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

niskanencenter.org

341–350 of 377 posts

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

#341

Earlier quoted context omitted.

Yes. Same hours but nosediving pay because we now have an infinite amount of deeply indebted doctors fresh off medical school competing for the same jobs. Wages are literally decreasing year upon year for the average brazilian medic. Workload is also increasing because healthcare managers are starting to interfere more and more in patient care. They want 10 minute consults.

So hours are long, and the number of Drs in the market are increasing. Are the number of patients increasing, or the time consumed by each increasing, or unemployment among Drs increasing?

> Are the number of patients increasing

The number of patients is literally never ending. It's a property of the decentralized public health system. If you have resources to spare, patients will be sent to you. No matter how much time and money you pour into healthcare, it's never enough. It's as if demand instantly scaled to exceed capacity.

> or the time consumed by each increasing

On the contrary, it's reducing. Cheap fast consults in popular clinics are now the norm. Doctors are doing more in less time for less money. The numbers are embarrassing, especially when converted to USD. The only consolation is it's still pretty good due to our low cost of living.

Brazilian software developers working for american companies for a salary that would be inhumane to an american put doctors here to shame. I'm talking 2-4x, depending on the company and exchange rate. It wasn't like this before.

> unemployment among Drs increasing?

A few years ago I saw someone joke about doctors driving Ubers for the first time. It's looking more and more likely each year. I'm also seeing doctors simply abandon the profession straight up.

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

#343

Earlier quoted context omitted.

Do you have some statistics for this? Also, most of the inflationary damage was done in the last 3 years. Unless 10 years ago you started at a very low salary I don’t think they’ve gone up significantly after inflation. If you were already a senior engineer 10 years ago for example.

Use BLS. Compensation for the average employee profile of "Software Developer" has far exceeded inflation. I can't remember the exact timeframe, but roughly 2016 - 2022, salary for the profile of Developer has gone from ~$86k to ~$130k mean. I think that beats inflation quite significantly.

Ok, so that fits with what I'm noticing among my peers. The lower and middle salary range of developers is continuing to increase, but not a lot ($86k in 2016 is equivalent to $110k now), whereas the high end is not increasing very much or is losing to inflation slightly (people who were already earning $150-200k or more base salary in 2016, the start of the reference range you mentioned).

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

#344

Earlier quoted context omitted.

> There are a ton of people in tech that struggle, and reach 50 just to be nearly living on the street. In the literal sense I doubt that. If they are "nearly living on the street" then they seem to have issues handling money. Literally everybody else around then is making less and is not in the street either. Or are you saying that the lady behind the Walmart cashier or the pizza place guy or the girl moving the off…

Perhaps I was over-stating. But it is true, that tech people retiring at 50 and living comfortably is a real small minority, not some common occurrence like everyone in tech is swimming in gold. Living on street was hyperbole, but I do see a lot of tech people working long hours, on -call 24-7, dealing with bad bosses, all because of the 'fear' of living on the street. So maybe they aren't close to the street. And if…

A more nuanced discussion would perhaps help. You are just jumping between extremes.

Obviously the average tech person can't retire with 50 while living in a golden castle. Nobody claimed that. If you retire that early then you lifestyle needs to match your wallet. I'm not even 50, I'm just below 40, but I could retire tomorrow despite not having worked at Google or similar. Obviously I couldn't own a 1500sqft condo in downtown SF, drive a big car and go on a yacht vacation in Monacco every year. But I could afford a nice place in the countryside and continue with the hobbies I have, none of them demanding big financial resources. It's about lifestyle choices, no matter how much money you have.

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

#345

Earlier quoted context omitted.

Perhaps I was over-stating. But it is true, that tech people retiring at 50 and living comfortably is a real small minority, not some common occurrence like everyone in tech is swimming in gold. Living on street was hyperbole, but I do see a lot of tech people working long hours, on -call 24-7, dealing with bad bosses, all because of the 'fear' of living on the street. So maybe they aren't close to the street. And if…

A more nuanced discussion would perhaps help. You are just jumping between extremes. Obviously the average tech person can't retire with 50 while living in a golden castle. Nobody claimed that. If you retire that early then you lifestyle needs to match your wallet. I'm not even 50, I'm just below 40, but I could retire tomorrow despite not having worked at Google or similar. Obviously I couldn't own a 1500sqft condo…

That was the claim, I was replying to : "Difference is that in tech you can retire with 50. Few people who still work at 70 do so by choice.".

Saying you can retire at 50 if you choose too, and working is a choice, is completely bogus. You are not being nuanced, you are being misleading.

Nobody is retiring at 50 that isn't very well off. Even with a small house, remember, there is covering health insurance, taxes, food. It is well beyond a large percentage of people.

Spinning it as lifestyle choice is not what was being alluded too. Yes, I could choose to live in a small apartment and live on rice, and thus 'retire'. Do you really think that is what the original post was implying.

"Nice place in the countryside and continue with the hobbies ". I just can't believe the levels of disconnection here. It almost comes full circle, I could 'retire' if I would just choose to live on the street, it's totally a lifestyle choice.

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

#346

Earlier quoted context omitted.

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 :)

I have to be honest and say working mostly in Security my pay is good enough and work is easy for me... Mostly I'm annoyed that my employer doesn't get enough projects for me...

I could be paid more, but I wonder would that be worth the extra effort.

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

#347

Earlier quoted context omitted.

> 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. Fuck. That made anxious. I am close to that age. Also, my middle manager friends are having much harder time finding a job than programmer types. Don't know if its just them or if its a trend.

No need to. If your experience is solid, there's plenty of work for consultants. Not those types, who walk in and get told to create a CRUD app, but those who can advise on tech, its implications on the business, the risks, etc.

Any resources for finding these opportunities?

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

#348

Earlier quoted context omitted.

When it comes to value, when my wife interviews for a job (she’s a physician) they fly her out and spend a day taking her to see the sights, so they convince here how great the city is. Then they take her out to a fancy dinner and woo her some more. When I interview at a new job as a very senior engineer (and relatively well known I in my area), I get to jump through 7 rounds of interviews where someone asks me the e…

> When it comes to value, when my wife interviews for a job (she’s a physician) they fly her out and spend a day taking her to see the sights, so they convince here how great the city is. Then they take her out to a fancy dinner and woo her some more. Interesting, are these in underserved areas? I just went through interviewing for a new job and despite being in an in-demand subspecialty with desperate employers the…

Curious if you could add some color to the switch from tech to medicine

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

#349

Earlier quoted context omitted.

> Many US private practice jobs are the same. Where are you getting this from? The vast majority of doctors have access to the same kinds of fixed benefit retirement plans as people in other industries have.

From my job search as a physician. Literally no private practice job I’ve interviewed at or heard of provides defined-benefit retirement, if you know one let me know. Similarly I don’t know of many non-medicine jobs that still offer this either, but they do offer defined-contribution plans and GlassDoor suggests Google matches 7%. The super high income (radiology) jobs people are alluding to here (500k-1m) are struct…

Just curious are aware how little CPP pays? Why is that even a consideration,I don’t understand.

The vast majority of tech jobs offer no RRSP match as well

Also consider how few faang jobs exist ( especially now) vs physician

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

#350
post #192

Earlier quoted context omitted.

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.

Haha, yeah but it will all different people getting the perks than those with perks now

Yes, we know how egalitarian the USSR was, they didn’t discriminate against Jews or Asian minorities at all… /s
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