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Vanishing? What a ridiculous concept!
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Date: 2007/06/26 16:48
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By: muen
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Status: User
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Karma: 1  
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Forum Junior Resident
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In my opinion the most important issue in medicine is the number of graduating medical students.
Why? Because supply and demand determines the price of any good or service. Train too many doctors and reimbursements will decline. This has already been happening since the mid eighties. It should not continue. The US are a better place to work for doctors than most European countries, and as a German I know this from my own personal experience. The US are a better place to be a physician, because someone was smart enough to freeze the opening of new medical schools and of new residency programs.
Now we have a most unfortunate study trying to predict the future - which always, always fails. This "study" which foresees a "physician shortage by 2020" and consequently university deans, eager to boost their reputation, funds and power that come with a medical school, clamor to create new medical schools. This study is a very damaging to our profession. The author of this study behaves like a "useful idiot" for the HMOs. You may remember the expression of "useful idiot" that was coined for Westeners that supported communist ideas during the cold war.
THE CONCEPT THAT WE DO NOT HAVE A PHYSICIAN OVERSUPPLY, BUT A SHORTAGE IS IS THE MOST DANGEROUS MISUNDERSTANDING IN MEDICINE TODAY.
Any increase in the number of physicians is absolutely detrimental to our profession. Incomes will drop even faster than they have in the last twenty years. Do you have trouble paying off your medical school debt? Well, just support new medical schools and more doctors, our pay will go down and you will have even more difficulties paying it off!
Are you enjoying the power and arrogance of HMOs? They will only get stronger the more doctors are around, because they will always find someone who works for less!
We need less doctors, not more. We need more physician assistants, nurses, nurse practitioners, nurse midwives. We do not need more doctors.
Would you be reading about declining reimbursements in every magazine if there was a physician shortage?
Would physicians complain that they have to work more and more for the same amount of money?
Would you hear physicians complaining that their income continues to go down if we had a shortage? How can our income go down since the eighties and there is a "shortage of physicians"? Excuse me, but since when does that make sense?
Where have you been the last few years? Show me where the incomes are going up, show me where HMOs are paying more, show me where malpractice issues soften, show me where doctors have to work less becuase they earn enough! Show me the money!
Show me the unfilled physician jobs, show me the lines of patients in front of physician offices, show me the newspaper reports that patients go unattended because there are no physicians in the community, show me the newspaper articles complaining that there
patients travel to other towns because there are no doctors in a given community. Where is the shortage?
Before you believe such as nonsense as "physician shortage" pay attention to reality.
And times change, new things happen that the predictors of the future did not even imagine. The latest issue of the American Medical News reports on the "burgeoning retail clinics". There is your competition that you did not see coming! There is your increase in health care providers and services that makes it unnecessary to train more doctors!
In Minnesota Blue Cross Blue Shield supported the opening of retail clinics and from 2004 to 2007 the number of visits increased from 9,800 to 33,800 and the charges per visit increased from 39.84 to 72.90! And you thought this was a "minor thing", you thought this was a negligible development. You thought people would not go to these clinics or they would go only to these clinics for insignificant issues!
Those that went to a retail clinic seemed satisfied. In the same article a table shows that atients that were very / somewhat satisfied with quality of care - 90%, with having qualified staff - 85%, with convenience 83% and with cost 80%.
This is completely in line with physician practices! And you thought retail clinics were no competition? We are already finding the solution for a non-exisiting "physician shortage"
Not only do we NOT have a physician shortage, we have a physician oversupply. The oversupply will get worse due to Internet medicine and retail clinics. HMOs will rejoice and their profits will grow, your income, my dear colleague, will shrink.
You have been warned.
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