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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)

#171
post #86

Earlier quoted context omitted.

Thanks for sharing. A couple of questions if I may: For a typical surgeon in the US, how common are lawsuits from patients? Do you have plans to run your own clinic (if not already doing so)? If so, would this address some of your current issues (work hours, compensation) at the risk of having to operate your own business?

> For a typical surgeon in the US, how common are lawsuits from patients? Not very common. Pretty much everyone gets sued at some point in their career, but it's rare to break through the malpractice insurance ceiling. That said, it's always in the back of your mind and when it happens it messes with you psychologically. >Do you have plans to run your own clinic (if not already doing so)? If so, >would this address s…

> Pretty much everyone gets sued at some point in their career, but it's rare to break through the malpractice insurance ceiling.

Attorneys don't want to ruin a doctor's career by going above the limit of their malpractice into personal funds. They target the policy as their bogey and work from there.

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

#172
post #78
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…

It would have been worse as a peasant under the tsar. Communism brought modernity to Russia and made it a world power.

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

#173

Earlier quoted context omitted.

"Communist" Cuba has 64 physicians per 10K population, which is 2nd in the entire world for physicians per capita. https://en.m.wikipedia.org/wiki/List_of_countries_and_depend... During the pandemic, they were sending droves of doctors to Europe. They offered to assist in NYC but Trump turned them away as our population dwindled. Famously, when a British cruise ship with ill passengers aboard was denied by ports in F…

The thing is, not all of those doctors work in Cuba. The government rents them to neighboring countries to make money.

This is definitely true, but enough work in Cuba to give them a higher life expectancy than the US.

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

#174

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…

> Looking through the "Who's Hiring" thread is soul-crushing. I know how you feel. I gave up on tech as a teenager and I still wonder what would've happened if I had stuck with it. Feels like it's impossible to switch careers now. Where I live practicing medicine used to be a respectable profession but that's completely changed for the worse in the last 20 years. The communists currently running my country are litera…

> They flooded the job market with doctors.

US doctors have to put in long hours because there aren't enough of them. Are things different in your country?

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

#175
post #154

Earlier quoted context omitted.

“ The super high income (radiology) jobs people are alluding to here (500k-1m) are structured as partnerships that don’t offer employer contributions” Am I reading correctly that having no 401k match would be a concern for someone making $500k-$1m annually?

You’re reading incorrectly and I also wasn’t very clear. It’s not a concern and I’m not saying we’re not well-compensated but 7% is something to consider when comparing total compensation across industries (and is one of the easiest line-items to objectively discuss). A larger part of that physician’s income has to go towards planning retirement and inflation (and self managing that) than is being posited here. In ad…

> You’re reading incorrectly and I also wasn’t very clear.

There's nothing in your 3-4 posts that is applicable to physicians that also isn't applicable to any other white collar job.

> Someone making 400k at a place matching 7% with a good benefits package isn’t making less than a radiologist at 500k in private practice.

Sure, but what does it have to do with the discussion at hand? People need to do their due diligence about compensation when accepting a position, any position. This isn't unique to 1 profession, 1 field or 1 geographical area.

> It’s the difference between any independent contractor vs employee, regardless of if that’s medicine, construction or freelance SWE so when comparing the “high income physician” job it should be compared like you would a freelancer to FAANG employee @ 10 years of experience.

Sure, but the original point was, people making 400k + 7% or 500k can both easily retire at 50. The rest is pointless bike shedding.

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

#176
post #118

Earlier quoted context omitted.

"Communist" Cuba has 64 physicians per 10K population, which is 2nd in the entire world for physicians per capita. https://en.m.wikipedia.org/wiki/List_of_countries_and_depend... During the pandemic, they were sending droves of doctors to Europe. They offered to assist in NYC but Trump turned them away as our population dwindled. Famously, when a British cruise ship with ill passengers aboard was denied by ports in F…

Some of those physicians (mostly young and female) take second jobs as prostitutes, because their baseline pay makes it hard to survive.

What? I would like some evidence of that.

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

#177

The health care industry seems to be profiting off this by having more care provided by nurse practitioners and physician assistants but billing the insurers same as they would charge for M.D./D.Os.

They carefully maintain the scarcity of doctors, but import as many nurses as they possibly can, work them hard, and pay them the least they can get away with. It's only logical.

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

#178

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…

Even now 300k TC is pretty easy to get for any competent engineer wanting to work for a publicly traded company that can get comp in RSUs.

It's also very easy to get a 200k+ remote eng job, even now, that will allow you to spend as much time with your family as you like, rarely have you working past 5pm, and working in predictable, relatively low stress (potentially fun!) problems all day.

The job security is a good point, but job security isn't as meaningful for extremely high stress jobs since the risk of burnout is much higher. Doesn't matter if it's easy to get work if you find that work destroying your personal life.

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

#179

Earlier quoted context omitted.

> 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…

Even now 300k TC is pretty easy to get for any competent engineer wanting to work for a publicly traded company that can get comp in RSUs. It's also very easy to get a 200k+ remote eng job, even now, that will allow you to spend as much time with your family as you like, rarely have you working past 5pm, and working in predictable, relatively low stress (potentially fun!) problems all day. The job security is a good…

Your circle of 2/300k engineers does not represent average people. 99% of Americans should not be able to get a faang job even if the exact park was laid in front of them before college.

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

#180

Earlier quoted context omitted.

> 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…

The job security issue is huge. Many of my tech and finance friends in their early 50's are getting pushed out of their jobs, while my physician friends in their 60's can keep their career as long as they want. A family member recently visited a dr. in his late 70's.

A 50 year old physician or lawyer, if they are good, is at the absolute top of their profession and can 90% expect work another ten or twenty or more years still earning top dollar.

A 50 year old non-management programmer? Look forward to having 23 year olds asking if you know what an array is for the rest of your work life.

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