“The interaction I have with students — they’re young and enthusiastic, and I don’t think they’ve had that much real-life experience understanding what lies ahead,” said Dr. Haynes, who also serves as senior policy analyst for Docs 4 Patient Care, which opposes the president’s health care law. “More physicians are going to become employees instead of small-business owners, and I have no problem with that decision, but then you’re getting to be more like civil servants.”
Not that there’s anything wrong with that, but Dr. Haynes and other physicians worry that the nation’s straight-A students aren’t pulling all-nighters in order to work someday for the medical equivalent of the Department of Motor Vehicles.
“What kind of individual is going to want to enter the medical school under those circumstances?” said Dr. Haynes. “That’s the concern of where things could be headed.”
The AMA is backing legislation introduced March 15 — known as “Match Day,” the day on which medical students are matched with residency openings — that would require the federal government to create 15,000 more residency positions.
The bill, which is estimated to cost about $2 billion over 10 years, is sponsored primarily by Democrats, but includes one Republican sponsor, Rep. Aaron Schock of Illinois.
The market already has responded by adding medical schools. The Association of American Medical Schools noted in a survey that between 1986 and 2004, its accrediting committee did not certify a single new U.S. medical school. Today, at least 18 universities are establishing medical schools, including at least a dozen that are in the pipeline to obtain accreditation.
Conservatives would prefer to allow the market to take an even bigger role in addressing the looming physician shortage by having more private dollars flow to teaching hospitals, something that is unlikely under Obamacare, which is scheduled to be fully implemented later this year.
“The ACA continues what I think is a broken system of administration pricing,” said Dr. Haynes. “It prevents a functional market. All the things we’re trying to achieve, like lower costs, they’re doing through burdensome regulation and administration.”
Nobody expects the Democrat-led Senate to pull the plug on Obamacare, nor the Republican House to approve $2 billion needed to fully fund it, which means the prognosis for medical students — and by extension, their patients — remains uncertain.
“The medical schools took the first step by expanding class sizes, which involved resources,” said Ms. Mitchell. “Now we really need someone to take the second step.”