That would likely land them on probation, as the only program I ever heard of doing so fell afoul of the ACGME and ended up on probation due to a violation of the institutional requirements. Years ago, this was allowed, but not these days.
It's more about the law if unintended consequences- without strict controls, residencies used to be quite abusive of residents. The rules are designed to maximize the fairness with which resident are treated, and to prevent programs from engaging in unethical practices.
Haha IF and only IF you or your friends have the balls, intelligence and good work ethic to crack it in this field legitimately then I would welcome in open arms. This is like a brotherhood. Noone should be allowed to cut corner or weasel his/her way into this noble profession.
Why don't you quit blaming other people for your problem? If you want to match then do better on rotations, study harder, score better on those exams. Instead you choose to sit there and whine like a bunch of millennial generation kids. ALWAYS SOMEONE ELSE'S FAULT right?
Turning medicine into a plutocracy won't fix things, that's for sure. If they allowed self-funding, as in the old days, then hospitals could just keep all of the funding that is normally passed on to residents, and tell them to "self-fund" their own salaries. Or they could accept unlimited people that were willing to pay. Or they could force all residents to subsidize their own training on top of what is already being provided by Medicare. There's a lot of slippery slope stuff that could happen, and that's why the practice is banned- back in the day residents were abused quite heavily financially, with positions offering no salary or compensation aside from room and board. The vast majority of people would prefer to not go back to such a system, particularly since it only benefits those few who are wealthy enough for it to not be a problem.
Because that's the way we used to do it and it was horrible. This isn't a thought exercise, we already know how things played out in the past and that is the precise reason things are the way they are today. Residents were abused, and hospitals had zero incentive to not do so. The ACGME leveled the playing field so that residents wouldn't have to live like indentured servants in a first world country, which is essentially what they were in times past. Screw anyone that would want to sell the vast majority of their peers down the river just so they could get ahead- that's precisely the sort of person we don't need in medicine.
and letting UNQUALIFIED person PAY for the tittle would fix that problem??????????
You say it's about helping patients and increasing access, and yet the policies you enact would likely decrease the number of people able to become physicians and make the path basically only open to the wealthy, hmmmm... It's almost like you have an agenda...
Are you really this delusional ??? You equate paying tuition for college to PAYING YOUR WAY INTO A JOB (yes , training but still a competitive JOB) ???? And NO I would not trust ANYONE who PAYS his or her way through life, whether it be law school , medical school, engineering school, whatever professions. I think I'm done talking to a wall.
I'd add that national medicare pricing also reduces the cost differential a free market would provide between regions of scarcity and regions of surplus.
I'd love to read more about this....do you have a link?
The trouble is that most medical students can't afford that, so less positions, not more, would be offered. The average US medical student us taking on between 200-400k already, another 200k would create insurmountable levels of debt that would be impossible to pay off care of the magic that is compound interest. Combine that with the likely reduced number of residencies that would come about in a free market GME system (as the only reason Medicare pays at all is that private funding does not exist- were programs to start accepting private funding, Medicare would follow through with what they have wanted to do for some time and defund GME), and you end up with a system that is worse for patients, worse for doctors, and worse for the country. The only people that would benefit would be the rich, and that's not something we abide in America.
We have a low unemployment rate because we have the right number of physicians, not too many. If physician unemployment were even 2%, that would be an impetus for residency closures. As to maldistribution, there is a lot of research out there on it- we don't have a shortage, we've got a distribution problem that has urban areas seriously overserved for various reasons. Health care does not follow normal apply and demand rules- Medicare isn't going to pay you drastically more for an office visit in ND than they will in NYC, despite the fact that the demand is substantially higher. So people go to the cities, where they make lower wages and see less patients due to the competition, but enjoy their lives more.
It isn't a big enough adjustment to compensate for the demand curve.
and the googling I did showed a price adjustment by cost of living (so NY would actually make more) not by area of need (in order to pay rural more).....anyone have any word on this?
I think you miss the fact that one cannot effectively gouge customers in most medical fields- insurance companies generally have a fairly inflexible fee schedule (you might end up plus or.minus fifteen percent), and privately paying individuals don't exist in great enough numbers to maintain most practices, let alone to let you gouge them.
https://www.ruralhealthinfo.org/topics/medicare
