The New York Times has a cute op-ed arguing that America should replace the unknown Surgeon General with a National Nurse whose pronouncements would focus on prevention and healthy living. Sounds good, though we can still keep the surgeon general around for kicks and non-preventive giggles. In any case, this country really has to start paying more attention to nurses. Not only are we losing them at an alarming rate but any efforts to fix our health care system and lower costs are going to need nurses and their cousins, nurse practitioners, to act as the new system's backbone.
America's doctors simply make too much money. Sorry guys, you do. But I don't blame you for wanting the big bucks, the hell we put you through in order to net that MD is just absurd. Why, exactly, do pediatricians need to know advanced physics? Or wait, riddle me this: multi-variable calculus? We've essentially weeded out anyone who doesn't like science from attending med school, as the pre-med requirements are so killer. And all that says nothing of the ass-kicking that actually is med school, or the hazing that is residency. And -- best of all -- we make them pay handsomely, and take on lots of debt, for the privilege. Thanks AMA, for screwing everything up.
Unfortunately, the AMA is a powerful, powerful group and they're not going to be crossed. Doctors are not going to lose their royal paychecks and the credentialing process is not going to become saner. Which is why the AMA should be sidestepped, and we should simply pump money into the popularization, education, and deployment of nurse practitioners for general medical tasks. It's all that makes sense. (It's also, by the way, the sort of solution that would emerge if health care wasn't wholly controlled by gatekeeper docs. I'm no fan of HSA's, but we really need to push some of their competitive aspects out into the wider health care economy, we just need to do it through smarter means.)