I agree with many of the posters that the reictsrtion in the number of doctors may not be a deliberate ploy to increase doctor's wages. Nonetheless, the AMA cartel and their monopoly on certification is still a problem. They are not serving the needs of the customers (patients). Perhaps one reason is that they have overly strict standards. A lot of people here and probably within the AMA are probably convinced that relaxing standards would only lead to poorer service and thus lower medical quality, but the high standards are restricting the number of places that can serve as medical and the profitability of medical schools and restricting the number of medical students and thus the number of doctors. Obviously, having too few doctors decreases quality of medical service. In other words, if relaxing standards can increase the number of doctors, then a balance needs to be struck between high standards and having enough doctors. If there were other certifying agencies we might have more diverse responses to this doctor shortage. From the looks of it, the AMA just sounds like it's a money problem: it costs more money to open more schools, so we just need more money, without being willing to make the type of compromises that could best serve the needs of the customers, which includes both quality medical service and affordable prices (whether one pays via an insurer or directly).If people are worried about medical malpractice, I read somewhere (I think it was in Gladwell's Blink) that the more time a doctor spends with a patient the less likely they are to be sued; ie the more attentive the doctor is and the more the doctor listens to the patient, the better. Patients like this, and aren't inclined to sue doctors they like, even if that doctor errors. Thus, these overworked doctors are a formula for malpractice and thus means more work for the abundance of lawyers.

IIRC somewhere aruond 1/3 of those who apply to medical school are accepted by at least one school (standard advice is apply to every school in your state plus a handfull of out of state).Medical schools generally claim that medical education is a financial looser for them, despite 100s of thousands of dollars per student in tuition. If true, that would discourage opening of new schools. As pointed out, the barriers to entry into medical education are exceedingly high. You need a major medical center with research faculty in all major fields (to teach in the classroom) and clinical faculty in all disciplines of sufficient number to accommodate all of your students. Currently the quality of accepted med school applicants is very high. A drastic increase in # of accepted students would drastically decrease quality (which could arguably be an acceptable tradeoff, however preselection of only the best students is one of several major factors that differentiate physicians from mid-levels and technical personnel.

Paul, as you know I always enjoy your blogs. One or two of the ciqahocus, or however you spell it, have been a bit left field, but I like the fact that they remind us often of lessons we have learned but forget to practice.It's perhaps indicative that even today the childcare experts agree that there is no single manual for successfully bringing up children. Many years ago I remember telling one of mine that some people learn from watching, some by reading warning signs, but others, including my much-loved son, just have to go out there and pee on the electric fence to find out for themselves!So if there is one thing I would want to pass on perhaps it is the advice to use your mouth and ears in proportion listen twice as much as you speak, and be open to learning.Probably not what you wanted, but hey at least it's a response!

US is taking in searevl thousands of foreign medical graduates ( some of them are US citizens studying abroad and most are foreign MD's). overall aprox. 20-25% of practicing MD's have done their medical school overseas and have done only residency in USA. nobody is restricting this access. so the AMA cartel hypothesis does not hold completely (why not let more Americans to become MD's and bring in foreign nationals. the limiting factor is the vast infrastructure one needs to train a medical student. books, labs, computers is no big deal but one needs older docs being willing to teach and chaperone/supervise medical students while in contact with the patients( it pays less to do academic medicine than private practice). I can not say how much is real constraint related with limited ability to involve more older docs in teaching and how much docs cartel.

Juandos, you can't really harp on me rediang the Nation and Harper's if you're puling from the AEI. Especially if it's an article by Bill Frist, the man who should have his MD license revoked for sheer stupidity. I'll read what he has to say, as my folks are doctors and I keep up on that stuff, but really. It's Bill Frist. Also, I noticed you mentioning something about doctors filling out paperwork, and I wonder what you think of the unofficial statistic I got from my psychiatrist mother that "most doctors would rather have a universal healthcare system than the one we have now." She obviously hasn't polled every doctor, but she and my stepdad meet a lot of doctors and this kind of debate certainly pops up at AMA meetings and elsewhere.