AAEM Position Statement on Growing # of EM Residency Programs

[VA Hopeful Dr]

I was talking about forced limitations of residencies keeping salaries high. If derm proliferated as much as EM it would be about as competitive as FM/psych.

I know what you were talking about, hence the direct quote from an AAD board member saying they need to expand residency spots.

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[Rekt]

I know what you were talking about, hence the direct quote from an AAD board member saying they need to expand residency spots.

So? It essentially about as useful as a school mission statement or talking about any physician shortage. You think they're going to be like "Nah, we don't really need to diversify anything. We're happy with the care people have access to. There's plenty of dermatologists." etc.

Hollow words.

 

[VA Hopeful Dr]

So? It essentially about as useful as a school mission statement or talking about any physician shortage. You think they're going to be like "Nah, we don't really need to diversify anything. We're happy with the care people have access to. There's plenty of dermatologists." etc.

Hollow words.

Duh. I've said as much in this very forum before.

 

[deleted941485]

No signs of oversupply on the horizon.
Graying doctors, patients to fuel 122K physician shortage by 2032, AAMC warns

The AAMC propaganda is so infuriating. Their constant cries of shortage serve no one that actually works in healthcare.

It’s just a crude way for them to sell more MCAT prep books and tests and other nonsense to a bunch of naive do gooders in their early twenties who were told they were special because they can fill in bubble tests better than 99% of the idiot spawn out there.

 

[Birdstrike]

The AAMC propaganda is so infuriating. Their constant cries of shortage serve no one that actually works in healthcare.

It’s just a crude way for them to sell more MCAT prep books and tests and other nonsense to a bunch of naive do gooders in their early twenties who were told they were special because they can fill in bubble tests better than 99% of the idiot spawn out there.

I suppose the silver lining is that if you're constantly short staffed and always expected to work 2 more shifts than your breaking point, then it could be a good thing to increase physician supply. But people want a low supply to ensure high pay, while simultaneously wanting an oversupply to ensure lower work/patient loads to prevent burnout. I'm not sure you can have both.

So the cycle repeats. Doctors demands supply restriction, then are asked to work 20% more hours, see 20% more patients than their breaking point and we get to read another viral blog post on burnout that's pure fire.

 

[deleted941485]

I suppose the silver lining is that if you're constantly short staffed and always expected to work 2 more shifts than your breaking point, then it could be a good thing to increase physician supply. But people want a low supply to ensure high pay, while simultaneously wanting an oversupply to ensure lower work/patient loads to prevent burnout. I'm not sure you can have both.

So the cycle repeats. Doctors demands supply restriction, then are asked to work 20% more hours, see 20% more patients than their breaking point and we get to read another viral blog post on burnout that's pure fire.

No problem with working hard dude. If youre at the beginning of your career, you probably shouldn’t have much to gripe with your gonna be busy. The important part is that you actually get paid well for it.

The problem is employer overloads (after destroying virtually every SDG outthere) want it all. They want cheap doctors working their balls off assuming all the risk and a residency program to train the newer younger cheaper and dumber replacements in greater quantities than before. Plus MLPs that you’ll basically sign off on without reading the chart.

 

[sonofva]

Does anyone actually have hard numbers on current supply, projected rates of retirement, and what the new residencies will really have impact on growth vs attrition from the specialty?

 

[Hercules]

Does anyone actually have hard numbers on current supply, projected rates of retirement, and what the new residencies will really have impact on growth vs attrition from the specialty?

No. Most of this is all conjecture and speculation. I don’t know how you could get hard numbers on retirement rates.

 

[deleted109597]

Does anyone actually have hard numbers on current supply, projected rates of retirement, and what the new residencies will really have impact on growth vs attrition from the specialty?

That's an easy one.
No.

 

[miacomet]

Salaries in my area have declined steadily for the last decade. No one is making what they were in 2010. It's a fairly popular market- canary in the coal mine.

 

[deleted941485]

Yeah even the sort of unreliable medscape comp reports for 2019 was a whopping 0.85%. If they aren’t going down (they probably are) they are definitely slowing down.

 

[Birdstrike]

No problem with working hard dude. If youre at the beginning of your career, you probably shouldn’t have much to gripe with your gonna be busy

I’m not at the beginning of my career. Middle.

