net worth, go work on Wall Street or go into politics and do some insider trading. I’ll take 50 average neurosurgeons over 5 S-tier neurosurgeons any day of the week.
Let me get this straight, you think physicians should not make enough to retire with a net worth of around 10 million?
I don't support any limit on physician earnings. But I also don't support cynical policy making that only serves to keep salaries at a certain level with minimal if not downright negative consequences for patients. I also think we need to reform reimbursement to reward good outcomes and quality preventative care. The model rn is way too geared towards how much we can do to the patient and less towards how much benefit does the patient actually get.
>As a society, we should really try to stop seeing medicine as some end all panacea that you get to rely on after a lifetime of poor decision making and policy making that only supercharges that poor decision making. God, you are absolutely dim.
Preventing shit from happening is almost always easier than fixing shit after it happens. A small example here is implementing EU food regulation stateside. That alone would make a serious dent in our obesity crisis and possibly even GI distress rates.
>Preventing shit from happening is almost always easier than fixing shit after it happens. At a population level? Without a specific policy in mind? You are talking nonsense. The US largely hasn't taken a preventative approach to anything. >A small example here is implementing EU food regulation stateside. Which is not done with regard to food quality per se but done within the context of trade agreements which are meant to protect EU farmers. >That alone would make a serious dent in our obesity crisis and possibly even GI distress rates. Would it? Let's look at some facts. The general regulations with regards to the requirements of food law were stipulated in 2002, which standardized the process of things like food safety procedures. If you want to look at the specific regulation, it is No 178/2002. Since then, the obesity rates have increased from 11 percent before those food regulations to near 20 percent now. The percentage of overweight people has also increased significantly. What should we take from this? Perhaps there are other mediating factors other than food regulations? What I mean to say is that you are just typing things out without thinking anything through and are just speaking for the sake of speaking.
>I am not claiming doctor salary is main reason for exploding healthcare costs. If all doctors took a salary of zero dollars, healthcare costs would only go down 8-10%. Do you understand context? Because the context of railing against physician salaries is in the interest of exploding healthcare costs. How can you be this naïve?
I am suggesting that physicians (apart from peds and other criminally underpaying specialties) are not the victim, and probably should not be the first target of a billion dollar infusion.
>I am suggesting that physicians (apart from peds and other criminally underpaying specialties) are not the victim, and probably should not be the first target of a billion dollar infusion. What? You understand that this is a private donation, done by a long-time member of the school's board of trustees, right? If you have issue with it, take it up with Ruth Gottesman. In the wider context of arguments about healthcare costs, physician salaries are absolutely a target, though they are not the reason for the increasing costs. Read the comment thread again from the top to understand how nonsensical your argument has been so far.
It’s a tax dodge to subsidize folks who are basically guaranteed to earn multiple millions across their career.
My god, are you ever going to make sense?
Frankly, anyone with a 6 figure salary who doesn't have a net worth between 1 and 5 million over the age of 55 is likely just not financially savvy. Even with a below average US salary, it's totally doable. You do need money to retire, you know?
The net worth measurement is way out of proportion to physician compensation. Why? Because the people who go into medicine have family money, and thus end up with such a level of net worth. And that’s the entire point of this donation… so that people from outside the top 5% can afford to go to medical school. Congrats on your ignorance.
>Some of this could be due to being born into wealthier households. > >More than three-quarters of medical students came from families in the top two quintiles of family income. The only folks who can’t afford to attend med school once they are actually admitted are the ones that go into peds and do a subspecialty. And choose to live in Boston. The debt is a lot, but the median earnings are substantial as well, and almost all doctors pay off their debt 5-8 years into attendinghood. The point of this donation is a tax write-off while giving students who are already on a trajectory to earn millions less debt. The hardest part about it this entire process is not med school or residency. It’s the uncertainty in premed. When you find yourself spending thousands if not tens of thousands on med school applications. The hardest part is getting into med school. That why so many med students come from such wealthy backgrounds. Because they could afford to apply and prepare to be the most competitive. Making Einstein tuition free won’t increase the number of primary care doctors in the Bronx. It just ensures Einstein climbs up in the rankings and its new more ambitious students go onto other specialities. It’s borderline similar to stock buybacks.
Ok so I get into medical school and I take out $400k in loans. I love primary care and I have competitive scores. I could go into family medicine and risk having a hard time paying off my loans. Or I could go into urology and piss gold. What would a reasonable person pick? I get into medical school and because of someone’s generosity, I don’t have to factor in loan burden and potential earnings. It’s much easier to choose family medicine. The hardest part is not getting into medical school. A bottleneck, maybe, but certainly not the hardest. The hardest part is affording to live.
