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?