Almost all burnout in the medical profession stems from state intervention and the extremely complex lobby relationships between different actors in the market. Classical liberal policies would change everything in the market.
In particular, there are a few things that crush doctors:
Problem: Cost of education: You require licenses per-state, and a license can be gotten only after a very grueling and expensive educational process in the half a million dollars range or more in student debt.
Solution: Make it legal to practice medicine with foreign education licenses. Doctors can study in countries where the education is free or nearly-free.
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Problem: Too few people go into the medical profession per-capita in the US. Currently a 20-year in practice specialist doctor from any other country has to go through a lowly paid residency in the US to be able to exercise, plus compete in the very narrow H1B visa space.
Solution: Make a special purpose visa for medical professionals (Nurses & Doctors) and allow them to practice medicine.
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Problem: Malpractice insurance is extremely expensive due to the high levels of litigation in the medical profession, that far outstrip the typical responsibility of a professional. Some specializations require insurance of thousands of dollars a month!
Solution: Allow for malpractice waivers that let doctors practice at a cheaper rate, and let patients decide what kind of risk they are willing to get or not.
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Problem: US has the lowest level of Primary Care doctors per capita of developed nations in great part because they are the least protected specialization by the AMA which is mostly compromised by specialty doctors. One rule made here is that PCP's cannot collect 'kickbacks' or revenue by referring patients to a speciality doctor, and thus the PCP works for free to provide referrals to specialists.
Solution: Allow for transparent processes of verticalization and monetization, which will bring PCP's to a more natural rate count.
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Problem: The government subsidizes medical insurance by making it tax exempt. This makes it so everyone gets insurance through their employer which in turn makes it impossible for a doctor to compete with the insurance model that is tax exempt by being all-cash. The tax benefit allows insurance companies an oligopoly against small practices.
Solution: Eliminate insurance through employer and/or get rid of the tax exemption.
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Problem: The government pays a higher revenue rate if the medical practice is digitalized. This has pushed the entire industry into using electronic records to get that revenue boost long before its time, producing terrible technical solutions. (The biggest player in the space, Epic, collections millions of dollars a year per hospital and its made in Visual Basic)
Solution: Get rid of all electronic record requirement laws, subsidies, programs, etc.
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I can keep going. In the health industry market literally every single player has a legal advantage over every single other. Its everyone screwing everyone.
It is definitely not state intervention alone that explains the culture within the medical profession overemphasizing hierarchical relationships and deemphasizing direct patient care
You would be surprised! That is exacty the history of american medicine, depicted in the seminal work “the social transformation of rhe americam physician”
In particular, there are a few things that crush doctors:
Problem: Cost of education: You require licenses per-state, and a license can be gotten only after a very grueling and expensive educational process in the half a million dollars range or more in student debt.
Solution: Make it legal to practice medicine with foreign education licenses. Doctors can study in countries where the education is free or nearly-free.
----
Problem: Too few people go into the medical profession per-capita in the US. Currently a 20-year in practice specialist doctor from any other country has to go through a lowly paid residency in the US to be able to exercise, plus compete in the very narrow H1B visa space.
Solution: Make a special purpose visa for medical professionals (Nurses & Doctors) and allow them to practice medicine.
----
Problem: Malpractice insurance is extremely expensive due to the high levels of litigation in the medical profession, that far outstrip the typical responsibility of a professional. Some specializations require insurance of thousands of dollars a month!
Solution: Allow for malpractice waivers that let doctors practice at a cheaper rate, and let patients decide what kind of risk they are willing to get or not.
----
Problem: US has the lowest level of Primary Care doctors per capita of developed nations in great part because they are the least protected specialization by the AMA which is mostly compromised by specialty doctors. One rule made here is that PCP's cannot collect 'kickbacks' or revenue by referring patients to a speciality doctor, and thus the PCP works for free to provide referrals to specialists.
Solution: Allow for transparent processes of verticalization and monetization, which will bring PCP's to a more natural rate count.
----
Problem: The government subsidizes medical insurance by making it tax exempt. This makes it so everyone gets insurance through their employer which in turn makes it impossible for a doctor to compete with the insurance model that is tax exempt by being all-cash. The tax benefit allows insurance companies an oligopoly against small practices.
Solution: Eliminate insurance through employer and/or get rid of the tax exemption.
----
Problem: The government pays a higher revenue rate if the medical practice is digitalized. This has pushed the entire industry into using electronic records to get that revenue boost long before its time, producing terrible technical solutions. (The biggest player in the space, Epic, collections millions of dollars a year per hospital and its made in Visual Basic)
Solution: Get rid of all electronic record requirement laws, subsidies, programs, etc.
----
I can keep going. In the health industry market literally every single player has a legal advantage over every single other. Its everyone screwing everyone.