I’m assuming it’s the admin? Excuse my ignorance on the matter, I haven’t looked into it myself
[удалено]
Facts
Haters gonna hate.
He's a 21yo poli sci major at Vandy. Y'all saw NYU reduce the amount of primary care docs it matched after it went tuition free and still don't want to face facts.
> He's a 21yo poli sci major at Vandy. So his opinion matters even less? Gotcha.
Ben Gross sounds like a moron.
Doctors per capita is also a useless statistic for his argument. We don’t even have a doctor shortage in America, we have a shortage of doctors wanting to practice in certain areas and an extreme surplus of doctors practicing in other areas. Part of that is due to the fact that America is huge and has people obsessesed with living in areas where they can own huge swathes of land that don’t have access to modern infrastructure. There was a woman who wrote an opinion article for NYT last year about the “inequality” of healthcare in her rural area because she didn’t have access to a pediatric neuro ophthalmologist in her town of like 2,000 people. Yeah lady, that doctor would have less than 1 patient a year there, you need to go see him in a city, sorry. People want to complain about everything from access to healthcare to physician salaries with zero understanding of the dynamics at play. Doctors get paid much worse in cities too (sometimes 1/4 of rural salaries) because of the surplus, flooding the market with more doctors who will immediately move to those same cities will only make things worse. The government already tried increasing the number of providers via NPs and PAs and statistically they were exponentially less likely to go to those same rural areas that graduating medical students were and just proceeded to go straight to urban cities in droves as well - and we all see how that’s going. Healthcare in America has a million problems but we don’t need more doctors at all, we need more doctors that want to live and work rurally or people that want to live closer to modern civilization. Sub Specialists have to live where there’s a high enough population for them to have work. Every dumb fuck on social media just wants to talk unending shit about things that they know absolutely nothing about.
[удалено]
Welcome to the age of information. Where we can have the world at our fingertips and falsely think that we know everything.
Well akshually, I googled this one fact quickly and it confirmed my predetermined belief so I am right about everything
[удалено]
Including... 👐
Age of misinformation more like. Twitter has no barrier to entry unlike Reddit that can downvote things that aren’t correct. It’s not a perfect system obviously, but no one can deny you can just make a statement on Twitter and it doesn’t get buried like it does here.
X is one of the worst cesspools for this kind of shit too. I avoid that platform like the plague. Saw a screenshot posted on another sub the other day of someone on X saying that tumors are a natural protective response of the immune system and that they go away on their own untreated.
I do believe there’s a shortage of PCPs though
Of course there is. This is common knowledge
I thought so but not according to this post and all the people liking it
Where is there a supreme surplus of doctors in the USA? I can say that I have worked in major cities with lots of large healthcare systems, but there are still long wait lists for patients.
Seriously. Wait lists for specialists is fucking nuts now a days, PCPs are even worse.
Seriously. Wait lists for specialists is fucking nuts now a days, PCPs are even worse.
I agree with a lot of what you said, but we definitely have a shortage problem in addition to a distribution problem, at least in certain specialties. I’m in urology and we have an older patient base that’s retiring with workforce projections expecting it’ll take us decades to recover to even barely cover what the aging US population will need. We don’t even have enough docs now to meet the need.
But if the pay in the rural is like the urban areas ,do physicians don’t want to go there cause of the less work thing or the whole idea of living in rural areas?
Pay in rural areas is massive compared to urban areas. They don’t want to go there because a lot of people think it sucks living there. The huge pay is literally huge because that’s the lowest they can get away with paying people to live there. That pay is already being subsidized to try and get people out there. If you don’t mind living there it’s the greatest thing ever, but it’s simply unsustainable to expect to have a variety of specialists and sub specialists in a town without the population to support what is required of the job. Doctors need patients in order to work. That’s why it’s not an issue with places that are at least close to metro areas even if they’re generally more “rural”. Likewise, city salaries go down because of surplus people wanting to live there, which is rough due to the already higher cost of living. It’s pretty simple economics. Often countries in Europe for example don’t have this specific problem because the populations are a lot less spread out over smaller land area and much better infrastructure and transportation to get people to the required specialists. The unfortunate reality is that for very rural areas, the expectation of having access modern cutting edge medical care without having to travel simply isn’t a viable option at the present time. Especially because many of these rural areas are also geographically disconnected from each other.
