HN Reader

When my primary care doc referred me to a dermatologist for a suspicious mole, I could not find an actual dermatologist who would see me in less than ~8 months. I ended up seeing a physician's assistant, which I'm still uneasy about since there's been a study that shows that PA's seem to have a lower success rate vs. doctors [1], and the educational requirements are very different for PAs.

As a layperson, it seems like we (patients / society) would benefit from having more doctors, i.e. opening up more residency slots and admitting more people to med school, but there's probably a lot I don't understand about the issue. Not sure if it's a lack of political willpower to do this, or if there are other reasons why the number of doctors we train is so restricted.

[1] https://pubmed.ncbi.nlm.nih.gov/29710082/ ("PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists")

Isn't this disconnected from the reality of medical school competitiveness that is, at least on paper, supposed to filter students who are not going to use their highly sought after education and resources for largely clerical jobs? What's the point of the American Medical Association restricting new medical schools and artificially constricting the number of medical students when the top of their field is to service patients with elective treatments?

Tried getting an appointment in Denmark. “We don’t take any new patients”. A familiar story when trying to reach many specialists in European countries (Germany, Belgium). Except I doubt they’re getting 500k.

Decades ago, I interviewed at five US medical schools. For each, two separate physician interviews contributed to my "candidate score." Ultimately I was accepted to my 2nd choice school, which I left after the first year.

One of those ten interviewers was a dermatologist: arrived late; bitchy attitude; chip-on-her-shoulder; challenged an easily-verifiable fact about my candidacy (she even rolled her eyes when I tried to change the subject!)... tl;dr: her undeserved apathy turned me off from her program, entirely.

The first few years after leaving medical school I felt bad about having "wasted a spot." After years of reflection (and an alternate career), I am now able to better-empathize with physicians — mainly for all the sacrifices they have made just for (most) patients to ignore their professional advice.

You cannot pay a US physician enough money to counteract all they've given up (life/balance/youth).

I did microneedling a couple times. If anything my scars are worse. I’d rather just get laser skin treatment in Thailand and save money. Or do the lower % acidic peels myself.

I had a similar experience - The dermatologist that I used to see moved to a new city and I needed to see one urgently for eczema. Primarily, I needed an RX.

For at least two months, no appointments were available with any derm in my network, so I immediately set up a telehealth appointment with one in another state, explained the condition, and got an RX on the same day.

Seinfeld did an episode about this issue in the 1990s. ("Skin cancer, eesh"

There is a joke going back at least fifty years, to the effect that dermatology is the ideal job: the patients never recover from their conditions and never die of them.

> Recently, her hospital’s dermatology program received more than 600 applications for four residency slots.

Perhaps if supply of dermatologists was not so strongly limited, prices and wait times would improve.

In general, there seems to be a trend towards lifestyle jobs, i.e. jobs that fit a certain lifestyle rather than being passions.