The AMA is a guild and the doctor shortage is their fault.
They are a labor organization that's intentionally limiting supply.
A few weeks later I read an article about a new cuneiform tablet that had just been translated. The oldest translated writing in the world, at the time. Evidently the brick-making guild hadn't been training enough young apprentices and the price of construction was becoming excessive. They wanted the king to step in. It was the same trick! This was literally the oldest trick in all of recorded history!
I am still somewhat adjacent to the biomedical scene and I've heard that the AMA has reversed course recently -- but I don't know the degree to which the new words correspond to actual actions. In any case, the sentiment is correct: if they don't become part of the solution, they will be seen as part of the problem when the eye of Sauron turns in their direction, and the terms imposed on them will be much worse than the terms that could otherwise have been arranged.
There's a huge opportunity in the market for providing low cost care that has fewer regulations and restrictions.
Honestly, I don't know if it will work or not, but I think it's interesting they're trying to take advantage of the (frankly ridiculous) medical situation in the US right now.
Why would you ever choose to be a doctor over an employee at a FAANG? It would be worse for your mental and physical health, and now the pay isn’t even much higher for doctors.
1) People tend to compare FANG to family medicine. It wouldn't be more apt to compare the average tech worker making 100-200k to family medicine, or compare to some of the more competitive specialties.
2) Salaries are underestimated by many people. The best source is the MGMA is is often used to negotiate salaries by the hiring side. Unfortunately the data is expensive to access so few have it - there's an older screenshot someone took [1]. Further, these are biased lower since academic medicine and part time researchers tend to make less. You can also tailor you're career with more flexibility. Want to make $1M? Go for it. Want to work 2 weeks a year and still bring in 2-300k? Go for it.
Now if you want to live in NY or SF tech will pay more as medicine pays more as you get more rural.
1) if US goes with taxpayer funded healthcare, expect pay to go down similar to other developed countries with taxpayer funded healthcare. Because there will be no negotiating power.
2) with the ACA framework, it’s a race for insurers, hospitals, and physicians groups to get as big as they can do they can gain as much negotiating power as they can. I can see it with all the M&A in the hospital and provider space, and the rule of thumb is “the closer you are to the money, the more you make”. In this case, insurers will hold the money, so it will be at their mercy that they approve or deny payments for certain procedures.
The American people themselves don’t have enough money to continue paying for this gravy train, and the government was picking up the slack, but I think that’s going to be over soon.
The CVS/Aetna vertical integration model is interesting too, as they are talking about adding doctors to their stores to make it a one stop shop. Insurance, provider, medicine all in one, similar to Kaiser.
And then there’s doctor groups who are able to pump out more work from one doctor by using physician assistances and nurse practitioners to actually see patients “supervised” by one doctor, but the doctor never actually sees the patient.
The NP/PA practice is also a growing concern amongst doctors. Those groups are advocating for independent practice despite reduced training.
I'll admit, I'm a fairly stereotypical introvert tech guy and tend to judge people more than I should. Talking to patients has a way of shifting your views. I used (and I suppose still do a bit) to judge alcoholics, drug users, and other preventable conditions. But you realize how they really are a result of social or medical circumstance and I think for that reason many doctors are willing to sacrifice some pay. Hell I went into medicine for the security and money (mostly, plus more academic stimulation than software), as taboo as that is, and I'd be ok with it.
That said I think specialty medicine pay is fairly safe. Fact is supply is limited, right thing or not.
But yes it appears the median doctor gets paid somewhat more than I thought. Although only a few of the surgical specialties outstrip my personal compensation, I would guess I'm a good deal above the median for software engineers and the median engineer is probably only in the same neighborhood as the median doctor, not above.
People also bring up malpractice but a good employment contract will include that with tail coverage.
I do know people who were engineers for a decade plus, and they had to do a year of coursework (special medicine program) before applying to med school.
If it's something you personally are interested in, happy to talk more.
However, for cardiologists, anesthesiologists, neurosurgeons, etc. you probably want a higher education standard.
For example, for an appendectomy, a non-teaching hospital might be reimbursed $4,500. If you’re a teaching hospital you get an extra 1.3% (too lazy to look up exact number, but it’s quite small), so $4,559. And that’s for every procedure at the hospital, whether the resident was involved or not.
Seems like a more direct, “here is $80,000 for each residency spot” would make things a bit more transparent?
Maybe drop the requirement that "only" governments fund residency slots?
They could say this is the quick fix but the long term solution is different.
If you want more doctors, lobby your government to increase residency training funding.