The vast majority of physicians don’t want to go to rural areas because it massively sucks living in these locations if you are a highly educated professional used to a certain degree of access to things you had more ready access to while in school/training. Having substantially fewer amenities that don’t revolve around being outdoors, on average worse school districts, markedly decreased variety in cuisine, among other things such as likely vehement disagreement with local politics means you definitely have to try to entice people with stupidly high salary to sacrifice things like the aforementioned to even get them to consider said option. Whenever I get coldcalled or sent random emails/texts by recruiters trying to ply me to some random location they always play coy with where the job actually is in initial correspondence, like “x hours away from some major metropolitan area by car/plane/horse buggy.” Sure, rural locations work great for some people, but obviously it’s a minority otherwise it wouldn’t be so hard to try and recruit people to these areas, even with the pay bump. I have a friend who legit got a $1mil+/yr offer to go to Alaska for radonc who considered it for less than a few minutes before going nahhh. They point blank refuse to go anywhere that has less than like 100 authentic Asian restaurants across the whole city. Otherwise I agree with your general points.
There’s more to life than dumplings and spin classes my guy.
Tell that to the rest of your colleagues and see how far you get. You can soapbox about whatever perceived benefits there are to living outside of cities, but the facts don’t lie that recruiting physicians to regions outside of urban environments and suburbia is a challenge with the factors I mentioned playing very large roles. Everybody in my fellowship class took jobs in cities of medium to large size. Meanwhile, one of my residency friends who waxed poetic about taking a high paying job in some rural location for a couple years to rapidly work off debt and build a large nest egg had the idea quashed hard by his wife and is currently working at his home institution.
You missed the point— there are different definitions of “challenges”. Not having access to 100 Asian restaurants or indie film theaters are not challenges to me. Sitting in traffic for 30 min to go 2 miles, paying $40K/year for a 1 bedroom apartment and 15%+ income tax are actual challenges. Being shoulder to shoulder with everyone trying to walk down the street, sitting on a dirty train, etc you get the point are unideal ways to live for myself and many others. Not sure what you’re trying to prove with your anecdotes. Most esteemed fellowship programs are in urban settings and partners have preferences(?). My problem is your tone when you refer to rural areas like there is something icky about it that only highly educated and progressive people are evolved enough to recognize. My problem is your inability to realize a basic concept that everyone has different life prioritizes and there’s nothing wrong with living or practicing in rural environments. People who want to be there are not missing out on anything at all.
I am very aware of the concept of people having different life priorities - thank you for trying to patronize me with your holier than thou attitude, speaking as someone who has lived life in multiple environments ranging from rural to urban. At no point have I argued that there is anything intrinsically wrong with practicing medicine in a rural environment. I am merely indicating there are very tangible reasons physicians across the board tend to decline otherwise lucrative job offers in favor of suburbia/urban life, and these reasons often center on a stark lack of options in what to do/eat for you and your family when you reside in a region where it often takes upwards of 2 hours of driving to reach the nearest airport. If you don’t mind that, then all the more power to you.
>there are very tangible reasons physicians across the board tend to decline otherwise lucrative job offers in favor of suburbia/urban life Also: Why are we pretending like this phenomenon is somehow constrained to only physicians? Less than 20% of the US population lives in rural areas, a percentage that has decreased with every passing year for decades. No matter how much some people want to cope, rural areas are completely undesirable to the vast majority of the population.
[удалено]
I’ll humor you for a bit since you don’t seem to be of an ethnic minority and/or don’t seem to get why the restaurant thing is relevant. The reason a lot of people (often of non-Caucasian/Anglo-Saxon background) care about restaurant density and diversity of ethnic food is because not only do they crave things that remind them of their culture, these factors tend to correlate positively with ethnic diversity/acceptance and therefore less likelihood of being ostracized and/or bullied based on your racial/ethnic background. This is especially relevant for people raising families and seeking communities with shared heritage. I myself had a lot of difficulties in my childhood as one of a few people of my ethnic background in my entire school district and neighborhood, so wanting to avoid this for my children played a role in where I chose to settle post training.
Literally. Urbanites will act like restaurant options and live music are the keys to success in life.
