Bureau of Labor Statistics Data for Physicians and Surgeons

[cpr231]

The Bureau of Labor Statistics projects 3% growth for physicians and surgeons during the years 2020 to 2030. In comparison, the BLS projects 45% job growth for nurse practitioners and 31% job growth for physician assistants. If these projections are accurate, does this mean that pursuing a career as a physician is a risky venture in terms of finding a job and that becoming a nurse practitioner, for example, is now the safer route to find employment? And does this mean that many physicians will be unemployed and in debt in the future?

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[TragicalDrFaust]

Remember this is a single statistic about a huge, multifactorial outcome. A couple things to consider: all physicians are not equal. It's likely that new Caribbean grads will get edged out before anything happens to US MDs and DOs. Also consider that there will be a generation of retiring physicians (boomers), leaving a gap for new grads to fill. Boomer PAs and NPs are far less common. The statistic doesn't show that the 3% is subtracting retiring physicians and adding new grads. The corresponding stats for PAs and NPs are larger because there will be far more new grads than retiring boomers.

Also legislation around PAs and NPs is evolving. I predict their scope will expand until patients start getting hurt, then they'll need to start worrying about lawsuits and their employers won't want the liability. Thus a PA or NP degree is riskier, in my opinion, because their scope of practice and pay is still being established.

Finally the physician lobby is extremely interested in and extremely adept at preserving its own wealth. For better or worse, we hold the most wealth out of the healthcare professions and that translates to political might.

I wouldn't worry too much about this for now though I agree it's something to be aware of.

 

[cpr231]

Remember this is a single statistic about a huge, multifactorial outcome. A couple things to consider: all physicians are not equal. It's likely that new Caribbean grads will get edged out before anything happens to US MDs and DOs. Also consider that there will be a generation of retiring physicians (boomers), leaving a gap for new grads to fill. Boomer PAs and NPs are far less common. The statistic doesn't show that the 3% is subtracting retiring physicians and adding new grads. The corresponding stats for PAs and NPs are larger because there will be far more new grads than retiring boomers.

Also legislation around PAs and NPs is evolving. I predict their scope will expand until patients start getting hurt, then they'll need to start worrying about lawsuits and their employers won't want the liability. Thus a PA or NP degree is riskier, in my opinion, because their scope of practice and pay is still being established.

Finally the physician lobby is extremely interested in and extremely adept at preserving its own wealth. For better or worse, we hold the most wealth out of the healthcare professions and that translates to political might.

I wouldn't worry too much about this for now though I agree it's something to be aware of.

You bring up some good points. However, the BLS specifically states “Most of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.” So doesn’t that mean they are accounting for retiring physicians in that 3% statistic?

Also, why does the BLS projection keep dropping year after year for physicians? I believe it was around 7% growth a couple years ago and then in the 10-20% range a few years prior to that. Does this mean the situation is getting gradually worse and that negative growth can soon be expected? Similar to pharmacy?

As far as political might, if physicians truly wield this much power, then why does it seem like they’ve been defeated repeatedly in the political arena and that they have created this situation that seems to put them at risk of being replaced by practitioners that were originally meant to help them, not replace them?

 

[LizzyM]

In my opinion, physicians have priced themselves out of the market for basic services provided in quickie-clinics and in the long-term management of chronic illnesses. Furthermore, many physicians do not want to work the hours required to provide urgent care to their patients and some find the routine management of chronic conditions to be mind-numbing. So, the garden variety problems such as tonsillitis, bladder infections, chest colds, sprains are being shunted to drop-in clinics and long-term management of asthma, type II diabetes, hypercholesterolemia, hypertension, anxiety, depression, and many forms of contraception and so forth are being handled by nurse practitioners at a lower cost for whomever is paying the bill.

 

[voxveritatisetlucis]

Apparently, patients do prefer physicians. Though, I’m not sure if the people conducting these surveys were able to be unbiased.

In terms of your question, I don’t think it is risky per se in that doctors will always be able to have a middle/upper middle class lifestyle, but don’t expect to own a house in Aspen, fly first class, or drive a Bentley.

If you want those things, try your luck at investment banking, private equity, hedge funds etc. Most who enter these fields won’t be able to afford those things either, but I would say maybe 15% will be able to make it to a high enough level to get those things

 

[cpr231]

I am not concerned about the salary. My main concern is going through medical school, residency, accruing a lot of debt and then not being able to find a job after all those years of education/training. Does this seem to be a likely outcome or highly unlikely? The AAMC seems to project that there is a massive shortage of physicians, but they have a financial incentive to project that. In contrast, the BLS seems to project an overabundance of physicians in the future, so who is right and who is wrong? Also, if it‘s the case that the physicians could get together and do that, then why haven’t they yet? I’ve seen a lot of complaints online regarding midlevel encroachment, but haven’t seen much action taken by physicians in the real word to address it.

 

[voxveritatisetlucis]

No that is not likely. Probably even close to impossible (unless you go into radonc or EM). And with EM you’d probably still be able to find a job with ease, just maybe not in California or New York City, and for less pay than before.

Things like uro and optho will always be good be current urologists ensure that there is a cap on residency slots

 

[cpr231]

No that is not likely. Probably even close to impossible (unless you go into radonc or EM). And with EM you’d probably still be able to find a job with ease, just maybe not in California or New York City, and for less pay than before.

