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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)

#161

Post by poirot2 »

was_a_dev wrote: post #111
pcrh wrote: post #70

A similar phenomenon occurred in the UK, where under fears of "medical unemployment", the British Medical Association argued against increasing medical school places [0]. The attitude persists even today, where the BMA advocates that medical school entries should be limited to the number of specialty training places that follow basic training, so as to avoid the risk of doctors becoming unemployed or under-employed.…

While this is a problem. The single largest issue that isn't properly being disscussed (especially during the strikes) is retention. The NHS is a leaking bucket of highly skilled doctors and nurses. Anecdotally, my wife is a doctor at a large tertiary hospital. Asking all the completing Foundation junior doctors what their career plans are, 80% of them have obtained either an Australian or New Zealand Visa and were s…

Completely true. Killer stats on this: 1 in 7 U.K. trained doctors work abroad The number of GP training places are up 2000 and number of qualified GPs hasn’t changed due to poor retention. I could go on and on. U.K. medicine is a shitshow of poor pay and poor retention. Even the cheap imported doctors are only staying a short time due to the chaos of the system and better ops back home once NHS training is on your CV

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

#162

Post by Pigalowda »

haldujai wrote: post #150
Pigalowda wrote: post #148

Earlier quoted context omitted.

You’re on the wrong forum to complain about the medical field. These SWE think you’re a privileged complaining brat (ironic) who breezed through the 15 years of school and training and don’t deserve anything but disrespect. You’re part of the medical cartel and for the most part, they despise you. Your salary is deemed too high and you are expensive overhead that needs to be decreased - hence the outrage and populari…

I remain optimistic that some people here are open to learning so I still try sometimes. - Also a radiologist who gets told I’m egregiously overpaid when [insert immature AI tech] can definitely do my job better.

I am not optimistic here. This is the lion’s den - I’m here to see what the predators have in store for us. Back in early residency it exposed me to CNN and real time object detectors and a co-resident and I made a little proof of concept app that detects ICD/PM on CXR.

So I think there’s value to me here - just no value in proselytizing and apologetics. They don’t like us and are here to eliminate us.

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

#163

Post by djmips »

haldujai wrote: post #137
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 agree, I left a FAANG and startup to pursue medicine (not that finances were my motivation) and my co-founder who went back to a FAANG is earning more than most physicians now. I’m far removed from this work environment now but at 10 years of SWE in a FAANG one seems to be making ~$350k-400k in total compensation? Not sure how many make it to L6 or higher, I defer to other commenters here. If you consider the compe…

But is that high paid era over?

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

#164

Post by djmips »

haldujai wrote: post #138
trashface wrote: post #123

Earlier quoted context omitted.

This viewpoint is just plain crazy. If you worked in tech you'd be totally disposable, just like all the rest of us programming drones. Hit 40-50 and boom, unless you've transitioned into management, suddenly no one wants to hire you, or if they do its half of what you were making before. Your MD degree and the AMA literally writing laws on your behalf limits labor supply competition like nothing in tech. You may hav…

Physicians are disposable too, look at what happened with primary care, nephrology, anesthesia and is starting in radiology where private equity firms move in and outsource physician care to allied health professions and create an “eat what you kill environment”. In other countries like Canada it’s also near impossible to get a job in a surgical specialty (and until 2 years ago other ones like radiology), especially…

The grass is always greener. Most Canadian software engineers are getting paid much less for the same work as across the border. Currently there are layoffs, hiring freezes and pay increase freezes. Canadian software engineers make less than doctors. FAANG salaries are a thing but you have to be willing to move to the US in order to attempt to achieve that.

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

#165

Post by haldujai »

Pigalowda wrote: post #162
haldujai wrote: post #150

Earlier quoted context omitted.

I remain optimistic that some people here are open to learning so I still try sometimes. - Also a radiologist who gets told I’m egregiously overpaid when [insert immature AI tech] can definitely do my job better.