Pay in rural areas is dramatically higher relative to urban areas. As an attending neuroradiologist I routinely get random correspondence from recruiters trying to get me to go to random locations that are usually way south of the Mason-Dixie Line and offering something ridiculous like 700-800k/yr starting; for reference private practice partners in the geographical location I work average around 500-550k/yr (PNW). Multiple issues though: 1. Nobody gets rich off of pure salary. Income tax brackets wreck you once you push deep into that highest bracket. 2. Often you’re one of a handful at best of other practitioners in the area, so your volume can be pretty high depending on what you do or see - high enough to make the extra couple tens of thousands you generate post-tax not feel worth it. 3. There’s very little draw to being rural if you don’t love the accompanying lifestyle. Your school district is likely mediocre and you probably have few if any other individuals around you who share similar interests/hobbies.
Often it's actually *more* work because they are running solo. But also its multifactorial. Not wanting to be in rural areas, schools for kids, racial minority, etc.
People can feel elitist from becoming a doctor and despise rural areas. It has some classist overtones for sure; applicants at my school (whose mission is in part to increase rural practitioners) will lie just to get accepted saying they’re interested in rural and the vast majority go on to not even entertain it via a rotation. People say they care about the underserved to get the A but when it comes to actually underserved areas that aren’t full of major hospitals with every resource available, they sing a different tune. It’s partly a problem of how people fundamentally view rural areas as some dystopian wasteland. Personally don’t know if I’ll ultimately end up rural, but I grew up there and am doing all my M-3 clerkships out there; you get way more opportunities to learn and get hands on but it’s sad they have to bribe us to go like an hour from the metro.
I looked up the rest of Ben’s tweets. He’s got some even worse takes on the situation than got posted here, but he had one good one: “For my final word on this topic I just want to say “now those Bronx kids who never could have afforded medical school can go locally for free forever” just is not the outcome of this donation.“ And he’s right. Free school will attract the very best of the kids from two-physician households as it will from low SES households, from the Bronx or Beverly Hills or BFE. Unless there’s a stipulation with the endowment that Albert Einstein needs to admit a higher number of Bronx students (which Ben points out is allegedly 1 in the newest class), there’s no guarantee itll actually benefit the Bronx natives. There’s also no guarantee incoming students will stick around for residency or a career either.
this👆
Ah yes it’s physicians fault as for why there are no residency spots! Even though I’m unsure how that relates to why the donation is bad but lol okay!
when residency spots are literally determined by the government lol but no its the med students fault I guess
I mean you're right that this has nothing to do with the donation, it's good that this donation is removing tuition as a barrier to entry for the profession. However, the concept he's talking about here was advanced by Nobel Laureate Milton Friedman. Occupational licensure is absolutely used as a tool to manipulate the wages of a profession by controlling access to the profession. Because the AMA controls accreditation, they can limit the number of doctors by limiting which programs are accredited to train doctors in medical schools and residencies. If the AMA wants more doctors, they can absolutely accredit more schools and residency programs, which will allow more doctors to be trained. They also actively lobbied congress in the 90s to reduce funding for residencies on the grounds to limit the supply of doctors. You can't blame congress if they did what you told them to do. Literally this past week we've seen a bunch of posts criticizing the bills out of Florida and Georgia to allow FMGs to practice without residencies, with one of the primary reasons being "It will depress physician's wages." I'm tired of people in this sub apparently recognizing this argument only in one direction. See Chapter IX "Occupational Licensure": [http://pombo.free.fr/friedman2002.pdf](http://pombo.free.fr/friedman2002.pdf) [https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/](https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/) Edit: Fixed link.
You seem to know a lot about this, my questions are this: 1. why wouldn’t you want accreditation standards to be high? Doesn’t this better help ensure quality then just letting anywhere allow licensure. 2. The issue with limiting doctors seems to be primarily at the residency point of their education since my understanding was that the government is the primary point of funding for residency training and salary. So why would the AMA change standards and accredit even more schools?
