Peter Robinson
1.1K posts

Peter Robinson
@PeterRobinsonMD
how is your headache doing

The lethality of gun shot wounds, head injuries, and massive trauma has not drastically improved since the 90s (the invention of antibiotics and 911 did help but that happened way earlier). There was some rise in crime post 2020 that is now ending, but there is still increased






“A clinical entity whose prevalence cannot be estimated within three orders of magnitude is not ready for ICD-10 codification. It is ready for more research” axios.com/2026/03/26/cdc…

There is no solution for the shortage of physicians outside of desirable metropolitan areas in the US. This is a consequence of these areas being 60-70 years into a process of outmigration. Doctors match the distribution of other skilled professions, but people somehow imagine physicians will choose to move to the towns that architects, engineers, scientists and even athletes and artists leave.


















Even people adjacent to it fail to understand the med student/resident/Match situation because it’s almost unbelievable when laid out. There are two bottlenecks, an artificially restricted number of med school spots AND an artificially restricted number of residency spots. This allows apologists to point at the other bottleneck depending on which part of the system they’re defending. If we didn’t have an artificial bottleneck at med schools far more American students could become doctors without much drop in quality. MCAT scores climbed for many years: kids who would’ve easily become doctors in the 1990s don’t have any shot today. But we prefer to keep our supply of American graduates far below demand and use international medical graduates to fill the delta, because they are a flexible pool of labor that we can expand and shrink at will and at a cartel level we don’t care if more or fewer international graduates get residency slots year to year. We do care about them once they become our residents, and want all residents to walk into jobs, so we also keep the supply of residents below demand. These bottlenecks serves the current physicians and the current med schools and residency programs because they guarantees no American med school graduate is ever without a residency and no American residency graduate is ever without a job. It does not serve patients and it does not serve young Americans who want to become doctors but haven’t yet gotten into med school, and nobody pretends it does.






