The Future of ENT

[ENTforME]

I was chatting with my faculty...and he said that the future of ENT is bleak...the jist...decreased pay and oversaturation...does this ring true with what you've heard/ experienced/ etc...

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[BOOURNS]

I was chatting with my faculty...and he said that the future of ENT is bleak...the jist...decreased pay and oversaturation...does this ring true with what you've heard/ experienced/ etc...

This didn't happen to be plastics faculty did it?

 

[resxn]

I was chatting with my faculty...and he said that the future of ENT is bleak...the jist...decreased pay and oversaturation...does this ring true with what you've heard/ experienced/ etc...

He's wrong. The future of medicine is bleak. ENT does not stand out as any worse than any other specialty.

The RRC for ENT has very tight control over how many ENT residents there are. They have maintained an appropriate graduating number very well. There is actually a dearth of ENT's in the US by about 2,500 or so (I have another post where I prove that by numbers based on the AAO-HNS est of a need of 1 ENT per 35,000 people). Since the number of ENT's trained is not keeping pace with the national growth, nor is the influx of FMG's in ENT making up for it by any means, we are in a good position in terms of numbers.

Where we hurt is in reimbursement. You'd be hard-pressed to find an ENT who didn't make more in the clinic now than in the OR--just the opposite of what it was 10 years ago. And now Medicare is dropping reimbursement by 10% and the first vote to reverse that actually got shot down. So guess who follows suit when Medicare lowers reimbursement? That's why it's bleak right now.

It's not as bad as being a PCP. They're getting it from both ends--midlevel providers getting increasing autonomy and opening up these primary care clinics in Wal-Mart and in pharmacies, as well as the reimbursement decreases.

We're relatively ok, but all of medicine as a whole is not.

 

[TheThroat]

Agree with resxn in that medicine in the US has had its peak and is now fighting to maintain what it currently has and is losing out to lower reimbursment, but docs in the US still have it much better than docs in most other developed countries (Europe and the UK, especially). Canadian docs get paid pretty well, but have a tighter limit that is hard to pass.

 

[Neuropathia]

Agree with resxn in that medicine in the US has had its peak and is now fighting to maintain what it currently has and is losing out to lower reimbursment, but docs in the US still have it much better than docs in most other developed countries (Europe and the UK, especially). Canadian docs get paid pretty well, but have a tighter limit that is hard to pass.

Why do you think docs in Europe have it worse than you do? And are you talking about doctors in hospitals? As from the residents point of view: we have a higher income, less working hours and more days off than you do in the US.

 

[TheThroat]

When looking at the "future of medicine", I have never looked at it from a resident's standpoint. Residencies in the US have certainly gotten much better from a quality of life standpoint since the 80 hour workweek rules came into effect.

What I am talking about is comparing compensation between practicing docs in the different locations. US docs, on average, make anywhere from 2 to 5 times the amount that docs in different European countries make, and have opportunity to buy into surgery centers, CT scanners, audiology practices, allergy practices, etc. I don't know about Europe, but many of these entrepreneurial (sp) activities. I don't hear any US docs saying, "well, I could do better if I moved to country X, redid my residency, and restarted my practice there. However, I know of docs from Greece, France, Scotland, South Africa, Egypt, India, Australia, and China who have done that very thing to have the opportunity to practice in the US.

 

[Neuropathia]

@ the throat:
well from the point of practising docs, you're certainly right. I don't know a single doc in practice who can claim to have gotten "rich" from their practice here. Obviously that has to do with the health care system. But I think there are more reasons than money, why European docs go to the US and why US docs rarely migrate to Europe.

 

[resxn]

@ the throat:
well from the point of practising docs, you're certainly right. I don't know a single doc in practice who can claim to have gotten "rich" from their practice here. Obviously that has to do with the health care system. But I think there are more reasons than money, why European docs go to the US and why US docs rarely migrate to Europe.

what are those reasons? I'd be interested to hear what you know, because unless it's political, every time I talk to a doc who immigrated to the US it was for money as the bottom line. Sometimes they phrase it in a more PC way such as "opportunity" or "freedom" or "autonomy" but all those discussions end up going back to the dollar as the underlying principle.

 

[Neuropathia]

Research (better facilities and easier to arrange with the clinical work), better training (especialy concerning specialized surgeries, which in Europe are rather performed by a small group of docs who will not give any training for fear of creating to many 'rivals'), more oportunities to open up a private practise.

I admit though the money is attractive, but from all I heard here in my country it's rather a desirable side-effect (but people may lie to me).

 

[resxn]

Research (better facilities and easier to arrange with the clinical work), better training (especialy concerning specialized surgeries, which in Europe are rather performed by a small group of docs who will not give any training for fear of creating to many 'rivals'), more oportunities to open up a private practise.

I admit though the money is attractive, but from all I heard here in my country it's rather a desirable side-effect (but people may lie to me).

I'd buy all that, just haven't heard it before.