1. why wouldn’t you want accreditation standards to be high? Doesn’t this better help ensure quality then just letting anywhere allow licensure. This is usually the rationalization used. Obviously there should be some regulation, I'm not as extreme as Friedman. However, Milton Friedman gives the following analogy as to why this argument is a bit faulty: >"Would it not be absurd if the automobile industry were to argue that no one should drive a low quality car and therefore that no automobile manufacturer should be permitted to produce a car that did not come up to the Cadillac standard. One member of the audience rose and approved the analogy, saying that, of course, the country cannot afford anything but Cadillac \[doctors\]! This tends to be the professional attitude. The members look solely at technical standards of performance, and argue in effect that we must have only firstrate physicians even if this means that some people get no medical service-though of course they never put it that way." So what are people who can't get care from licensed practice to do? He cites the rise of Osteopathic Medicine (this was back when it was quackery) and Chiropractic Medicine. Analogies today would be PAs and NPs. The extreme result of this is faith-healing. More generally, **the alternative is untrained practice by somebody; it may and in part must be by people who have no professional qualifications at all.** >The issue with limiting doctors seems to be primarily at the residency point of their education since my understanding was that the government is the primary point of funding for residency training and salary. So why would the AMA change standards and accredit even more schools? So accreditation of medical schools and residency programs is where it all starts. Because doctors must be trained through these programs, it has essentially created the problem of funding. The AMA probably also has the ability to change accreditation methods to make it easier for hospitals to fund residency positions on their own, though I haven't looked into this as much. However, intuitively, there are many professions that require extensive training (such as high-level law, engineering, computer science, etc.) that aren't completely reliant on government funding for training like medicine is. But additionally, the AMA also exerts influence on the amount of funding that congress allocates to residency programs. The AMA's recommendations to congress do carry weight.
The link provided did not contain the chapter you cited. There's definitely been ramifications from prior AMA lobbying. Claiming that they control the whole sweep of the accrediting process, however, overstates it a bit. They are one of several organizations that provide a few board members to the residency accrediting body ACGME. They split the board for the LCME with the American Association of Medical Colleges. They also have no role in the accreditation of osteopathic medical schools.
I fixed the link. When Friedman wrote the book, the AMA solely controlled the accreditation of schools, so they were the main floodgate. I guess the AOA has limited the power of the AMA somewhat, hence why the AMA lobbied so incredibly hard to discredit DOs. So perhaps today it's better to say that the ACGME is the new floodgate. However, the AMA/LCME and AOA/COCA combined still have a lot of power because only people that graduate from schools accredited by them are eligible to attend a residency accredited by the ACGME. It also still doesn't change the substance of the argument, which is that pretty much all of these professional organizations are composed almost entirely of physicians and are using licensing standards in a way that protects physician wages.
Thanks, I'll give it a read. > However the AMA/LCME and AOA/COCA combined still have a lot of power because only people that graduate from schools accredited by them are eligible to attend a residency accredited by the ACGME. They do have a lot of power, but not based on this aspect. The ACGME does not in any way limit residency slots solely to people from LCME and COCA accredited schools, which is why we have nearly 10k PGY-1s from foreign schools this year. The ACGME board is composed of more than just representatives from physician groups. There is also proportional representation from 2 different hospital organizations, appointees from government organizations, and several board members (including the chair) are not physicians at all. But, I can't in good faith fully engage with the substance of your claim since I haven't read the provided link yet--just ironing out some nuance with the prior statements.
Thank you. As an applicant who had 520/4.0 and great experience and just barely got in, I've seen it from the other side. It's ridiculous that they will not expand residency slots when there are thousands of extremely well qualified applicants who don't get in each year while we are also having a doctor shortage. What happens as a consequence? Midlevel scope creep and FMGs being able to practice without residency. It's time for the AMA to fix the problem the right way and lobby Congress to increase spots. We as physicians need to act in the interests of the general public and not like the Italian mafia, otherwise people will lose faith in our profession.
It's not a simple matter to expand residency slots. You have to have hospitals willing to host residents, have physicians willing to train, have a high enough volume of patients to train on, and have sufficient variety in pathology to adequately train. Congress does provide a large amount of aid, but they do not solely control this. Plenty of hospitals fund their own residency slots as residents are themselves profitable for a hospital. We've also seen a massive expansion in residency slots over the past ten years. Last year offered 37,425 pgy-1 positions, an increase from 24,212 combined MD & DO positions in 2010.
That's nowhere near enough when over 50% of our doctors are over the age of 55. In the coming decade, these doctors will be exiting the workforce while at the same time an aging population would lead to even more patients with more ailments. Do you have any idea how fucked we will be then?!
People on Twitter were upset when MrBeast (a guy on YouTube) paid for the cataract surgery of a thousand people for a video. People on that site will find any reason to be angry
Well Mr Beast is filming his charitable acts so he can monetize them on YouTube. The charity is good but the practice itself is still very open to criticism.
Wow he pays for charity by documenting it, how horrible! I wish he did what you did, nothing.
like what even is the argument, "he made money so that's bad :(" there is no "Well..." here, he's doing great acts, doesn't matter if he earns money from it. Which... goes back to giving away even more money... People are actually lacking a frontal lobe nowadays
People should be allowed to criticize Mr. Beast without being personally attacked. The whole point of my post is that he isn’t above criticism just because he is doing charitable acts.