I am not optimistic here. This is the lion’s den - I’m here to see what the predators have in store for us. Back in early residency it exposed me to CNN and real time object detectors and a co-resident and I made a little proof of concept app that detects ICD/PM on CXR. So I think there’s value to me here - just no value in proselytizing and apologetics. They don’t like us and are here to eliminate us.

I don’t view it as adversarial. I’ve had productive conversations on HN including some which gave me NLP approaches I hadn’t considered.

Engineers (including myself when I had a health-tech startup before my MD) tend to misunderstand the problem space (simply put they consider radiology a classification task and assume ground truth labels exist/are even possible like for object recognition) so it seems easy to them, but I don’t believe the intent is nefarious.

Perhaps it’s my naivety but I think most smart people at least partly care at improving society on some level (even if they want to make a lot of money doing it) and the physician-services budget is a large line-item that seems like an easy target rather than the ??? to improve inefficiencies and outcomes.

Without a doubt the AI-enabled radiologist will render the non-AI rad obsolete but it won’t replace our profession. I don’t believe anyone with the skillset and experience in the relevant AI tech believes that it will eliminate radiologists (other than maybe Hinton), certainly isn’t the attitude of the pure CS supervisors I’ve had in my training (or the folks I collaborate with now).

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

#166

Post by [deleted] »

weatherlite wrote: post #105
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…

[deleted]

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

#167

Post by mensetmanusman »

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…

Is working for half time for half the salary an option?

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

#169

Post by haldujai »

djmips wrote: post #164
haldujai wrote: post #138

Earlier quoted context omitted.

Physicians are disposable too, look at what happened with primary care, nephrology, anesthesia and is starting in radiology where private equity firms move in and outsource physician care to allied health professions and create an “eat what you kill environment”. In other countries like Canada it’s also near impossible to get a job in a surgical specialty (and until 2 years ago other ones like radiology), especially…

The grass is always greener. Most Canadian software engineers are getting paid much less for the same work as across the border. Currently there are layoffs, hiring freezes and pay increase freezes. Canadian software engineers make less than doctors. FAANG salaries are a thing but you have to be willing to move to the US in order to attempt to achieve that.

Yes, if you consider non NYC/SV salaries physicians come out ahead in the vast majority of cases, we earn more or less the same no matter where we live.

I’m happy with my compensation but I’m also happy with my job/not optimizing solely for it. My point is that if I was I would have chosen a different career.

I also left Canada to make less in the US as a physician because I wanted more work/life balance and not to be working in a system constantly on the brink of collapse. The hospital I trained at was on “life or limb critical capacity” so often I had to set up an e-mail filter to send it to my junk.

Speaking of hiring freezes, from 2010-2020 the only jobs for radiologists were in small towns or undesirable locations, it’s better now for rads. Most surgeons and proceduralists (cardiology being a horrible one) still can’t find jobs in major metros without 2+ fellowships and at least one somewhere prestigious. It’s still hard with that.

As in all things, it really depends what you want in life. But if you have the aptitude to reach the highest levels of physician income and have mobility you’re probably skilled enough to have done the same in other professions (e.g. finance, software) with an easier (physically speaking) path and less opportunity cost.

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

#170

Post by haldujai »

djmips wrote: post #163
haldujai wrote: post #137

Earlier quoted context omitted.

I agree, I left a FAANG and startup to pursue medicine (not that finances were my motivation) and my co-founder who went back to a FAANG is earning more than most physicians now. I’m far removed from this work environment now but at 10 years of SWE in a FAANG one seems to be making ~$350k-400k in total compensation? Not sure how many make it to L6 or higher, I defer to other commenters here. If you consider the compe…

But is that high paid era over?

Could be. Could also happen in medicine (many think the golden era for compensation is nearing its end)

A decade ago nephrologists in a dialysis unit were making high 6 figures until private-equity moved in and now they make 1-200k.

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