Kyle Johnson

I don’t believe the “40% of med students don’t plan to practice” stat…but even if I did, here’s some more relevant stats. - the government has cut RVU reimbursement year over year, while inflation has only increased…in the past few years alone we took a double digit pay cut because of government @MedicareGov reimbursement when adjusted for inflation - private equity has taken over healthcare, fairly unchecked. This results in bad patient care, unstable healthcare markets and poor working conditions for physicians… -healthcare administrators have grown 3800% versus physician #s growing 200% since the 70s. This represents declining physician autonomy and an overwhelming administrative burden…much of which is created by government programs like CMS “Quality Measures” which are less about care quality and more about gamesmanship and documentation burden - insurance companies have a chokehold on the finances of healthcare…and their lobby dollars fund the congressmen who help keep them in power and allow them to continue to squeeze physicians and patients both How ‘bout you work on some of those issues, Congressman…and get back to the med students after you do?

A history of @theNRMP match: 🧵 The Match was established in 1952 when available resident positions vastly exceeded the number of graduating medical students. As a way to secure top students as residents, hospitals were: 1. Offering positions earlier and earlier, sometimes even prior to a student’s clinical years 2. “Exploding” offers and demanding a acceptance or rejection of an offer within minutes. The labor market is different now. The match has also created an economic monopsony where there is one buyer (the match) and many sellers (student). As a result, you see: 1. Wage suppression: The match eliminates any negotiation on salary or work conditions — with one “buyer”, they functionally control (and suppress) the wages of residents. 2. Lack of negotiation power: Once matched, students are obligated to accept the employment terms laid out by the program. This limits the ability of residents to negotiate better working conditions or benefits, which is a common practice in almost all other labor markets. 3. Limiting choice: Because candidates and programs must rank each other prior to the match, there is no opportunity for a student to decline an offer from a less-preferred program if they match there. This gets increasingly complex with scenarios like couples match. 4. Waste. Application fees, interview costs easily rack up thousands of dollars more of debt as students are incentivized to apply/interview at as many programs as possible to be able to rank more. Economics aside, the match strips students of agency - to choose, to negotiate, to refuse…it treats students as widgets, interchangeable as just a body to fill a spot as determined by a faceless algorithm… The “widgetization” of doctors is something we are well familiar with (ahem, CMGs…). No wonder we end up how we do, burned out, treated as dispensable and replaceable by corporations, when this is how we start our careers. @AmerMedicalAssn @AAMCtoday @AMAmedstudents