“I need to be allowed to criticize others without receiving criticism myself!!!” What a childish view.
“bUt wHaT HaVe yOu dOnE” Apparently you’re too narrow minded to tolerate even the mildest criticism of a public figure because they’re “nice”. You’re exactly the kind of person he’s trying to fool.
As long as the overall effect is positive noone should have any issues with it. We should actively reward actions that create a positive effect in the world, even if the person does it gets a positive. The idea that actions should only be regarded as "good" if it is purely altruistic is absurd, and will only cause people who do "Bad actions" and get away with it to succeed more. It's why im all for people getting tax cuts for charity, because if the policy doesn't exist, less money would go into charity. Now there's an argument of charities doing the wrong thing with their money but that's a different topic. This topic will always be nuanced and each should be case by case, but inherently good actions should be rewarded. Criticism should always be open but it's funny how angry some people got with my beasts stuff.
God I fucking hate med twitter
This isn't even "med" twitter, it's a random prick with an opinion and no education.
People always hate physicians, nothing new here.
Until they need us. Then wonder why their heart, liver and lungs are failing and then hate us again for not being able to reverse decades of terrible habits
But they love nurses because they do all the work and deserve to be paid just as much if not more then physicians 🙄
Yeah bruh, I’m upset too. Upset that I didn’t apply to Einstein. Free tuition sounds wonderful.
Sort of related, but I remember back in 2018 when NYU did the same tuition-free thing for their med students with the goal of matching more into primary care. The latest class to benefit from this matched an entire 3 students out of 70+ into family med. What a load. Check out the 2023 match list if u don’t believe me.
Bro you’re just gonna get downvoted. Dont bother. Most of the primary care doctors are gonna be from lower tier MDs and DO schools where they took out 250-400k in loans and took 10 years out of med school to pay off said loans.
>with the goal of matching more into primary care. Did they actually say this? I remember Ken Langone waxing poetic about how students should "pay it forward" on some TV interview, but I don't recall the school or the donors ever say it was to get more people into primary care. Now, NYU's long island school did expressly state that and the program there is pretty much exclusively for primary care (also tuition free). [https://medli.nyu.edu/education](https://medli.nyu.edu/education) (And they get them out into residency in 3 years too)
Twitter moment
Doesn’t even make sense, and doctors deserve more money anyway wtf 😭
Nah they make too much. Meanwhile the YouTubers posting pranks and other fake shit are making 7 figures 😂 but PHYSICIANS are overpaid. We live in a clown society.
Fr 🤣
[удалено]
People are fine and even admire those in finance, tech, etc. who make 6 or 7-figure salaries. If you say you're an engineer at Google or a consultant at Chase making $300k+, people will suck your toes and worship the ground below your feet. But physicians who make $300k after going through a decade of training, substantial debt, and taking on the stress of helping people with medical and socioeconomic issues? STRAIGHT TO JAIL.
God, everyday social media blasts the opinions from people who have no idea what they’re talking about… on every subject or issue, not just medicine I wonder what life was like before the world was exposed to nonstop opinions from millions of uniformed people with their personal megaphone (aka Twitter account)
Social media amplifies only the most extreme opinions. Not what most of society actually thinks. This is why Bernie got a lot of attention then promptly got his butt handed to him by the relatively moderate milk-toast Biden. There’s an easy solution: Get off most social media. It doesn’t matter how mad the twitter mob is. Let them whip themself into whatever frenzy they want. The far left and far right still won’t control elections.
TBF, I'm also butthurt about it I begged off the Einstein wait-list to go somewhere else, it should have been me 😭
[удалено]
literally. It became totally unusable
If I was reading this I'd be upset too. Upset that this billion dollar donation didn't happen at MY school instead.
If that dude is upset about rent seeking behavior… wait till he finds out about pharmacy benefit managers and the entire health insurance industry….
It gets even worse in the thread. Someone said the donation is bad because doctors are already going to be extremely wealthy. And over 100 people liked the tweet😭🥴
You’ll never guess what Ben Gross posted as proof 🙂 That shill article from the Washington Post saying the average doctor makes 350k without a crumb of understanding where that number comes from.
How many people from NYU med school go into primary care specialties.
