For America

Building off the success of Teach For America (TFA), the next step is to start Medicine for America (MFA).  It sounds absurd, but hear me out.

Take the sharpest minds from the best universities. Then, give them 6-8 weeks of intensive study in medical school curriculum.  Next, place them in areas of need, usually the inner city, where the “corps” can do great work, saving people at a high rate.  Sure, they aren’t prepared like trained “doctors,” but they are better than nothing, right?

Now, like TFA, place the “corps” in a new area where they only know other corps and hospital members.  While not explicit, the camaraderie allows them to work long hours since everyone they know also works similar hours.  In addition, by recruiting just out of college, few are married and even fewer have families.  This means fewer distractions, more work hours, and a bigger impact.  Granted, the lack of training puts their patients at a disadvantage, but by their 2nd year, the corps probably have overcome most of their deficits.  Sure, the 1st year is bad, but again, it is better than nothing, right?

Now, the hospital administration would love the new corps.  They work hard, they are smart, and most importantly, they are cheap.  True, they make a starting doctor’s (residents) salary, but much less than an experienced doctor.  They also work longer hours (no family/life) which allows them to put more time in, getting better results in the aggregate.  It also permits controlled labor costs and limits staff demands.  How?

Well, in signing a MFA contract, the hospital administration has a continuous pool of talented graduates parading into their hospital each year.  This allows them to let more expensive doctors go (assuming no union or tenure).  In addition, the hospital would not improve the conditions that originally made it a poor place to work.  Despite higher pay, the bad hospital could not attract doctors, not because of patients;  rather, the bureaucracy and leadership were often the reasons doctors did not want to work there. MFA would allow these situations to continues and also potentially shrink the hospital’s bottom line.

Yes, in the short run, patients may suffer, but by the 2nd year, the corps would be equivalent or potentially better than any doctor taken at random in the entire hospital.  If the numbers correspond to those of TFA, after 2 years, 34% of the corps will stay on for a 3rd year (1).  Now, while the majority leave (66%), many alumni would stay active in medicine (63%) (1).  Now, this could mean at any level from returning to school, working for an insurance company, or running a medical policy institute.  In fact, one of the “corps” might work for three years on the front lines and then parlay that into a job as chief of Medicine in a hospital system after running a medical non-profit (2).

So what do you think?  Do you think the American Medical Association might have a problem?  What about doctors?  In truth, they should get over it. People are unhealthy and dying out there and it is the doctors’ fault.  Just like teachers, who are failing their kids, it is time to build a system to rectify the situation.  So this system begins to correct the problem, right?

If you replace the word “doctor” with experienced teachers and “hospital” with school in this post, you essentially have a description of Teach for America. Now you might think, oh, a teacher’s husband is bashing TFA, shocking!  In truth, I see great value in the program; TFA recruits amazing people from the best universities.  It gives an opportunity to teach which may not have been available or looked down upon at their highly competitive school.  TFA also benefits from the fact that exceptional people are successful at nearly anything they do.

On the other hand, TFA does a disservice to education.  Some corps members stay in education, even at the school they started in.  However, in my exposure to TFA, the majority of corps members end up burned out.  Having been placed in the terrible teaching situations, the circumstances are set up for failure, thus extinguishing their teaching passion.   It also perpetuates toxic school environments that resulted in teachers not wanting to teach there in the first place.

My wife had this experience; she did not want to apply to a big city school system because it treats its teachers poorly (especially the new ones).  In the end, she did apply having an education and psychology degree from a top university.  She didn’t get a job though; the big city school system had already filled most of its positions with TFA, as dictated by the contract. So a person with no education background got a job in a tough district while a person with vast experience (The Teacher) did not get called until after school had started.

I guess in a way it was a good thing.  It kept this blog from starting 7 years ago.

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