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I know you hate that argument so I very specifically didn't make it this time.
Based off your historical unwillingness to update your understanding of anesthesia compensation and work duties I don't think we are going to have a fruitful discussion on the doctor skills/role and work alternatives side of things.
By the way, and I truly am sorry if you’ve gotten that impression, I have a great deal of respect for doctors. I think you do a great job, and I think you should be well-paid for it. And and, I think doctors’ pay is only one part of the issue with the US system’s immense inefficiencies, of which a great deal can be laid at the feet of Congress, insurance companies (not out of ‘evil’ or even the profit motive, but just because of the perverse regulatory and incentive environment they’ve been out in), the way big pharma is funded and to some extent the tragedy of the commons.
My only real ‘thought’ on doctor pay is that we should have more doctors. Let’s train them, let’s import them (from native english-speaking countries with decent standards, like our peers in the anglosphere), let’s do whatever it takes to increase residency spaces. And let’s make residency easier, let’s limit medical liability to bring down the ridiculous cost of malpractice insurance, let’s make medicine an undergraduate course like it is elsewhere so doctors don’t have to waste four years and more money going into debt.
But yes, ultimately, let’s work to bring down some salary costs. Is that so unreasonable?
Do these people want to come? I'm not sure they do.
Usually when this conversation comes up what happens is that I say something like "sure increase supply just don't compromise quality" and then someone says "being a doctor is easy, there aren't really quality differences or problems" I recall this argument from you in the past but if you don't endorse it now no problem, but ultimately most supply increasing options involve compromising quality in some way. Americans are mostly uninterested in decreasing quality, but if we decide that's on the table then we have a lot more tools available to solve some of these problems without touching supply at all.
Also, right now we seem to be in a situation where shortages are pronounced enough that the market can absorb a much higher number of physicians without bringing salaries down. In fact we likely need to increase salaries (specifically: one of the biggest problems right now is that people will refuse to work in red states or rural areas, these jobs already offer higher salaries, sometimes as much as twice as much, but in some cases that's not enough).
We already have some evidence that salaries are too low for some needs, taking salaries down further is liable to make those issues first (and again does little to decrease the overall healthcare costs).
From the UK? I assure you they do.
Why don't they then?
I wasn't able to find a good single source of truth but medical students can do it (which Scott did(ish)) if they are interested. It's harder than it would be a for a U.S. grad but likely much much easier than an Indian medical school grad.
The BMA website implies that some "adult" (saying it this way because I can never remember the British terms) doctors may be able to come over without any specific retraining but does not provide details.
Training is probably somewhat worse in the UK but not enough that I'd have any complaints about anyone coming over (although this would obviously be bad for the UK).
You need to redo your residency if you want to become a US doctor even if you are a consultant with 15 years of experience in the UK. That is enough of a barrier that prevents people from coming over, never mind the extremely onerous visa requirements the US imposes on foreign professionals of every trade and type.
The official stance of the BMA per their website is:
"Doctors who are already on the UK specialist register may be able to apply for partial exemption from the residency programme requirement. To check if you are eligible, you should contact the relevant specialty board in the US."
My guess is that the answer is not yes or no but "it depends."
It happens a handful of times a year for people who are usually elite figures in surgical and clinical specialties, for example the surgical director of a top UK hospital trust hired to run a similarly-sized team in the US (who, for reputation’s sake, is still expected to do some surgery/clinical work on the side), or a renowned psychiatrist hired by a US university/teaching hospital whose application is obviously expedited for similar reasons.
For any normal senior doctor they will in 99% of cases have to redo residency unless they’re a global figure of import, presenting in top slots at the bigger international conferences in their field and have a lot of people on side in the US.
So sure, if you’re a towering figure in ophthalmology and are friends with half the people on the leadership committee of the American Board of Ophthalmology or whatever and get hired for a top position at a hospital in NYC or LA then you can probably skip it and they’ll wave you through. Otherwise, the possibility of an exemption is a myth.
Hah! Thank you, that's just what I was theorizing in the other thread line.
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