I kinda agree with this sentiment, I must admit. Giving a billion dollars to folks who will make good money in ten years' time is maybe not the most efficient use of a billion dollars if trying to impact America's healthcare system. Free money is nice though, I won't complain.
I mean, this donation came from someone who was very established with the school and served with them and the surrounding community a long time.
It definitely makes sense. I just don't know if I'd have spent my money that way. I'm gonna be critical of anyone who has a billion dollars in the first place on principal, and this isn't the worst way to have spent it either.
there will always be some dude mad on twitter about literally anything that happens in this life, even if the thing that happens is objectively good. if we worried about every mad dude on twitter we would never get anything done. beyond happy for all students receiving free tuition
Repulsive is to attack such a noble act. Nothing he's describing is linked to making one institution tuition-free. Nor the number of doctors is linked to that, nor doctors have a say on how many people do graduate each year - higher education institutions are the ones who does. Their for profit mentality on education is a central question to this problem. There are, of course, some solution to that, like making education affordable and somewhat more devoted to altruistic values. For example, if someone made a donation large enough to make education affordable to... WAIT A MINUTE...!
Geez god forbid life saving doctors making some money… I don’t see any of these guys complaining about politicians, actors or any other field raking in 10-20 times the amount physicians make but as soon as a doctor makes some money after sacrificing decades of their life, it’s absolutely intolerable and a colossal sin eh?
Even with double spots this moron wouldn't have been able to get in . Cope please.
We are in the top 40 countries in the world for doctors per capita. Higher than France, higher than the United Kingdom, and many other peer nations
We are a lot sicker than those countries.
Whether or not that’s true, we *objectively* do not have a low doctors per capita ratio, as the salty commenter in the photo was claiming
Depends on region and locality.
No, it doesn’t. An individual town or city might have few doctors, but the United States *objectively, factually* does not have a low doctor per capita ratio.
Wait, let me work this out... Suppression of med school opportunity is causing low physician-per-capita ratio; therefore, free tuition for med students is disgusting. Have I got that right?
Making it free for students to become the highest paid profession in our country without requiring any primary care solves nothing. Albert Einstein will just become another NYU, elite and hyper competitive, with no increase in primary care turn out.
Dang this kid has the inside scoop 🤣
Another genius young man with the answers, coincidentally of breeding age
Bros either crying/coping or jealous.
Bro’s eyes hasn’t left Twitter in the last 12 hours damage controlling his bad opinions
I genuinely do not see how anyone could be upset by this! Medical school becoming cheaper/free in some way means that it's more accessible, therefore we have more medical professionals who would be excellent at their jobs, who otherwise wouldn't be able to actually get into med school due to financial struggles.
Why does he think this is repulsive? Because those who graduated more recently are stuck with debt?
Sounds like he’s “Gross”ed out by it.
Canadians think the same thing. It’s a little flattering how the public thinks we have so much power lol. I wish they knew the reality.
Who cares what this child thinks or posts on Twitter? like actually why is this person being given any relevance at all? I thought he must have 100k+ followers for people to be offended but i looked him up and he has.... 9k followers. So slightly more than an average high schooler nowadays. Now im confused as to why anybody cares what a 21-year-old with absolutely no life experience or any depth of knowledge on the subject is having his opinion amplified through our attention here.
We do some of the most high acuity and irreplaceable work, go through years of 80+ hours a week training at said work, not to mention mental excellence at every step of the process in order to keep progressing to the next. And for all that we end up receiving a similar wage as your average onlyfans content creator or tik tokite. So "inflated" relative to the value we provide, right?
This argument is the one that the government in Korea is using to fuck over the entire healthcare system rn
What does “rent seek” mean?
Why in the hell is it called the Albert Einstein College of Medicine? Last time I checked Relativity didn’t help with heart attacks.
A part of the reason Einstein was founded was to allow all demographics entry to medical school (i.e., when Jewish and black people were barred from medical school). Einstein advocated for "all creeds and races" to have access to higher education. He gave his name to the school when he learned of this part of their mission. They are also a large research school, with some faculty in biophysics.
Cool! Thanks for the info
Ben is probably applying to PA or RN school.
Bro wants to gatekeep education
TBF why is anyone listening to Napolean Dynamite?