Things like uro and optho will always be good be current urologists ensure that there is a cap on residency slots

Okay so is the BLS just totally wrong on their projections and don’t understand what’s really going on in healthcare? That would seem to make sense based on what you’re saying, but isn’t it their entire job to be right about these types of things?

 

[voxveritatisetlucis]

They’re not wrong. I mean how would physician jobs even increase by that much if residency slots are capped?

It would be way more concerning if the BLS was projecting a 15% increase rather than a 3% increase. Supply and demand

If the number of doctors increases rapidly, the supply becomes too high, reducing pay

 

[cpr231]

They’re not wrong. I mean how would physician jobs even increase by that much if residency slots are capped?

It would be way more concerning if the BLS was projecting a 15% increase rather than a 3% increase. Supply and demand

If the number of doctors increases rapidly, the supply becomes too high, reducing pay

Okay but why the rapid decline in projected growth in just the past few years? I think it was at like 7% a few years ago and then somewhere in the 10-20% range maybe 6 years ago.

 

[deleted1065184]

Could you link the report? Curious to know if they're accounting for the potential up-tick in physicians leaving the profession as a result of the pandemic.

 

[jhmmd]

The Bureau of Labor Statistics projects 3% growth for physicians and surgeons during the years 2020 to 2030. In comparison, the BLS projects 45% job growth for nurse practitioners and 31% job growth for physician assistants. If these projections are accurate, does this mean that pursuing a career as a physician is a risky venture in terms of finding a job and that becoming a nurse practitioner, for example, is now the safer route to find employment? And does this mean that many physicians will be unemployed and in debt in the future?

Re: Bureau of Labor Statistics Data for Physicians and Surgeons

There are a lot of other things at play that you may be overlooking here, namely
1) It is hard to become a doctor, therefore the number of doctors per year is not increasing greatly. This keeps supply low (~3% over 10 years sounds about right with the aging population) and demand high (keeping our salaries high).
2) Even if the percentage is not what you might want it to be, this does not make doctoring a "risky" venture. Becoming a physician has been and will continue to be one of, if not the most, stable position on the market. And it will continue to be that way.
3) Nurses are not going to give physicians a run for their money for several reasons:
a. Physicians have more training and are better qualified
b. The market can afford it (can afford to pay physicians as opp. to NPs for most positions)
c. PAs (same principle applies)
4) I really don't see how you can draw your conclusion from the bold text. A medical degree ==> guarantees you a GOOD job somewhere, not just a job. And with that degree comes the ability to pay off debt of any kind.

 

[jhmmd]

Okay but why the rapid decline in projected growth in just the past few years? I think it was at like 7% a few years ago and then somewhere in the 10-20% range maybe 6 years ago.

You're not looking at whole picture. There are thousands (if not millions) of doctors. These slight fluctuations have no bearing on our salaries

 

[Moko]

3) Nurses are not going to give physicians a run for their money for several reasons:
a. Physicians have more training and are better qualified
b. The market can afford it (can afford to pay physicians as opp. to NPs for most positions)
c. PAs (same principle applies)

The big wigs don't care about getting the person with the most training or best qualifications. They're often looking for the cheapest person who can meet the minimum standards. So being the most qualified is no guarantee that the job will go to you. Similarly, just because the market can afford to hire you does not mean that they will if there is a cheaper alternative. Medicine has become a business like any other. Just my thoughts.

 

[cpr231]

The big wigs don't care about getting the person with the most training or best qualifications. They're often looking for the cheapest person who can meet the minimum standards. So being the most qualified is no guarantee that the job will go to you. Similarly, just because the market can afford to hire you does not mean that they will if there is a cheaper alternative. Medicine has become a business like any other. Just my thoughts.

So then are you suggesting that many physicians could be unemployed in the future if NPs/PAs are the most cost effective solution and the general public can’t tell the difference in the quality of care between the different types of “providers?”

 

[voxveritatisetlucis]

Just do general surgery, neurosurgery, radiology, pathology, neurology, obgyn, ortho, optho, uro, ent, or plastics. Problem solved.

I don’t mention IM subspecialties because one can never know before matching if they’ll be able to do it.

That’s a good speciality mix, with a wide range of competitiveness.

 

[Med Ed]

So then are you suggesting that many physicians could be unemployed in the future if NPs/PAs are the most cost effective solution and the general public can’t tell the difference in the quality of care between the different types of “providers?”

The general public may not be able to, but the lawyers sure can.

 

[Browns99]

Stop worrying....if you're passionate about wanting to become a physician, then go for it.

 

[DOVinciRobot]

You’re understanding the statistics wrong.

A few things:

1. The rapid growth in NPs and PAs have made their job market much tighter than most realize. For example, the glut of CRNAs has led to completely saturated CRNA markets in many places. You want to be an ortho PA? Tough beans if you want to live in any sort of reasonable location without personally knowing a surgeon who said they will hire you.

2. There are certain specialties that have poor job markets and will continue to do so for the foreseeable future. Namely Rad Onc and EM, and only EM is even partly because of midlevels. The vast majority of specialties have no issues getting a jobs in good locations (sure if you want to live in NY/SF/LA you’ll have to compete just like anyone else). Hell, even the pathology job market has rebounded significantly.

3. Unless something drastically changes in how healthcare is paid for in this country, or if we suddenly drop all regulations for foreign physicians practicing in the US, becoming a US trained physician is still the most secure path to a very comfortable working lifestyle with unparalleled job security.