The future of medicine

Just last week, I posted about how Obamacare was forcing health providers to find cheaper ways of treating patients. Well, here is one way. Minnesota is using paramedics, who are being called "mid level practitioners" to perform medical procedures previously reserved for medical professionals with higher levels of education and training, with doctors being available for television consultation and supervision.

This is happening despite the objections of Nursing associations, who have long opposed having paramedics being considered as their equals. Even though a paramedic has undergone the same amount of training (45 credit hours for nursing, versus 50 for Paramedic, both form the core for associate's degrees), many in the nursing community have fought to keep them in the back of the bus. (However, this post is not intended to fight the nurse versus paramedic battle.)

The thing that this drives home is that our health care system is poorly organized and antiquated. There is no way that a doctor can know everything that a patient will need, and they have begun to specialize in fields, leaving general doctors hard to find. The amount of school that a person must attend takes a decade and leaves the new doctor with over a half of a million dollars in student loan debts. Doctors expect to earn large sums of money, so that they can be reimbursed for the decade of work that it took to become a doctor and so that they can repay the student loans.

Physician assistants and Nurse practitioners programs have addressed some of that, and there are many people trying to get into and complete these programs, but there are fewer of them than there are medical schools, and competition is fierce. There are just over 150 physician assistant schools in the United States, and they are producing less than 7400 licensed physician assistants a year. Not nearly enough when you consider that US medical schools produce 18,000 doctors each year, and that doesn't count foreign medical schools, like the ones in the Caribbean or in India. Physician assistant schools are a 24-30 month long Master's degree program, but the schools do not care what your bachelor's degree was in, just that you have one.

So the gaps are being filled in with paramedics, who have a two year associate's degree and likely make less than $15 an hour. I am a paramedic, and I can tell you that there are some good ones out there, and there are some bad ones, but paramedics do not know enough about general medicine, especially when they are right out of school, to do this job effectively. That doesn't mean that they can't be taught, because after all, physician assistants are trained in two years, but I don't think this is the answer.

Now that doesn't mean that our heath system doesn't need an overhaul. I have long felt that it was ridiculous that I need a bachelor's degree (it doesn't matter in what- one doctor I know has a bachelor's in golf) to attend medical school, or physician assistant school. Eliminating that requirement would cut the time and money needed to become a doctor or a physician assistant considerably.

As the shortage of medical professionals continues, pressure will mount for lower level providers (who make less money) to take on an increasing role in your health care, because Obamacare will pressure the medical profession into providing cheaper, but not necessarily better, health care.