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The planning of U.S. physician shortages (2020)

niskanencenter.org

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Re: The planning of U.S. physician shortages (2020)

#101

Post by brutusborn »

epicureanideal wrote: post #98
the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

> Physician salaries are the only ones that do not grow relative to inflation Same has been happening to software engineers for the last 10 years at least. Salaries go up but not as fast as inflation. I’ve gotten higher titles and more responsibility over the years but inflation is still winning compared to 5+ years ago. > That said, is anyone hiring an ophthalmologist with CS and Math degrees? As soon as the job mar…

Same has been happening to all labour. At least in Aus I think labour’s share has been going down since the 80s

Re: The planning of U.S. physician shortages (2020)

#102

Post by carabiner »

the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

> That said, is anyone hiring an ophthalmologist with CS and Math degrees?

As someone who recently transitioned to a tech role, I'd urge you to focus on applying to companies related to your existing fields (ophthalmology, medicine, surgery, and their derivatives) who happen to be seeking SWE's, rather than general tech companies. Especially Series A, B, C startups. Look up all the companies that make your equipment or the software that you use, and go to their jobs pages. See anything that is tech or tech adjacent: swe, swe test, qa engineer, automation engineer, data engineer, anything mentioning python or javascript. The job market is the worst in 20 years and so the only companies that gave me the light of day were the ones in my previous field (energy and mechanical engineering).

Re: The planning of U.S. physician shortages (2020)

#103

Post by biorach »

lr1970 wrote: post #78
scythe wrote: post #35

Earlier quoted context omitted.

>Central planning on resources has been especially rife with failed examples (the USSR being the all-in poster child.) This assertion is greatly exaggerated. It's certainly true that the centrally planned economy of the USSR didn't grow as quickly as peer countries with similar levels of economic development. The typical contrast is the much faster growth of Japan versus the Soviet Union in the late twentieth century…

> But the Soviet Union nonetheless grew. Its growth rate was similar to that of the United States, but starting from a lower level (missing out on catch-up growth). ... Even though the system was not efficient, it wasn't disastrous by itself, only suboptimal. I am sorry but it is total BS. I grew up in late USSR and can attest that its economy was in free fall. Central planning was one big demotivator and major contr…

What you're describing sounds suboptimal rather than disastrous

Re: The planning of U.S. physician shortages (2020)

#104

Post by mixmastamyk »

the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

> soul-crushing tech salaries

No one really gets those (statistically). I never did, despite being great at what I do. Basically a lottery system where the one lucky person who did the same exact problem two days ago wins.

Re: The planning of U.S. physician shortages (2020)

#105

Post by weatherlite »

the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

> There's just no reason to do the job when you can get the same compensation working remotely in tech. Looking through the "Who's Hiring" thread is soul-crushing. Physician salaries are the only ones that do not grow relative to inflation and have decreased year-on-year relative to inflation for decades.

What ? Most U.S physicians make 300K + after residency with job security set for life. The real bright ones, the "faang" doctors make close to a million. Show me anyone in tech who can have that guaranteed for him. You're basically guaranteed to join the millionaire club if you decide to work enough years even as a mediocre doctor. Yes its an extremely difficult job I have no argument there, but there's no comparison to tech in terms of compensation or job security.

Re: The planning of U.S. physician shortages (2020)

#106

Post by TacticalCoder »

the_d3f4ult wrote: post #62

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent…

I've got friends and family that are physicians and they also work a lot. They're in the EU so at least the "getting sued" part is close to non-existent (there's still a risk but typically only if there's a real fuckup). At least one of them also complain that the job isn't paid well enough and that the job kinda lost some of its luster.

But...

> There's just no reason to do the job when you can get the same compensation working remotely in tech.

Compared to serving ads and/or engaging in surveillance capitalism, at least there's a lot of comfort in that they're doing (and you 're doing) a useful job.

So I know it's not much but thanks a huge lot for what you're doing.

Re: The planning of U.S. physician shortages (2020)

#107

Post by transcoderx »

scythe wrote: post #35
bruce511 wrote: post #6

Planning and predicting highly variable systems is hard. Long-range interventions are especially risky given the possibilities for unexpected consequences and also the long lead times in fixing the problems. Central planning on resources has been especially rife with failed examples (the USSR being the all-in poster child.) As the article points out, the concept of central planning is orthogonal to who is providing t…

>Central planning on resources has been especially rife with failed examples (the USSR being the all-in poster child.) This assertion is greatly exaggerated. It's certainly true that the centrally planned economy of the USSR didn't grow as quickly as peer countries with similar levels of economic development. The typical contrast is the much faster growth of Japan versus the Soviet Union in the late twentieth century…

[dead]

Re: The planning of U.S. physician shortages (2020)

#108

Post by sarchertech »

MauroIksem wrote: post #58
lotsofpulp wrote: post #26

Earlier quoted context omitted.

There already has been. The solution was to pump out physician assistants (PAs) and nurse practitioners (NPs) that require a fraction of the training of a doctor to get licensed, and then have them practice medicine under the “supervision” of a doctor. Some states even went as far as giving people with no medical training the right to prescribe, such as naturopaths, whatever that means. So it is up to each person now…

You're being disingenuous. PAs are required to have 2000 hours of clinical experience before they can sit for their licensing exam. NPs however only require 500 hours. MDs require 4000 hours.

Where are you getting these numbers? 4000 hours for what specialty? Let’s take Pediatric Emergency Medicine as an example. 4 years of med school, 3 years of residency, then 3 years of fellowship.

That’s many times 4k hours. The difference in training time between a newly minted PA and MD working in a children’s ER is not 2x, it’s many times that.

Re: The planning of U.S. physician shortages (2020)

#109

Post by sarchertech »

MauroIksem wrote: post #56
w10-1 wrote: post #46

Earlier quoted context omitted.

Medicare and most insurance strictly control this. But the industry benefits from a constrained supply of doctors because it means less competition; laws ultimately require doctors to be in charge of a practice. Some laws are now even restricting the number of PA/NP's that can be supervised, but it's not a strong effect. Some states permit NP's to practice without a physician, but PA's all require a supervising physi…

PA's no longer require a supervising physician. Also why do people seem to think PAs and NPs are equivalent? PA's have 4x the clinical experience/ training that NPs have. 2000 hours vs 500 and MDs at 4000.

Depending on the specialty, 4000 hours is off by many multiples. And that’s on top of 2 extra years of classroom training.

Re: The planning of U.S. physician shortages (2020)

#110

Post by wrp »

What is a nutshell explanation of how healthcare got to the overall shortage state? (For the USA, but curious about other countries.) In the past 20 years, costs have shot up, doctors are seeing many more patients, and quality of care seems to have generally declined. Where have the resources gone? In the 1990s my GP had time to shoot the breeze for 20 minutes or more. Now I get a 5-minute diagnosis on the run, after scheduling months in advance.
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