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My mom's neurologist just informed us that he is retiring at the end of the month and he's not that old. Her PCP is retiring sometime at the end of the year. sigh
Went threw the same thing a few years ago when my much loved PCP retired. He was a true old school physician who was very hands on with a great bedside manner. What caused him to hand in his chips was the coming rules/regs thanks to Obamacare, especially regarding electronic medical records.
That being said there isn't a shortage of physicians here, but then again am in NYC. What is hard to find is another guy like my former GP. These young hot shot MDs walk in, look at you, write a script and are gone in a few minutes. You spend more time with their nurse/PA and of course the front desk paying the bill/filling out forms.
Can't speak to elsewhere but the growing thing here are various urgent care places like City MD. That and or hospital affiliated group physician practices. Mount Sinai, NYP, NYU, North Shore-LIJ.... all the majors have them and are expanding.
There has been and remains an acute shortage of doctors and nurses in the third world, since forever.
Since most folk don't care about the third world, let alone any world outside their own, the First World shortage gets more than its fair share of attention. Those countries with the largest aging population masses, which include retiring doctors, feel a greater pinch.
Cuba is the global exception and has the highest Doctor- patient ratio in the world and send more doctors to the third world. The government picks up the tab for medical school and students come from everywhere.
Unfortunately, the schools are limited to books and equipment that are 50 years old. Wages in Cuba are working class.
Then there's the Gulf states that rely entirely on foreiners for doctors/ nurses. They are compensated according to the color of their passports. A doctor/ nurse with an Indian passport is paid the least while those with Canadian, Australian or US passports are paid the most. In effect they are paid the going rate in the country of their passport. Income is tax free and not reported to the medical professional's home country. Housing, utilities, transportation, R/T air, generous paid leaves between contracts are all included.
Unlike the US, most other governments take care of the cost of education for highly qualified students accepted into medical school. Despite the cost, there are far more qualified applicants who are declined than accepted by US medical schools and the majority come from families with incomes in multiples of the national average.
The fewer slots in US medical schools means, in theory, only the best are accepted. It also means a greater potential for financial rewards down the road if/ when they choose / qualify for lucrative specialties. The Association of Medical Colleges announced back in 2002 that they expected to increase medical school enrollment by 30% between 2002-2017. This does not however, mean doctors will choose less lucrative specialties or relocate to areas with shortages.
Like with everything, shortages/ surpluses are geographical issues, down to the zip code.
And that's not to mention the ungodly amount of paperwork that ObamaCare brings on to these doctors. Kids find that out, and then they don't want to deal with that, thus discouraging them from the profession.
Insurance brought about electronic billing/ record keeping beginning about 15 years ago.
Medicare realized the efficiencies of technology and set a deadline and Congress approved funding to offset the cost of the transistion.
There's no incremental " ungodly amount of paperwork" associated with the ACA.
Over the past 20+/- years, Managed Care and Healthcare systems have been acquiring medical practices to the point that it's the rare MD that operates as a sole practitioner, anymore. The unaffiliated that remain, tend to join or merge with other practices and operate out of multiple locations.
This has as much to do with MDs wanting a better life- balance situation and sharing the cost of practice than anything else.
My long time OB/ Gyn operated a sole practitioner practice for more than 30 years and was adamant she would never affiliate with another practice or healthcare system. I was surprised to learn that she sold her practice to a major healthcare system and is now an employee with set hours and a guaranteed paycheck. She is thrilled to discover there is life outside medicine and does not miss the challenges of running her own business.
There has been and remains an acute shortage of doctors and nurses in the third world, since forever.
Since most folk don't care about the third world, let alone any world outside their own, the First World shortage gets more than its fair share of attention. Those countries with the largest aging population masses, which include retiring doctors, feel a greater pinch.
Cuba is the global exception and has the highest Doctor- patient ratio in the world and send more doctors to the third world. The government picks up the tab for medical school and students come from everywhere.
Unfortunately, the schools are limited to books and equipment that are 50 years old. Wages in Cuba are working class.
Then there's the Gulf states that rely entirely on foreiners for doctors/ nurses. They are compensated according to the color of their passports. A doctor/ nurse with an Indian passport is paid the least while those with Canadian, Australian or US passports are paid the most. In effect they are paid the going rate in the country of their passport. Income is tax free and not reported to the medical professional's home country. Housing, utilities, transportation, R/T air, generous paid leaves between contracts are all included.
