Thursday, July 19, 2007

We have a Physician Oversupply, not a shortage

How will health care look and feel like in the year 2020 when we have the "physician shortage" that Dr. Cooper predicted in his shaky and dubious study? When we supposedly will be short 200,000 physicians?
Will people die in the streets? Lines in the ER around the block? People traveling hundreds of miles for cancer treatment? Mortality at an all time high? Women delivering babies in buses?

I believe those will be everyday scenarios - or not?

Well, this kind of future is very easy to foresee. It actually is already here. In Oklahoma. Just fly there and look around, go to the offices and hospitals, get treated at modern and pleasant ERs, have attentive doctors and nurses take care of you.

Oklahoma has numbers that Dr.Cooper foresees as catastrophic. The physician density is 1.6 for 1000 Americans. The US average is 2.6. The Massachusetts average is 4.3!!! And that is why you hear the whining of "shortage of primary care physicians" the loudest in Massachusetts.
Strangely, you do not hear "help, we are sinking into a health care crisis" screams from Oklahoma.

Does that make you a little skeptical of the "looming disaster"? It sure should.

Dr.Cooper is very wrong in important points, as I have laid out in a previous blogpost. I can only suspect who supports him and why...

It is time that the AMA, ACOG and other professional societies take a better look at his numbers and consider modern developments such as the exploding "Minute Clinics", growing telemedicine and the progress in genetics. And for the notion that the "coming generation of physicians is not willing to work hard", that is the old stuff that parents have ben saying about their children's generation for ages. Ahhh the good old times. Everything was better back then, right?

The "looming physician shortage" is blatant nonsense. In fact, we have an oversupply of physicians since the mid eighties. The proof is simple and does not require any fancy studies: Our incomes have gone down continuously since that time.


RoseAG said...

I was just reading a post yesterday about the shortage in MA. Nobody there mentioned 4+ @ person there and many fewer in OK.

My Dad in Topeka has a Dermatologist who was telling him that he out earns his classmates who are practicing in NYC.

I think you are on the money. Are you sure you aren't an economist?

ObGynThoughts said...

Hi, RoseAG!
Thank you for your comment. I think this whole discussion about physician shortage is pathetic. When I see my income doubling, then I am willing to consider "shortage". At the moment, I am earning less and less.
And physicians are notorious for being bad business people. Therefore too many have no notion of the dramatic conflict between earning less on one hand and the talk about shortage on the other hand. It is very sad.
Physicians in the states with a lower ratio of physicians to population always earn more, and it is natural that the dermatologist in Topeka out-earns his colleagues in NYC. In addition, cost of living in Topeka is significantly lower than in NYC. It is similar with real estate.
A colleague of mine, a family doctor, moved from Boston, MA to Norman, OK, and now not only earns twice as much, but also lives in "a ridiculously large mansion" that he bought for 350K, something that in Boston, MA would be considered a down payment on a condo.
All very interesting. But do not believe a word about "physician shortage"!

Anonymous said...

In the eyes of certain organizations there will always be a shortage. For a deer hunter, will there ever be an oversupply of deer? of course not.
One of the biggest organizations pushing a physician shortage in congress is the AAFP (American academy of family physicians). According to them "we need more residency spots" for the already overcrowded 430 residency programs in the country. What they don't tell you is that they get millions of dollars each year JUST in membership fees from family physicians, not to mention their CME activities, commercial endeavors and other activities for which they receive pretty large sums of money. They will not rest until they get their pockets even bigger and family physicians are looking for jobs at the mall for pennies on the dollar. They don't care that more residents and more doctors mean an even bigger burden on our bankrupt medicare system who picks up the tab for medical education. By my calculations, at least 30% or residency programs need to close in order to balance the equation. Of course residency program directors are corrupt bastards whose meal ticket could possibly be an oversupply of physicians. We need less physicians, close the borders for the foreign ones and stop this madness!!!

Anonymous said...

7 Years later and more people need to read this.