In the UK with NHS shortages it's all about wages though. The time component just means that whenever they finally get the wages figured out it will still take years to improve.
If you really need doctors NOW, bump up the rates as high as they will go. At some point you will either run out of money, or you'll find a doctor somewhere in the world willing to take the 12 hour plane to move to the UK for the 1 million pound an hour wage you're offering them.
Also worth keeping in mind - there's a big difference in "market rate" between "well-treated doctor in a well-functioning health system" and "relentlessly over-worked doctor in a wretchedly crumbling health system". And even if paid well above "market rate", the latter position will attract far fewer applicants who really care about patient welfare and outcomes. And suffer considerably higher turn-over.
Ultimately, it still boils down to “I think you should be limited to making X for doing job Y, because I don’t believe it should be worth as much as job Z, which is clearly prestigious enough to be worth 2X.”
Market forces are a surprisingly efficient means of separating perceived and actual value for pretty much anything, even with some fairly sizeable warts.
Yes and no. A nation like the UK can afford to pay any one doctor millions of pounds. But that solution scales poorly to a national level. And worse if you try to scale it to all the other sorts of essential workers. And when an extremely large, complex system is wretchedly mismanaged - paying the guys in the trenches 10X does not fix that. For example, many of the UK's public buildings were built with "RAAC", and are at risk of collapse: https://www.theguardian.com/uk-news/2023/sep/04/raac-crisis-...
Meanwhile - a rather large number of HNer's seem to disagree with you about the virtues of those "efficient market forces" when it comes to health care. Perhaps discuss it with them here? - https://news.ycombinator.com/item?id=37398504
If you live elsewhere and are surprised to have never heard about this, it’s because it hasn’t been acknowledged yet by the government to save face, but anyone with relatives stuck on a NHS waiting list or who have sadly passed away waiting for an ambulance that doesn’t come already knows this.
Aren't you sorta forgetting the more salient point of this headline? That it was an outright fabrication with no justification or basis in reality?
Factory owners understand and exploit this. In one such instance that I found frightening, a shop I was visiting in MI had plastered posters up with messages to the effect of "you have a right to work, don't let anyone take it!" as though their governer's repeal of the Right to Work was somehow an attack on workers themselves, and not a gut punch to factory owners who are anti-union. These same owners will spout "nobody wants to work anymore" while offering a pitiful wage for jobs that demand years of experience, or special skills.
I see the gaslighting in everything from tiny 10-man shops to factories the size of small towns, and it is frightening how much power the owners have over this population through insighting fear and anger.
If prosperity was shared as in 1965, the mode income would be 6 figures.
A friend of mine runs a successful business bringing over doctors from the Philippines, Pakistan, etc to work in the NHS, so the gap gets filled that way.
I know two junior doctors, one is working in Australia and the other is still in the NHS and would never countenance leaving no matter how rational a decision it may appear.
This is far from true. On the margin, doctors can work in the private sector or leave the country. Only a few choose to do so, but this is (among other reasons) because the NHS always has to respond to price pressure to keep that small number from growing to where it causes shortages.
Recently a change in how pension contributions are taxed was pushed through almost entirely because it affected senior doctors. If the NHS had pricing power as you suggest, why wouldn't they just tell doctors to pay up?
I wonder what would it take to end feudal employment model that so, so many industries have and what software seems to mostly avoid.
I remember arguing with my doctor mother that had an intern. She practically claimed that the intern _should be_ paying her for learning experience and that's so burdensome for her to even share the knowledge she gathered during decades of experience. It's unthinkable for most software engineers, who often create free products, tutorials, articles with no expectations of pay.
another specter hanging over the industry is that studies have shown that hand-offs to different nurses and doctors is what leads to errors, and in medicine that sometimes means people dying cuz of dumb mistakes. the solution was to keep someone on shift, like 12+ hours, or often more for sensitive cases.
i've done 60 hour weeks in IT, and even napped in a data center -- that hum is relaxing! -- but those were one-offs, while it's a lifestyle for the docs.
Which was entirely the wrong "lesson" to learn! Once again doctors bristle at being told they should improve their processes instead of being arrogant hero complexes that can do no wrong.
They should have improved the handoff and paperwork processes. Airplane mechanics have been handing off extremely complex procedures and concerns for decades, with very few accidents. So maybe we should learn from them instead of letting tired doctors continue to mistreat people.
Doctors similarly were grumpy about bringing in checklists like pilots have, despite them having a demonstrated effect.
Here in the UK we have a perpetual doctor shortage, except that we don't, because young doctors are worked to the bone in incredibly stressful environments in what seems to be a "paying your dues" model so that you can possibly, maybe earn the fat consultant money that older doctors get on their way to retirement. My understanding is that most leave for better money and living conditions in places like Australia. They exist, they just opt-out.
In the UK, independent software contractors are vilified pretty regularly, and there's often a lot of learn-to-code pushes because there's a perceived shortage. Maybe some of those people could just learn-to-medicine instead and solve both problems.