Unlike the US, most other governments take care of the cost of education for highly qualified students accepted into medical school. Despite the cost, there are far more qualified applicants who are declined than accepted by US medical schools and the majority come from families with incomes in multiples of the national average.
The fewer slots in US medical schools means, in theory, only the best are accepted. It also means a greater potential for financial rewards down the road if/ when they choose / qualify for lucrative specialties. The Association of Medical Colleges announced back in 2002 that they expected to increase medical school enrollment by 30% between 2002-2017. This does not however, mean doctors will choose less lucrative specialties or relocate to areas with shortages.
Like with everything, shortages/ surpluses are geographical issues, down to the zip code.
Anyone think there's a shortage in Malbu?
Medical profession and to an extent including schools are one of the biggest closed monopolies in the United States. Nursing schools are cranking out hundreds of graduates that are in many cases surplus to local requirements, and new programs are starting all the time. In contrast the roll out of new medical schools has been painfully slow in this country.
Physicians as a group also make it very difficult for foreign trained doctors to practice in this country. Case in point while Obama has been busy putting out the welcome mat for Cuban doctors to arrive in the USA from anywhere in the world they happen to be; once they arrive getting to practice medicine is another story. A good number end up like other foreign physicians; becoming nurses or doing something else entirely unrelated to healthcare while they ponder their next move. Cuban doctors facing challenges due to US Regulations | CCTV America
Then you have the fact US medical schools accept and graduate a good number of international students who often do their post graduate work here; however only a small number actually are able to get visas to remain. So they head back to their home countries. Of this number you find a good amount are in urban areas/places where other (US born and raised) doctors don't want any part; urban setting, poor/under served areas....
And that's not to mention the ungodly amount of paperwork that ObamaCare brings on to these doctors. Kids find that out, and then they don't want to deal with that, thus discouraging them from the profession.
The grotesque amount of administrative overhead found in the US system way predates the ACA. And it is due to the privatized nature of health insurance.
The grotesque amount of administrative overhead found in the US system way predates the ACA. And it is due to the privatized nature of health insurance.
You mean private concerns being forced to comply with govt concerns.
Went threw the same thing a few years ago when my much loved PCP retired. He was a true old school physician who was very hands on with a great bedside manner. What caused him to hand in his chips was the coming rules/regs thanks to Obamacare, especially regarding electronic medical records.
That being said there isn't a shortage of physicians here, but then again am in NYC. What is hard to find is another guy like my former GP. These young hot shot MDs walk in, look at you, write a script and are gone in a few minutes. You spend more time with their nurse/PA and of course the front desk paying the bill/filling out forms.
Can't speak to elsewhere but the growing thing here are various urgent care places like City MD. That and or hospital affiliated group physician practices. Mount Sinai, NYP, NYU, North Shore-LIJ.... all the majors have them and are expanding.
So you don't see the efficiency and value of an electronic healthcare record compared to a hard copy? Early on the Bush Administration announced the goal of eliminating most handwritten clinical data by 2010. In 2004, Bush announced the creation of a government over site office to make Electronic a Healthcare Records ( EHR) available to most Americans. Since 2006, government has been certifying products to effect EHR objectives.
Obama followed through with financial incentives to encourage millions of healthcare providers to eliminate the paper and get with the program.
I seriously cannot imagine a medical school student today who would seek to practice medicine in a hard copy enviornment. Seems to me that most of today's medical school students seek a better work- life balance than many of their predecessors did. They are also disinclined to make the huge personal investment in maintaining a state of the Art environment. Seems to me, most who are passionate and competent about practicing medicine are not necessarily inclined to operate a righ risk business model.
As it relates to the young hot shots.... It's all about higher and better use of the talent which in some cases probably leaves some patients with unmet emotional needs , longing for the days when more doctors took the time to get to know their patients.
You're pretty much spot on as usual. Although there a few med students and docs in training coming through looking at a more direct pay medical office model, and that tends to leave out the EMR.
If you click on the link, You'll see that the article has been corrected. The projected shortage is as many as 100,000 doctors, NOT 1 million doctors.
LOL that makes much more sense!
Thanks for clearing this up. Go back to business as usual folks.
I am seeing a trend where people are avoiding the doctors if possible. I know people who stop taking their kids to the doctor office every time they think the kid has a flu.
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