The problem is employer overloads (after destroying virtually every SDG outthere) want it all.

Correct

They want cheap doctors working their balls off assuming all the risk and a residency program to train the newer younger cheaper and dumber replacements in greater quantities than before. Plus MLPs that you’ll basically sign off on without reading the chart.

Correct

 

[miacomet]

And this is why, no matter what field of medicine you are in, but especially EM, you'd better save your money and have an exit strategy. Medicine, like anything else, is fine when you are an owner, but now that most of us are employed it's less valuable and valued.

 

[Hercules]

Medicine, like anything else, is fine when you are an owner, but now that most of us are employed it's less valuable and valued.

Cant stress this quote enough. Lack of control exponentially increases burnout.

 

[TheComebacKid]

Well, I blame a lot of EM docs (including several who post on here) for why we are no longer owners and lack control. While CMG expansion is definitely a huge player, there are MANY docs who want to go to work and punch their card and then call it a day without taking any responsibility for the nitty gritty that goes into running a practice.

You don't get to play zero role in advocacy and leadership within your organization and then complain when CMG policies screw you over.

CMG takeover is partially a function both of corporate greed/hospital politics and the fact that very few EM docs are willing to step up to the plate.

 

[GeneralVeers]

Well, I blame a lot of EM docs (including several who post on here) for why we are no longer owners and lack control. While CMG expansion is definitely a huge player, there are MANY docs who want to go to work and punch their card and then call it a day without taking any responsibility for the nitty gritty that goes into running a practice.

You don't get to play zero role in advocacy and leadership within your organization and then complain when CMG policies screw you over.

CMG takeover is partially a function both of corporate greed/hospital politics and the fact that very few EM docs are willing to step up to the plate.

I have no problem with working in a group to maintain a contract. There has to be some reward to doing it, however. Also geographic areas limit where one can practice in a SDG. In my home state it is not possible to work for anything other than a CMG.

 

[GonnaBeADoc2222]

Exactly. I have no problem doing admin stuff but I need to be paid for it.

 

[TooMuchResearch]

Our group pays for it. Not as well as clinical time, but the risk is low, the hours are day time, and I assume they don't feel drained when they go home.

 

[RustedFox]

Well, I blame a lot of EM docs (including several who post on here) for why we are no longer owners and lack control. While CMG expansion is definitely a huge player, there are MANY docs who want to go to work and punch their card and then call it a day without taking any responsibility for the nitty gritty that goes into running a practice.

You don't get to play zero role in advocacy and leadership within your organization and then complain when CMG policies screw you over.

CMG takeover is partially a function both of corporate greed/hospital politics and the fact that very few EM docs are willing to step up to the plate.

If you want to blame someone, blame the admin jackwads who betrayed their SDGs and threw them out after years of good faith and cooperation only to replace them with CMGs.

Its funny; every so often I get asked by my site medical director to serve on a comittee to "bring our group some presence in the hospital".

Why would I ever do that? If the admin crew treats me like a replaceable widget and doesn't listen to anything we say... then that's exactly how I'll act. I'm not giving them an extra minute of my time if they don't care to hear what I have to say when its my turn to speak.

 

[GeneralVeers]

If you want to blame someone, blame the admin jackwads who betrayed their SDGs and threw them out after years of good faith and cooperation only to replace them with CMGs.

Its funny; every so often I get asked by my site medical director to serve on a comittee to "bring our group some presence in the hospital".

Why would I ever do that? If the admin crew treats me like a replaceable widget and doesn't listen to anything we say... then that's exactly how I'll act. I'm not giving them an extra minute of my time if they don't care to hear what I have to say when its my turn to speak.

Right. Showing "face" on one of these committees means absolutely nothing to these amoral idiots. My current hospital has now twice, within 5 years thrown out the existing group with no notice and having a back-door corrupt deal already arranged with a new CMG. They only care about their metric bonuses and will give the contract to any group that claims they can fix the hospital's problems.

 

[Backpack234]

Right. Showing "face" on one of these committees means absolutely nothing to these amoral idiots. My current hospital has now twice, within 5 years thrown out the existing group with no notice and having a back-door corrupt deal already arranged with a new CMG. They only care about their metric bonuses and will give the contract to any group that claims they can fix the hospital's problems.

