Gyroscopic Investing

Get out while you still can!  There's no price elasticity in this Politburo-controlled market. 

[quote=https://www.aamc.org/download/426248/da ... 013to2.pdf]
Projections of future supply and demand for physicians suggest a shortfall of 46,100 to 90,400 physicians, including a shortfall of 12,500 to 31,100 primary care physicians and a shortfall of 28,200 to 63,700 non-primary care physicians. 3  In percentage terms the shortfall is greatest among surgical specialties (excluding obstetrics and gynecology) reflecting little projected growth in supply of surgeons and limitations on the ability to augment staffing with other types of clinicians.

Uncertainties regarding how emerging care delivery models and changing care practices might affect physician supply and demand, together with uncertainties regarding how clinicians and care settings will respond to economic and other trends, underscore the importance of ongoing research on potential implications of the evolving health care system for the nation’s physicians. The large range for the shortage projections reflects uncertainty about key supply and demand determinants, reflecting important areas for future research. These include: 1) how physician retirement patterns might change over time based on economic factors, work satisfaction, trends in health and mortality, and cultural norms regarding retirement; 2) whether younger physicians will continue to have similar work-life balance expectations as older cohorts; 3) how clinician staffing patterns are likely to evolve over time; and 4) the effects of different payment models.

Differences in projections between this 2015 report and the 2008 and 2010 reports reflect updates to key supply and demand drivers (e.g., population projections) and acceleration in the pace of change in health care delivery. These differences in projections highlight the importance of continually monitoring projected adequacy of supply to incorporate the latest trends in supply and demand determinants, the latest research on care delivery models (e.g., Accountable Care Organizations), and changing technology and economic conditions.


[/quote]

LOL "millenial hours"

Within the broader labor force (i.e., beyond the physician workforce) there is some indication of a
possible “cohort effect.” Namely, younger workers might desire to work fewer hours than their older
counterparts. However, within the physician workforce there are counterbalancing factors. Younger
physicians might prefer to work fewer hours and maintain a better work-life balance. On the other hand,
rising debt levels for graduating physicians could spur increased hours worked. Analysis by the AAMC’s
Center for Workforce Studies comparing self-reported hours worked per week from the 1980 Census to
hours reported in the 2009-2011 files of the American Community Survey suggest that male physicians
age 26-35 worked 5.4 fewer hours per week in 2010 relative to 1980. Hours worked per week for
physicians above age 35 were similar between 2010 and 1980. A 3.5 decline in hours worked per week was observed among women physicians age 26 to 35 when comparing 1980 to 2010 hours worked
patterns, though among female physicians above age 35 hours worked were higher in 2010 versus 1980.
This may reflect more women entering surgery and other specialties that traditionally have worked
more hours per week.
The supply scenarios modeled all use current patterns of hours worked to model the implications of
changing demographics among the physician workforce, with the exception of the Millennial Hours
scenario which assumes that physicians currently under age 35 will continue to work approximately 7%
fewer hours per week relative to earlier cohorts

I have definitely noticed that residents are increasingly choosing careers with fixed hours and no beeper to bug you at home.  Critical care, emergency room, urgent care clinic, and hospitalist jobs are all getting a lot more love than traditional office-based practices. 

Whereas, office based practices are, increasingly, nothing more than a way to go broke while working practically round the clock for a respectable, but not great salary.    The "mystique" of medicine kept this going for quite a long time, but now that the mystique is gone and medicine is just another job, there are more and more people who realize that this is actually a monumentally stupid career path.

Not sure what this implies for those wildly speculative charts in the OP.  I am guessing that medicine will be increasingly about getting patients efficiently to the diagnostic procedures that make money, and the time spent sitting with your doctor and asking tons of questions and being examined will soon be a thing of the past.  The former is certainly far quicker, can be done easily by an NP or physician assistant, and of course will be dramatically more expensive.

WiseOne wrote: Not sure what this implies for those wildly speculative charts in the OP.  I am guessing that medicine will be increasingly about getting patients efficiently to the diagnostic procedures that make money, and the time spent sitting with your doctor and asking tons of questions and being examined will soon be a thing of the past.  The former is certainly far quicker, can be done easily by an NP or physician assistant, and of course will be dramatically more expensive.

Why would it be more expensive to be seen by NP or PA instead of doctors?

More diagnostic tests + less thought = more expensive.  But a heck of a lot easier :-)