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

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

#191

Post by candiddevmike »

jimmydddd wrote: post #120
weatherlite wrote: post #105

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.

It's interesting that places value seniority and experience so much more in medicine vs tech. Things change daily in both fields--new procedures, new findings--yet tech seems to have far more ageism. Why is an older doctor so much more valuable than an older developer?

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

#192

Post by elteto »

lokar wrote: post #42
DSingularity wrote: post #15

Earlier quoted context omitted.

I feel like we are going too far. Central planning in presence of hostile adversaries unrestricted by any ethical systems failed. And by what measures has “free market” has proven itself as successful? You can come up with your measures of success and others will propose measures of shortcoming. Others will even dispute the claim the American-led west is anything different from a centrally planned set of cooperating…

Critics of mostly free market systems generally base their argument on a comparison of wealth levels in such systems. They implicitly assume (or don’t care) that in a planned system the total wealth would be the same, just distributed differently. There is little evidence to support this.

Correct. Moreover, if you shift the goalposts (wealth is no longer/can’t be primarily defined by a balance in a bank account) then society will adapt and create different wealth constructs to make up for it. So, you’ll have the government caste with nicer perks and opportunities, and then everyone else from there on down.

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

#194

Post by wonderwonder »

soared wrote: post #179
PheonixPharts wrote: post #178

Earlier quoted context omitted.

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.

To be fair, I think op was referring to engineers specifically. You don't need Faang to make 200k as a sr. Look at non tech focused fortune 500 companies. 200k is available to sr engineers, even remote if US based

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

#195

Post by [deleted] »

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…

[deleted]

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

#196

Post by mportela »

nemonemo wrote: post #40
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…

My experience with PAs and NPs have been mixed. I would still prefer MD doctors if I have a choice. Now that there are many reasonably good medical education systems outside US, why doesn't US just open more to those international MDs? I would prefer those MDs to NPs or PAs. Maybe doctors' golden years have been passed, but I don't think that necessarily means more accessibility to quality cares.

Your are extremely optimistic to think the US will make immigration easier anytime soon.

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

#197

Post by haldujai »

candiddevmike wrote: post #191
jimmydddd wrote: post #120

Earlier quoted context omitted.

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.

It's interesting that places value seniority and experience so much more in medicine vs tech. Things change daily in both fields--new procedures, new findings--yet tech seems to have far more ageism. Why is an older doctor so much more valuable than an older developer?

I wouldn't say they're valued, the compensation is (with some nuance) based on a work-unit/fee-code which is the same for all of us. The academic component goes up for relevant physicians like it does for any professor-type role.

Doctors work longer mostly because you can't fire them unless they're negligent/incompetent (for various reasons including that most are self-employed/contractors either individually or as a group).

The only value the hospital places on seniority is that you know the local practice patterns so there's less of a learning curve as compared to someone ewer.

> Things change daily in both fields--new procedures, new findings--yet tech seems to have far more ageism.

We have continuing medical education requirements but the reality is most of medicine is designed to be easy and guideline based. Weird and wonderful stuff benefits from experience.

> Why is an older doctor so much more valuable than an older developer?

A 60 year old surgeon is still taking out an appendix, just with newer tools than when they were 30, for the same amount of money as a newer one. I would imagine an older developer would want to be more well-compensated and have career growth focusing on things like architecture or having a team but I defer to practicing developers for their input on why they're not valued.

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

#198

Post by naveen99 »

There is also planning of hospital bed shortages through certificates of need. https://en.wikipedia.org/wiki/Certificate_of_need

anti kickback laws are also a double edged sword. https://en.wikipedia.org/wiki/Stark_Law

But in the end, the usa has the healthcare system where doctors want to work and rich patients want to be treated given an option of any country.

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

#199

Post by throwaway173738 »

shadowofneptune wrote: post #85
whimsicalism wrote: post #80

Earlier quoted context omitted.

That makes no sense, if the capital is expensive then you should hire more labor.

The question is what you are angling for . If your goal is, sincerely, to provide better service, then you won't get it. Keep in mind that with so many patients nowadays being eligible for Medicare, the money will come in anyway. Nursing homes got the brunt of the attention for their quality of care, but with hospitals facing the same population the same management techniques come too. I work as a nurse on nights and…

> EDIT: Also these companies now often run pharmacies, investment systems, healthcare programs... patient care is by no means the biggest earner.

Are you referring to companies like Optum in the US?

They own entire medical systems(Everett Clinic in Washington), an insurance company(United Healthcare), and a pharmacy(Optum Rx) as subsidiaries so if there’s a problem everyone can point fingers and nothing gets done. This seems to be the new model for healthcare in the US.

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

#200

Post by BurningFrog »

trentnix wrote: post #188
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 no doubt the stress of your work is immense and the constant threat of litigation (and the expense of the insurance to fight it) can be overwhelming. As a recipient of multiple eye surgeries (I had strabismus as a kid), I am grateful for competent professionals like you. But I think you buried the lede. In the 2010s I owned a high-end bicycle and sporting good store. It was 7 days of 10+ hours a day most weeks.…

The grass is always greener in another profession, and my problems are always uniquely bad :)
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