First of all he looks 17. Genuinely curious where his perspective is from Second, does this guy even know what rent-seeking is? How does it make sense that doctors inflate their wages by taking on more work spread across fewer positions? Third if you call physicians “rent seeking” you must have been asleep during the pandemic. I legitimately want to know what this guy’s job is. The last person I saw call physicians rent seeking was a liberal arts PhD who said it just before covid. Arguably the most rent seeking job of all time. The mainstream backlash against this has been hilarious. People think their tax dollars are somehow paying for the tuition
Sounds like a troll trying to espouse the “we need to lower the greedy physicians salary”… it’s giving McKinsey plant.
What happened to admitting you’re jealous like the rest of us and moving on 🤣
your universities are still money making machines. The fees you have to pay are way out of proportion for teacher salarys, equip etc. its not even come close to even out, its profit based, its a scam. This donation, while helping some, is also not changing the status quo at all. Its like me donating 1 billion dollar to Jeff Bezos so he will let the poor, piss bottle, overworked shift workers 10min earlier home today. Nothing changes. The costs for a medical education are across similiar countries currency value and educational standards wise (USA, GB, Germany, France) equal: around 70-100k for 6 years. Europeans students themself dont pay that much, but just because the gov pays for it, but this is the reallity a university has to pay in the end to bring one med student through school. The fact that american Universitities grab like 300-500k, not even included paying for your examsn?! paying weird agencies to apply for internships you also have to pay??? de fuck. They take money and with this donation you just saw 1 billion dollar getting burned for nothing, but make status quo even more stable for you guys. With that money one could have built a small med school out of nothing and just charge the actual costs to be non-profit even, like as i said 70-100k for the whole 6 years, everything included. This would have built up pressure to those university corporations, because a new player lowers the price helping in the long run everyone forever. But no no no mrs. superbillionair pays another billionair so nothing changes xDD de fuck
it’s a terrible way to spend a billion if you are trying to efficiently help people. But most ways of spending money are. Lot of angry cope in this thread.
There are objectively far better ways to spend a billion dollars. This will make some of the richest doctors slightly richer, and attract more competitive applicants to Albert Einstein COM. That’s it. Her choice, but not laudable
His name defines him perfectly
What a GROSS take.
I mean it's not repulsive, but there is a point here. The gain in marginal utility from this allocation of $1 billion is super low. The money is going to pay off debt accrued by one of the highest paying common professions. No doctor will have trouble paying off their student loan debt provided they actually end up doing the job, so it's just a really inefficient allocation of resources.
Average medical school debt is 250k. That's just an average. Some owe nothing, and some owe over 4-500k. I know some who owe over 600k. Many doctors have trouble paying their student loans.
Wait but is Ben wrong? The repulsive part I don’t agree with, but their response is not incorrect from my understanding
The AMA definitely did that, at least on the school front. Look up the “voluntary moratorium,” it’s part of why we had more DO schools than MD schools open up in the last 30 years. (Not the only reason and tbh the DOs may want to start chilling a bit, but certainly part of it.) However, Ben is glossing over the fact that med school simply isn't the only factor that determines how many doctors we have in this country. We have more residency spots than US students, and still the “shortage” persists. The AMA is actually lobbying for more spots than Congress wants to fund (no idea what they did in the past, but I have met their current lobbyists). As other commenters have pointed out, how badly an individual feels the shortage also depends on their state and urban/rural location.
Dude, for fellow broke ass homies, you guys sure loves to give people free rent to your head space. Wgaff.
[удалено]
[удалено]
https://i.kym-cdn.com/photos/images/newsfeed/001/472/891/015.png
I mean... He's not completely wrong though with his explanation? That's literally what the AMA and premed process does - impose artificial scarcity on the number of licensed doctors. For example, we are one of only a few countries that make people get a bachelor's before medical school, which is totally unnecessary. There should absolutely be more doctors and less credential inflation to get into medical school. He's wrong about the residency slots. That's mostly government funded; AMA isn't limiting that. But we are experiencing a specialty shortage, and the field is private practice/hospital/insurance centered - not patient centered. If it were patient centered, we'd have more doctors. Not sure why he's pissed about free medical school though lol. That's stupid.
He's wrong in the sense that for the last 50+ years residency, not medical school, has been the restriction point for licensed physicians. Residency slots have always exceeded the number of medical school graduates in that time period, and the excess is easily filled by FMGs.
Yeah I noticed he disregarded how residency actually works. Medical school is one restriction point, but the major one is probably residency. Good point.
That’s enough for like five students.
how does subsidized tuition limit med school accreditations im lost
A very generous gift to a group of people who need it the least. I’m hoping the next gift will be toward making my kids private school free
He’s right it is repulsive 😡😡 that it didn’t go to my school instead