This is in response to a comment yesterday from Simon on my comment that the American medical system restricts doctor supply to increase incumbent incomes:
suppose you could build a medical system around undertrained practitioners who don’t even know what they don’t know, but why? Hating on doctors salaries and their “guild” is easy but analyzing how high their salaries really are when you take medical debt, hours worked and years of training into account is more difficult
Below is a graph of MCAT scores and science undergraduate GPAs of 1st year med school students by incoming class year from the Association of American Medical Colleges:
Is Simon saying the 2003 class of doctors (those are the docs who should be entering their prime earning and practice years right about now) are blundering idiots and that the only good docs are from the most recent classes as they have higher incoming credentials. Or have standards gone up (my quick back of the envelope story is that medicine is still extremely lucrative, and the bust of finance in 2008 plus the secular decline of the legal market is shifting some of the very smart people who aren’t quite sure what they want to do away from law and finance and towards medicine — one of my drinking buddies from college fits that description to a T) faster than enrollment capacity? If we as a society were completely happy with the doctors being produced from the 2003 first year cohort, what is the marginal gain in further heightening standards?
Are there people in the 2014 enrollment pool who have better pre-med credentials than below median 2003 enrollees who could not enroll?
Most likely yes, there are people in 2014 who were rejected everywhere who would have been accepted somewhere in 2003.
Are we better off with keeping those highly qualified people out of the medical training stream as they are no longer part of the potential guild, or is a slightly lower level of credentialing which allows them to do 80% as much as a MD/DO a good policy choice? Most people need primary care providers who can recognize common problems and also recognize things that look wierd and refer out. Would a person who was the marginal No for medical school in 2011, 2012, 2013, or 2014 be fully capable of performing that function, thus allowing a few more doctors to work higher up the care spectrum?