But this is capitalism, right?

 

[Birdstrike]

But this is capitalism, right?

Yes. No one ever said you didn't have to hustle, to be rewarded.

 

[GeneralVeers]

But this is capitalism, right?

Yes, and it sure beats the alternative.

 

[Backpack234]

Yes, and it sure beats the alternative.

You're right. I would rather have existing groups thrown out in a corrupt back door deal arranged with a CMG that only cares about metric bonuses (rather than, say, patient care) to any level of anything else, especially since anything that isn't pure capitalism is socialism.

 

[BoardingDoc]

For ****s sake, can we please have at least one thread in the EM forum that isn't a political pissing match? Or can we just create a separate thread solely for arguments between all the people who believe that liberals are power hungry men with guns who steal taxes from you, and the people who believe that conservatives are jackasses who would rather watch a baby die of sepsis than give it a shot of antibiotics that it didn't pay for?

 

[TooMuchResearch]

For ****s sake, can we please have at least one thread in the EM forum that isn't a political pissing match? Or can we just create a separate thread solely for arguments between all the people who believe that liberals are power hungry men with guns who steal taxes from you, and the people who believe that conservatives are jackasses who would rather watch a baby die of sepsis than give it a shot of antibiotics that it didn't pay for?

Agree.

 

[GeneralVeers]

You're right. I would rather have existing groups thrown out in a corrupt back door deal arranged with a CMG that only cares about metric bonuses (rather than, say, patient care) to any level of anything else, especially since anything that isn't pure capitalism is socialism.

I'm glad we agree on this.

 

[SeasideDoc]

Right. Showing "face" on one of these committees means absolutely nothing to these amoral idiots. My current hospital has now twice, within 5 years thrown out the existing group with no notice and having a back-door corrupt deal already arranged with a new CMG. They only care about their metric bonuses and will give the contract to any group that claims they can fix the hospital's problems.

And yet you work at this hospital? Doesn't make sense for someone with your experience.

 

[deleted941485]

And yet you work at this hospital? Doesn't make sense for someone with your experience.

It’s actually really pathetic when you see these corporate staffing proposals to hospital admin. You can always tell which admin scum they greased ahead of time.

The presenter “we will cut your hospital subsidy by 50% and improve coverage!” Here’s a BS graph that tells us nothing

Bribed admin: “this is a great proposal!! This is exactly what this hospital needs. Call up the SDG that’s been here for 30 years and tell them to pack their bags!! There a new healthcare game I town!”

Everyone else nods along but knows they’ll be back here in 3-5 years listening to the same nonsense when they don’t deliver.

 

[GeneralVeers]

And yet you work at this hospital? Doesn't make sense for someone with your experience.

It's next to my house (4 min drive) and the pay is equivalent to the higher TX gigs atm.

The problem is that in Vegas we only have the choice between EmCare, TeamHealth, USACS and Vituity. Vituity is the least offensive of these, and recently got the contract at my hospital which is why I started again after a 5 year hiatus there. Hopefully they will last a whole year.

 

[miacomet]

It's next to my house (4 min drive) and the pay is equivalent to the higher TX gigs atm.

The problem is that in Vegas we only have the choice between EmCare, TeamHealth, USACS and Vituity. Vituity is the least offensive of these, and recently got the contract at my hospital which is why I started again after a 5 year hiatus there. Hopefully they will last a whole year.

Veers, I'm impressed by how sanguine you manage to be about the entire corrupt situation.

 

[GeneralVeers]

Veers, I'm impressed by how sanguine you manage to be about the entire corrupt situation.

When you've put in enough time in different hospitals, and different CMGs you get used to it. I used to work for USACS (then EMP) for 5 years. After them, no amount of corruption in our system will astonish me.

 

[miacomet]

When you've put in enough time in different hospitals, and different CMGs you get used to it. I used to work for USACS (then EMP) for 5 years. After them, no amount of corruption in our system will astonish me.

Good attitude. Others develop PTSD.

 

[GeneralVeers]

Good attitude. Others develop PTSD.

I did for awhile which is why I quit my full time job and went locums for awhile.