The Doctor Monopoly is Killing American Patients

How the American Medical Association deliberately created a U.S. physician shortage in order to protect jobs and inflate pay.

In April 2016, Charles Johnson and his wife Kira went to the Cedars Sinai hospital in Los Angeles for the birth to their son Langston. They expected it to be one of the happiest days of their lives, but soon Charles found they had “walked into a nightmare.”

Within an hour of delivery, Charles noticed blood flowing from Kira’s catheter. He called for help, but it took over eight hours before a doctor said he could take her back in for surgery to look at her C-section. That was the last time he saw his wife Kira alive. When they opened her up, she died with 3.5 liters of blood in her abdomen.

Deaths in childbirth in the U.S. are higher than any other developed nation, and the trend has been rising. While there are inevitably some complications in childbirth, a study of infant mortality across countries shows that there is a strong inverse relationship between number of physicians and death. Numerous studies suggest that one in three maternal deaths is entirely preventable.

Los Angeles is not a third world city, and Cedars Sinai is a fine hospital. Charles and Kira were giving birth in a major urban area with a high number of doctors and hospitals per capita. Dig deeper, however, and there is a different story.  The Statin Disaster David Brownstein Best Price: $24.83 (as of 06:30 UTC - Details)

The United States is facing a looming health crisis due to a shortage of obstetricians and gynecologists (OB-GYNs). A report by Doximity, a social network for physicians, highlights that most OB-GYN doctors are near retirement age and there are few doctors to take their place. The average age is 51 years old, which is dire, given that most OB-GYNs retire at 59. The study noted that the city of Los Angeles, where Charles and Kira had their child, is number three in terms of cities at risk for shortages of OB-GYN.

The situation is bordering on disaster in large parts of the country. In 2004, 45 percent of rural counties lacked a hospital with obstetrics services. A study in the journal Health Affairs shows that the trend has been getting worse. Astonishingly, today half of all counties lack a single OB-GYN and 56 percent are without a nurse midwife. Approximately two and a half million women of childbearing age live in counties without hospitals that deliver babies. Women’s lives are endangered by very long journeys for essential medical care.

So why is there such a shortage of doctors and how did we get here?

The simple explanation is that U.S. doctors operate as a cartel to restrict trade and reduce competition. The American Medical Association (AMA) artificially limits the number of doctors, which drives up salaries for doctors and reduces the availability of care. This has been the story of the AMA since it started, and now it has become deadly.

The shortage of doctors is not restricted to childbirth. The problem is much broader and is affecting all areas of medicine. Today, already more than 66 million Americans live in Health Professional Shortage Areas, or areas where the ratio of population to general care providers is deemed insufficient by federal standards. Sadly, the U.S. is far below the average for developed countries when it comes to doctors per capita.

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