I keep getting served a Facebook ad from the American Association of Medical Colleges imploring me to ask politicians to fund residency training for medical school graduates. The link leads to a webpage with neat graphics and a series of well-designed cartoons dramatizing an ominous shortage of 90,000 doctors expected to occur by 2025.
Now, the notion of “doctor shortage” by itself is meaningless. Doctors—like plumbers—are a scarce resource and therefore always in shortage. Patients have always had to contend with waiting rooms, whether at the outpatient clinic or in the emergency department. People have always had to wait to see a specialist, especially a good one, and this will never change. The supply of doctors must be judged in the context of the needs of patients and the economics of supply and demand.
But here’s the rub.
In our distorted health care economy, patients rarely pay doctors in such a way as to express the urgency and intensity of their demand for medical attention. Without a market price to guide supply and demand, the estimation of how many doctors will be needed—and of how long the waiting periods ought to be—always emanate from bureaucratic decisions and speculations.
If indeed there will be an massive shortage of doctors in the near future, the important practical question is: at what level of physician income will the expected shortage take place? How many residents will be able to make a living at the income level they will eventually achieve in 2025?
If you are a college student contemplating a career in medicine, you would do well to ask yourself the following questions:
Isn’t the health care bubble of last 60 years imploding? Aren’t doctors’ incomes on a steady downward course? Isn’t Uncle Sam, the major payer of doctors, completely broke? What will happen to Uncle Sam’s ability to pay me if his creditors stop loaning him money? How much of my income will be consumed to pay back my educational debt?
I have no idea how many doctors the economy will be able to support in 2025, and I doubt very much that politicians have a better idea. Perhaps it will support another 90,000 doctors. Or perhaps a tanking economy could turn the expected shortage into a massive oversupply.
The AAMC doesn’t want the next generation of medical school graduates driving Ubers to make ends meet, does it?
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The next generation of doctors is already in trouble. There are so many medical graduates who have not matched to a residency position. Many of us feel pressured to take the research jobs for free just to get something for our CV’s (the best offer I have heard is 1/2 a resident’s pay). I have MD grad colleagues who are using the food bank and Medicaid. There simply are not enough residency positions for the current number of applicants. There are more medical schools now, but the funding in the U.S. is stuck at 1997 levels for graduate medical education. It is shameful.
You are correct, Keri. My best advice is to keep costs and debt as low as possible, and be as inventive and imaginative as possible to try to bring value to patients. It’s going to be very tough for a lot of folks.
I’m a productive software engineer. I volunteer as an EMT. I could easily go to medical school – one of my friends in a similar position has done the same and is partway through his residency at Famous Medical School.
That having been said, the payback period for me would be something like 11 years, and that assumes that I managed to go to school for free. My current job pays well enough that the opportunity cost is quite high.
So, no, there isn’t a looming shortage of doctors. If there was, one of the local hospitals would love to pay for me to go to medical school in exchange for a 10-year contract. Not happening.